Systematic consultations in the last years with representatives from sectors particularly affected by climate change have helped the Climate Service Center Germany (GERICS) to identify the most pressing needs of stakeholders from public and private sectors. Besides the development of innovative climate service products and methods, areas are also identified, for which intensive research activities have to be initiated. An example is the demand of decision makers for high-resolution climate change information needed at regional to local levels for their activities towards climate change adaptation. For questions concerning adaptation to climate change, no standard solutions can be provided. Different from mitigation measures, adaptation measures must be framed in accordance with the specific circumstances prevailing in the local situation. Here, individual solutions, which satisfy the individual requirements and needs, are necessary. They have to be developed in close co-operation with the customers and users. For example, the implications of climate change on strategic and operative decisions, e.g. in enterprises and urban planning, are becoming increasingly important. Therefore, high-quality consultancy for businesses and public administration is needed, in order to support decision makers in identifying associated risks and opportunities. For the development of prototype products, GERICS has framed a general methodological approach, including the idea generation, the iterative development, and the prototype testing in co-development with the user. High process transparency and high product quality are prerequisite for the success of a product. The co-development process ensures the best possible communication of user tailored climate change information for different target groups.
Dittmann, Jana; Steinebach, Martin; Wohlmacher, Petra; Ackermann, Ralf
Digital watermarking is well known as enabling technology to prove ownership on copyrighted material, detect originators of illegally made copies, monitor the usage of the copyrighted multimedia data and analyze the spread spectrum of the data over networks and servers. Research has shown that data hiding techniques can be applied successfully to other application areas like manipulations recognition. In this paper, we show our innovative approach for integrating watermark and cryptography based methods within a framework of new application scenarios spanning a wide range from dedicated and user specific services, "Try&Buy" mechanisms to general means for long-term customer relationships. The tremendous recent efforts to develop and deploy ubiquitous mobile communication possibilities are changing the demands but also possibilities for establishing new business and commerce relationships. Especially we motivate annotation watermarks and aspects of M-Commerce to show important scenarios for access control. Based on a description of the challenges of the application domain and our latest work we discuss, which methods can be used for establishing services in a fast convenient and secure way for conditional access services based on digital watermarking combined with cryptographic techniques. We introduce an example scenario for digital audio and an overview of steps in order to establish these concepts practically.
State Employees Division of Senior and Disabilities Services DHSS State of Alaska Home Divisions and ; Assistance Senior Benefits Program Medicare Substance Abuse Treatment Alaska Tribal Child Welfare Compact ; Senior and Disabilities Services Page Content Director Duane Mayes photo image. Duane Mayes Director
Seval Cambaz Ulas
Full Text Available In Turkey there are approximately 8.5 million (% 12.3 disabled people. While the ratio of orthopedic, visual, auditory, speech, and talking disabilities and mental disability is 2.6%, the ratio of the people who have chronic diseases is 9.7% In our country, by the beginning of 1982 Constitution, there have been a lot of legal regulations. If the services for disabled persons considered as social security-related legislation for care, healthcare, education, employment and practices; the legal regulation on the year 2005 (The Disability Law no. 5378 has covered many blankness and also evolved the services to the disabled people. However, despite these recent legal regulation it is questionable that if the services for the disabled are adequate or not. In this review, the services, which offered to the disabled people, are evaluated as the topics mentioned above. [TAF Prev Med Bull 2012; 11(4.000: 483-488
The book takes account of the key fact that to maximize their potential, people must have lifelong access to the information and services offered through books and libraries. Whether to address concerns of an ageing population or to enable all citizens to contribute fully through meaningful education and work opportunities, more emphasis is being given to promoting library services to people who have disabilities. This book is a compendium of articles focused on serving adults with disabilities in an international setting. From this book, librarians, policy makers and constituents will underst
Vaughan, Elizabeth; Woodruffe-Burton, Helen
Purpose: The purpose of this paper is to empirically test a new disabled service user-specific service quality model ARCHSECRET against a modified SERVQUAL model in the context of disabled students within higher education. Design/methodology/approach: The application of SERVQUAL in the voluntary sector had raised serious issues on its portability…
Full Text Available The purpose of this study is to improve library promotional marketing for the disabled by identifying requirements of public library disability services. This study aimed to investigate librarian service providers' awareness of library programs for the disabled in order to prepare a systematic plan for promoting such library services. Research methods used are a literature analysis and survey. First, the ratio of respondents with experience promoting activities and services for the disabled was less than 50%. Second, regarding methods for promoting library disability services, the respondents used library homepages, press releases, library user guides, library newsletters, and library pamphlets in that order. Third, when asked what kind of PR media the library disability service providers had experience with and how often they use it, library boards and banners were the most common response. Fourth, suggested improvements to the current design and content of PR materials included: clearer word choice (or greater understandability, more detailed descriptions, simpler layouts, and more interesting or eye-catching content in that order. Fifth, the library disability services which are in the most need of public relations were guide information for library disability services, Library and Information Service (DOI services and search services, using alternative materials and the library collection, and aiding the information search. Overall, when evaluating the promotion of disability services in Korea, the library's public relations for disabled services needs to improve because currently neither librarians nor the disabled community they are targeting has frequent or quality experience with it. Thus, the policy department for the library disability services must develop a variety of promotional strategies adjusted for each type of the disability and distribute PR materials to service providers individually, making sure to utilize effective PR
Cummings, Katrina P.; Hardin, Belinda J.
Cultural beliefs, values, language differences, and unfamiliar educational infrastructures and practices can impact immigrant parents' capacity to support their children with disabilities in their new country. This study presents perspectives of disability and experiences with special education services based on interviews with eight immigrant…
aggravation of disease) and third element (nexus between in-service occurrence/aggravation of disease and current disease) of the prima facie case for...occurring within two years of separation from active duty military service. In the following years, additions to the presumptive list were made by...the change of mission for U.S. forces in Iraq. 4 Veterans Benefits Disability Commission, Honoring the Call to Duty : Veterans’ Disability Benefits in
Castro, Shamyr Sulyvan; Lefèvre, Fernando; Lefèvre, Ana Maria Cavalcanti; Cesar, Chester Luiz Galvão
To analyze the difficulties in accessibility to health services experienced by persons with disabilities. A qualitative study was performed with individuals who reported having a certain type of disability (paralysis or amputation of limbs; low vision, unilateral or total blindness; low hearing, unilateral or total deafness). A total of 25 individuals (14 women) were interviewed in the city of São Paulo, Southeastern Brazil, between June and August 2007, responding to questions about transportation and accessibility to health services. Collective Subject Discourse was the methodology used to analyze results and analyses were performed with the Qualiquantisoft software. The analysis of discourses on transportation to health services revealed a diversity in terms of the user going to the service alone or accompanied; using a private car, public transportation or ambulance or walking; and requiring different times to arrive at the service. With regard to the difficulties in accessibility to health services, there were reports of delayed service, problems with parking, and lack of ramps, elevators, wheelchairs, doctors and adapted toilets. Individuals with a certain type of disability used various means of transportation, requiring someone to accompany them in some cases. Problems with accessibility to health services were reported by persons with disabilities, contradicting the principle of equity, a precept of the Brazilian Unified Health System.
Brown, Jason D.; Moraes, Sabrina; Mayhew, Janet
We examined the service needs of foster families with children who have disabilities. Foster parents in a large Canadian city were asked "What services or supports would be helpful to you?" The responses to this question were edited for clarity and to eliminate redundancies, and sorted into piles of like statements by a group of 15…
Hinton, Cynthia F; Kraus, Lewis E; Richards, T Anne; Fox, Michael H; Campbell, Vincent A
Approximately 40 million people in the U.S. identify as having a serious disability, and people with disabilities experience many health disparities compared with the general population. The Guide to Community Preventive Services (The Community Guide) identifies evidence-based programs and policies recommended by the Community Preventive Services Task Force (Task Force) to promote health and prevent disease. The Community Guide was assessed to answer the questions: are Community Guide public health intervention recommendations applicable to people with disabilities, and are adaptations required? An assessment of 91 recommendations from The Community Guide was conducted for 15 health topics by qualitative analysis involving three data approaches: an integrative literature review (years 1980-2011), key informant interviews, and focus group discussion during 2011. Twenty-six recommended interventions would not need any adaptation to be of benefit to people with disabilities. Forty-one recommended interventions could benefit from adaptations in communication and technology; 33 could benefit from training adaptations; 31 from physical accessibility adaptations; and 16 could benefit from other adaptations, such as written policy changes and creation of peer support networks. Thirty-eight recommended interventions could benefit from one or more adaptations to enhance disability inclusion. As public health and healthcare systems implement Task Force recommendations, identifying and addressing barriers to full participation for people with disabilities is important so that interventions reach the entire population. With appropriate adaptations, implementation of recommendations from The Community Guide could be successfully expanded to address the needs of people with disabilities. Published by Elsevier Inc.
Conclusions: There are statistical differences of disability prevalence attributed to mental disorders by people and region in China. Service use in disabled people with mental disorders is insufficient.
Choi, Nari; Ostendorf, Raymond
Parents' perception of disabilities and special education services can impact the way they interact with professionals providing services for their children with disabilities. In addition, the cultural background of parents plays an important role in their perception of disabilities, as well as how they communicate with professionals. Thus, it is…
To evaluate the application of one particular quality measurement tool, the SERVQUAL instrument, as a potential mechanism to measure quality in services for children with disabilities Staff and family of children with an intellectual disability in two organisations providing specialist therapy and day completed an adapted SERVQUAL questionnaire. A total of 81 SERVQUAL questionnaires were distributed and 59 questionnaires were returned (response rate of 73 per cent). The SERVQUAL instrument can be considered as a useful diagnostic tool to identify particular strengths and areas for improvement in services for people with disabilities as the instrument lends itself for the monitoring of the effectiveness of quality improvement initiatives over time. The findings also showed relatively high customer expectations and the organisations involved in this research are currently not meeting all of these high expectations as significant quality gaps were found in the areas of reliability and responsiveness. The sample size was relatively small and the measurement of quality using the SERVQUAL instrument remains a challenge, due to the conceptual and empirical difficulties. The SERVQUAL instrument is probably most be attractive to service managers and funding organisations because of its ability to identify gaps in the quality of the service. The tool had been used to measure quality in services for people with disabilities and the research has shown that this tool might be an important additional quality measurement tool for services.
How useful are disability services in the current higher education for college students with psychiatric disabilities? The purpose of this research paper is to answer this question by exploring an agenda of accommodation and support at a disabilities service center for college students with psychiatric disabilities. Two studies were conducted using questionnaires to collect data from students （study 1） and staffs （teaching and clerical staff） （study 2） in higher education. The ...
Murphy, John W
Service delivery has traditionally been based on market forces. When this is the case, the community becomes a silent partner in this process. Services, accordingly, are directed mostly to correcting personal ills and have little to do with community uplift. Another model, based on the work of Amartya Sen, is available that conceptualizes interventions in a very different way. If understood in the context of community development, the focus of services is social change, rather than merely personal rehabilitation. This reorientation is discussed in this article.
Lees, Carolyn; Poole, Helen; Brennan, Michelle; Irvine, Fiona
Background: The government alongside other health and social care organisation have identified the need to improve the care provided for people with learning disabilities. Materials and Methods: This service evaluation aimed to explore the experiences of people with learning disabilities and their carers who accessed community dental services…
Dura-Vila, G.; Hodes, M.
Background: This study examined whether service utilisation among children with intellectual disability (ID) varied by ethnic cultural group. Method: Survey carried out in four special schools in London. Information was provided by school teachers using case files, and 242 children aged 7 to 17 years with mild and moderate ID were identified.…
Madaus, Joseph W.
In 2002, Brinckerhoff, McGuire, and Shaw observed that the field of postsecondary education and disability services had "moved through its adolescence and was embarking on adulthood" (xiii). Indeed, the field had undergone rapid expansion nationwide in the prior 30 years and grew into a full-fledged profession within higher education (Jarrow…
Duryan, Meri; Nikolik, Dragan; van Merode, Godefridus; Curfs, Leopold
Organizations providing services to persons with intellectual disabilities (ID) are complex because of many interacting stakeholders with often different and competing interests. The combination of increased consumer demand and diminished resources makes organizational planning a challenge for the managers of such organizations. Such challenges…
McKenzie, Judith Anne; McConkey, Roy; Adnams, Colleen
Although intellectual disability (ID) is probably the largest impairment grouping on the African continent, few indigenous research and evaluation studies have been undertaken. This article is an initial attempt to relate service delivery issues to an African research agenda. We critically analysed the available literature, drawing on academic publications and those of non-governmental agencies. In this process we identified several key issues for further investigation, namely: understanding ID in African contexts, access to education and health care, the provision of appropriate assistance and support, and income generation. We relate our analysis to the recommendations made in the World Report on Disability but with a specific focus on ID in Africa. The need for mainstreaming and prioritising ID in non-disability related and across impairment programmes is highlighted. We note the importance of families and emphasise the need to draw on informal and traditional forms of care and participation. The need for reliable research evidence to support practice is highlighted. We conclude with a call to action by and on behalf of individuals with ID to be included in the development priorities of the continent. Implications for Rehabilitation Service provision for people with intellectual disabilities in Africa is not always well served by insights obtained from western research agendas. Appropriate and effective rehabilitation requires an understanding of the context and the environment in which the disabled person operates. Indigenous research into the provision of support to families and the inclusion of persons with intellectual disability into mainstream programmes as well as disability specific provision is recommended.
Balogh, Robert; McMorris, Carly A; Lunsky, Yona; Ouellette-Kuntz, Helene; Bourne, Laurie; Colantonio, Angela; Gonçalves-Bradley, Daniela C
When compared to the general population, persons with an intellectual disability have lower life expectancy, higher morbidity, and more difficulty finding and obtaining healthcare. Organisational interventions are used to reconfigure the structure or delivery of healthcare services. This is the first update of the original review. To assess the effects of organisational interventions of healthcare services for the mental and physical health problems of persons with an intellectual disability. For this update we searched CENTRAL, MEDLINE, EMBASE, CINAHL and other databases, from April 2006 to 4 September 2015. We checked reference lists of included studies and consulted experts in the field. Randomised controlled trials of organisational interventions of healthcare services aimed at improving care of mental and physical health problems of adult persons with an intellectual disability. We employed standard methodological procedures as outlined in the Cochrane Handbook of Systematic Reviews of Interventions, in addition to specific guidance from the Cochrane Effective Practice and Organisation of Care (EPOC) Group. We identified one new trial from the updated searches.Seven trials (347 participants) met the selection criteria. The interventions varied but had common components: interventions that increased the intensity and frequency of service delivery (4 trials, 200 participants), community-based specialist behaviour therapy (1 trial, 63 participants), and outreach treatment (1 trial, 50 participants). Another trial compared two active arms (traditional counselling and integrated intervention for bereavement, 34 participants).The included studies investigated interventions dealing with the mental health problems of persons with an intellectual disability; none focused on physical health problems. Four studies assessed the effect of organisational interventions on behavioural problems for persons with an intellectual disability, three assessed care giver burden, and
Full Text Available Sensors have become ubiquitous in their reach and scope of application. They are a technological cornerstone for various modes of health surveillance and participatory medicine—such as quantifying oneself; they are also employed to track people with certain as impairments perceived ability differences. This paper presents quantitative and qualitative data of an exploratory, non-generalizable study into the perceptions, attitudes and concerns of staff of a disability service organization, that mostly serve people with intellectual disabilities, towards the use of various types of sensor technologies that might be used by and with their clients. In addition, perspectives of various types of privacy issues linked to sensors, as well data regarding the concept of quantified self were obtained. Our results highlight the need to involve disabled people and their support networks in sensor and quantified-self discourses, in order to prevent undue disadvantages.
Yell, Mitchell; Smith, Carl; Katsiyannis, Antonis; Losinski, Mickey
In the past few years, the provision of mental health services in public schools has received considerable attention. When students with disabilities are eligible for special education and related services under the Individuals With Disabilities Education Act (IDEA), mental health services are required if such services are needed to provide…
Breen, Lauren; Wildy, Helen; Saggers, Sherry
Despite increasing demand for wellness approaches from disability advocates and consumer groups, they are not implemented routinely in childhood disability services. Interviews were conducted with 23 allied health therapists and managers working within four Australian childhood disability services. They described attempts to embed wellness…
... Nondiscrimination on the Basis of Disability in State and Local Government Services, Public Accommodations and in... of Disability; Accessibility of Web Information and Services of State and Local Government Entities and Public Accommodations; Nondiscrimination on the Basis of Disability in State and Local Government...
Mackey, Ellen; Dodd, Karen
Following Beacroft & Dodd's (2009) audit of pain recognition and management within learning disability services in Surrey, it was recommended that learning disability services should receive training in pain recognition and management. Two hundred and seventy-five services were invited to participate, of which 197 services in Surrey accepted…
... seeking to employ individuals with disabilities. (5) In the case of any small business enterprise operated..., including enterprises established under the Randolph-Sheppard program, management services and supervision... and improve small business enterprises operated by individuals with significant disabilities...
This paper discusses issues regarding the validity and reliability of psychoeducational assessments provided to Disability Services Offices at Canadian Universities. Several vignettes illustrate some current issues and the potential consequences when university students are given less than thorough disability evaluations and ascribed diagnoses.…
Danquah, Lisa; Polack, Sarah; Brus, Aude; Mactaggart, Islay; Houdon, Claire Perrin; Senia, Patrick; Gallien, Pierre; Kuper, Hannah
To assess the prevalence of disability and service needs in post-earthquake Haiti, and to compare the inclusion and living conditions of people with disabilities to those without disabilities. A population-based prevalence survey of disability was undertaken in 2012 in Port-au-Prince region, which was at the centre of the earthquake in 2010. Sixty clusters of 50 people aged 5 + years were selected with probability proportionate to size sampling and screened for disability (Washington Group short set questionnaire). A case-control study was undertaken, nested within the survey, matching cases to controls by age, gender and cluster. There was additional case finding to identify further children with disabilities. Information was collected on: socioeconomic status, education, livelihood, health, activities, participation and barriers. The prevalence of disability was 4.1% (3.4-4.7%) across 3132 eligible individuals. The earthquake was the second leading cause of disability. Disability was more common with increasing age, but unrelated to poverty. Large gaps existed in access of services for people with disabilities. Adults with disabilities were less likely to be literate or work and more likely to visit health services than adults without disabilities. Children with disabilities were less likely to be currently enrolled at school compared to controls. Children and adults with disabilities reported more activity limitations and participation restriction. Further focus is needed to improve inclusion of people with disabilities in post-earthquake Haiti to ensure that their rights are fulfilled. Almost one in six households in this region of Haiti included a person with a disability, and the earthquake was the second leading cause of disability. Fewer than half of people who reported needing medical rehabilitation had received this service. The leading reported barriers to the uptake of health services included financial constraints (50%) and difficulties with
Matthew P. JANICKI
Full Text Available With improved general health status many adults with intellectual disabilities (ID are living to old age, much like other adults. The World Health Organization has recognized the needs of this older population and identified the challenges they pose for governmental ministries and non-governmental organizations charged with planning, advocacy, financing, and delivery of specialty lifecare services and rehabilitation programs. These challenges include a range of issues normally confronting older adults, such as pensioning and financial security, changes in lifestyles associated with retirement and adaptations to living arrangements and housing, modifications in daily activities and community inclusion, changing physical and sensory abilities, and greater demands for support for aging families and other carers. As older adults with ID may also be affected by latelife or age-related conditions and begin to experience secondary impairments, these challenges may be more pronounced when encountered by NGOs located in countries with developing market economies. In these instances, the onus on promoting healthy aging will fall upon national entities which are responsible for targeting people with disabilities from infancy and childhood, and providing lifelong supports for adolescents, adults, and families. Ideally, if such efforts are undertaken early, they will lead to actions that can be undertaken to promote better health as people with ID age and ensure that the latter part of their lives are experienced as ‘quality of life years.’
Whittle, Erin Louise; Fisher, Karen R.; Reppermund, Simone; Lenroot, Rhoshel; Trollor, Julian
Background: It is well established that people with an intellectual disability have high rates of mental health problems, yet rates of uptake of services do not match need. Aim: To identify the current literature pertaining to the barriers and facilitators to access to mental health services for people with an intellectual disability. Method: A…
Bullock, Charles C.; Mahon, Michael J.; Killingsworth, Charles L.
Ultimately, all successful recreation programs center around its participants wants and needs. Serving people with disabilities is no exception. "Introduction to Recreation Services for People with Disabilities" is intended to be an introductory book for anyone planning or working in the parks, recreation, and leisure service industry. Through…
Peter Thomas Sandy
Conclusion: Observation is a useful practice in in-patient learning disability services, which can be used to prevent or reduce the incidence of self-harm in these settings. This approach should therefore be an integral part of nurses' daily therapeutic activities in in-patient learning disability services.
Rice, Travis A.
The main purpose of this study was to investigate the disability support service (DSS) office designs at three varying U.S. postsecondary institutions and their relationship to the experiences of students with a learning disability. The three postsecondary institutions represent a community college, a medium sized university and a large research university all-residing in a single bellwether state. Selection of the cases and postsecondary institutions was carefully done in order to investig...
Full Text Available The European Union Floods Directive requires the establishment of flood maps for high risk areas in all European member states by 2013. However, the current practice of flood mapping in Europe still shows some deficits. Firstly, flood maps are frequently seen as an information tool rather than a communication tool. This means that, for example, local stocks of knowledge are not incorporated. Secondly, the contents of flood maps often do not match the requirements of the end-users. Finally, flood maps are often designed and visualised in a way that cannot be easily understood by residents at risk and/or that is not suitable for the respective needs of public authorities in risk and event management. The RISK MAP project examined how end-user participation in the mapping process may be used to overcome these barriers and enhance the communicative power of flood maps, fundamentally increasing their effectiveness.
Based on empirical findings from a participatory approach that incorporated interviews, workshops and eye-tracking tests, conducted in five European case studies, this paper outlines recommendations for user-specific enhancements of flood maps. More specific, recommendations are given with regard to (1 appropriate stakeholder participation processes, which allow incorporating local knowledge and preferences, (2 the improvement of the contents of flood maps by considering user-specific needs and (3 the improvement of the visualisation of risk maps in order to produce user-friendly and understandable risk maps for the user groups concerned. Furthermore, "idealised" maps for different user groups are presented: for strategic planning, emergency management and the public.
Weatherill, Pamela; Bahn, Susanne; Cooper, Trudi
This article uses the evaluation of a school-aged therapy service for children with disabilities in Western Australia to investigate models of service delivery. The current literature on family-centered practice, multidisciplinary and transdisciplinary approaches, and 4 models of service are reviewed. The models include the life needs model, the relational goal-orientated model of optimal service delivery to children and families, the quality of life model, and the collaborative model of service delivery. Analysis of the data is presented together with a bespoke model of service delivery for children with disabilities, arguing that local contexts benefit from custom-made service design.
Graungaard, Anette Hauskov; Skov, Lotte; Andersen, John Sahl
parents of a severely disabled young child during the first two years after the diagnosis of the child's disabilities. Data were analysed using grounded theory. RESULTS: We found that the encounter with the social services increased stress in the families. Parental expectations were not met, especially......INTRODUCTION: Parents of a young child with severe disabilities are facing a large range of new challenges; furthermore, most of these families have extended social needs regarding information, financial support, day care facilities, disability aids, etc. Many parents with disabled children have...
Samant, Deepti; Soffer, Michal; Hernandez, Brigida; Adya, Meera; Akinpelu, Omolara; Levy, Joel M; Repoli, Elizabeth; Kramer, Michael; Blanck, Peter
Corporate culture reflects an organization's value system and impacts the recruitment, retention, and promotion of employees. Individuals with disabilities are positively impacted by a corporate culture that espouses and establishes a diverse workforce as a priority. This article provides an overview of corporate culture and the employment of individuals with disabilities, and presents a case example of the corporate culture of a large not-for-profit disability service organization. With an in-depth understanding of corporate culture and disability issues, social workers can be particularly helpful to applicants and employees with disabilities as well as employers.
Mac Giolla Phadraig, Caoimhin
This study aimed to generate prioritised goals for oral health services for people with disabilities as a first step in meeting the need for evidence based oral health services for people with disabilities in Ireland.
Biebel, Kathleen; Mizrahi, Raphael; Ringeisen, Heather
Accessing and successfully completing postsecondary educational opportunities may be challenging for those living with psychiatric disabilities. This exploratory study highlights the experiences of individuals with psychiatric disabilities participating in postsecondary educational support initiatives. Investigators conducted case studies with 3 education support initiatives across the United States. Focus groups revealed what concrete supported education services were helpful and key ingredients in delivering education supports. Access to specialists, mindfulness techniques, help with time management and procrastination, and facilitating classroom accommodations were identified as critical. Developing authentic relationships with supported education staff, flexibility in service delivery and access to student peers living with psychiatric disabilities were noted as key ingredients in service delivery. Incorporating the voice of students with psychiatric disabilities into supported education services can increase access, involvement, and retention, therein providing more supports to students with psychiatric disabilities achieving their postsecondary education goals. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Lawson, Janelle E; Cruz, Rebecca A; Knollman, Gregory A
Providing equal-status contact between those with and without disabilities can improve attitudes and reduce discrimination toward individuals with disabilities. This study investigated community service learning as a means by which to provide college students with equal-status contact with individuals with disabilities and increase their positive attitudes toward those with disabilities. A total of 166 college students in one university in the United States enrolled in an Introduction to Disability course received content on disability in society and participated in community service involving 20h of direct contact with individuals with disabilities. Findings indicated that college students who had prior contact with individuals with disabilities had more positive attitudes toward individuals with disabilities than college students who did not have prior contact at the start of the course. For the college students who did not have any prior contact, their attitudes toward individuals with disabilities became significantly more positive at the end of the community service learning course. Implications and suggestions for future research are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Park, Jiyoon; Bouck, Emily
Although there are many secondary data analyses of the National Longitudinal Transition Study-2 (NLTS-2) to investigate post-school outcome for students with disabilities, there has been a lack of research with in-school service predictors and post-school outcome for students with specific disability categories. This study was a secondary data analysis of NLTS-2 to investigate the relationship between current employment status and in-school services for individuals with intellectual disability. Statistical methods such as descriptive statistics and logistic regression were used to analyze NLTS-2 data set. The main findings included that in-school services were correlated with current employment status, and that primary disability (i.e., mild intellectual disability and moderate/severe intellectual disability) was associated with current employment status. In-school services are critical in predicting current employment for individuals with intellectual disability. Also, data suggest additional research is needed to investigate various in-school services and variables that could predict employment differences between individuals with mild and moderate/severe intellectual disability. Copyright © 2018 Elsevier Ltd. All rights reserved.
Trute, B; Hiebert-Murphy, D; Wright, A
Potential service outcome measures were tested for their utility in the assessment of the quality of 'family centred' service coordination in the provincial network of children's disability services in Manitoba, Canada. This study is based on in-home survey data provided by 103 mothers at 6 and 18 months following assignment of a 'dedicated' service coordinator. Service outcome indicators included measures of parent self-esteem, parenting stress, family functioning and the need for family support resources. Hierarchical regression analyses showed no relationship between level of quality of family-centred service coordination and standardized psychosocial measures of parent and family functioning. However, family centredness of service coordination was found to predict significant reduction in level of family need for psychosocial support resources after 18 months of contact with a service coordinator. Outcome measures that are focused on specific and tangible results of service coordination appear to be of higher utility in service quality assessment than are more global, standardized measures of parent and family functioning.
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ENGLISH ABSTRACT: Specifications translated from user requirements are prescribed in an attempt to capture and incorporate best practices with regards to the design, fabrication, testing, and operation of pressure vessels. The question as to whether these requirements affect the technical integrity of pressure vessels is often a subjective matter. This paper examines typical user requirement specifications against technical integrity of pressure vessels.
The paper draws on a survey of a convenience sample of practising engineers in a diversified petrochemical company. When compared with failures on selected pressure vessels recorded by Phillips and Warwick, the respondent feedback confirms the user specifications that have the highest impact on technical integrity.
AFRIKAANSE OPSOMMING: Gebruikersbehoeftes word saamgevat in spesifikasies wat lei tot goeie praktyk vir ontwerp, vervaarding, toetsing en bedryf van drukvate. Subjektiwiteit van die gebruikersbehoeftes mag soms die tegniese integriteit van ‘n drukvat beinvloed.
Die navorsing maak by wyse van monsterneming gebruik van die kennis van ingenieurs wat werk in ‘n gediversifiseerde petrochemiese bedryf. Die terugvoering bevestig dat bogenoemde spesifikasies inderdaad die grootste invloed het op tegniese integriteit.
Sosulski, Marya R; Donnell, Chandra; Kim, Woo Jong
Studies indicate positive effects of the U.S. Vocational Rehabilitation Services (VRS) in assisting people with disabilities to find independent employment. Underemployment continues to impact access to adequate health care and other benefits. Workers with disabilities receive fewer benefits, overall. With data from the Longitudinal Study of Vocational Rehabilitation Services Program (LSVRSP), the authors compare the rates of receipt of 6 types of benefits for people with physical, mental, and sensory impairments. Although those with physical disabilities are most likely to receive benefits, all groups lack adequate access to health care, sick leave, and vacation. The authors discuss implications for services provision in the current job market.
Buys, L.; Aird, R.; Miller, E.
Background: Considerable attention is currently being directed towards both active ageing and the revising of standards for disability services within Australia and internationally. Yet, to date, no consideration appears to have been given to ways to promote active ageing among older adults with intellectual disabilities (IDs). Methods:…
Johnson, Clair; Viljoen, Nina
Background: Systemic approaches can be useful in working with people with learning disabilities and their network. The evidence base for these approaches within the field of learning disabilities, however, is currently limited. Materials and Methods: This article presents part of a service evaluation of systemic consultations in a Community…
Devereux, Jason; Hastings, Richard; Noone, Steve
Background: Staff in intellectual disability services can be at risk of stress and burnout at work. Given that staff well-being has implications for the quality of life of the staff themselves and people with intellectual disabilities themselves, this is an important research and practical topic. In this paper, we review work stress theories that…
Boland, Máirín C
There is limited background information on self-rated health in people with disability in Ireland. This paper examines self-rated health scores and dimensions of functioning in people attending disability services and compares scores to the general population in Ireland, which has not been done before.
Diodati, Melissa R.
Leisure participation is influential on the quality of life of individuals. Individuals with disabilities can face barriers in leisure participation, impacting their quality of life. IDEA (2004) recognizes recreation as a related service as one way to enhance the leisure experiences for students with disabilities. The purpose of this embedded case…
Holly, Deirdre; Sharp, John
People with learning disabilities are at increased risk of coronary heart disease (CHD). Research suggests this may be due to inequalities in health status and inequities in the way health services respond to need. Little is known about the most effective way to improve health outcomes for people with learning disabilities. A previously developed…
Daudji, Anisa; Eby, Sarah; Foo, Tina; Ladak, Fahreen; Sinclair, Cameal; Landry, Michel D; Moody, Kim; Gibson, Barbara E
The objectives of this study were to describe perceptions of disability among South Asian immigrant mothers of children with disabilities in a large multicultural urban centre in Ontario, Canada, and to explore how these perceptions influence rehabilitation services. The study was built on our previous work conducted with mothers in South Asia. A descriptive qualitative research design was employed. Semi-structured interviews were conducted with five mothers who had immigrated to Canada from South Asia in the last decade, and whose children were receiving outpatient rehabilitation services. Three primary themes were identified: (1) perceptions of disability reflected a mix of traditional and western beliefs; (2) mothers experienced physical, emotional and social suffering related to socio-cultural and material barriers and (3) mothers' primary goal for their children was the achievement of independent walking, which was linked to notions of achieving a ?normal? life and the desire for more rehabilitation interventions. South Asian immigrant mothers' perceptions of their children's disabilities had important similarities and differences to mothers living in South Asia. Healthcare professionals can assist families in managing and coping with their child's disabilities by exploring their unique values and beliefs and identifying achievable outcomes together.
Olsen, Angela; Majeed-Ariss, Rabiya; Teniola, Simonette; White, Catherine
Background: People with learning disabilities are more likely to experience sexual abuse and less likely to access support than the general population, this is due to a range of variables at the individual, societal and service-delivery level. This study presents a service evaluation of St Mary's Sexual Assault Referral Centre, Manchester to…
... necessary to legally transport service animals on flights from the U.S. into the United Kingdom is found in... disability to travel with service animals? 382.117 Section 382.117 Aeronautics and Space OFFICE OF THE... disability to travel with service animals? (a) As a carrier, you must permit a service animal to accompany a...
compensation amount for each rating, and the tax advantage of each VA award (disability compensation is not subject to fed- eral income or payroll tax...17,030). Disability compensation has further advantages for veterans, because these payments are not subject to federal income and payroll tax. When...Burnham, and N. Augustin (1997). “Model Selection: An Integral Part of Inference.” Biometrics , Vol. 53, No. 2, pp. 603–618. Buddin, Richard, and Kanika
Mac Giolla Phadraig, Caoimhin; Dougall, Alison; Stapleton, Siobhan; McGeown, Danielle; Nunn, June; Guerin, Suzanne
Background: In Ireland, people with learning disabilities have poor oral health. This is in part due to inappropriate oral health services. Recognising the value of inclusive approaches to research and healthcare planning, this study sought to include a group of people with learning disabilities in priority setting for oral health services in…
Cartwright, J Daniel
Children and adolescents with chronic diseases and disabling conditions often need educationally related services. As medical home providers, physicians and other health care professionals can assist children, adolescents, and their families with the complex federal, state, and local laws, regulations, and systems associated with these services. Expanded roles for physicians and other health care professionals in individualized family service plan, individualized education plan, and Section 504 plan development and implementation are recommended. Recent updates to the Individuals With Disabilities Education Act will also affect these services. Funding for these services by private and nonprivate sources also continue to affect the availability of these educationally related services. The complex range of federal, state, and local laws, regulations, and systems for special education and related services for children and adolescents in public schools is beyond the scope of this statement. Readers are referred to the American Academy of Pediatrics policy statement "The Pediatrician's Role in Development and Implementation of an Individual Education Plan (IEP) and/or an Individual Family Service Plan (IFSP)" for additional background materials. The focus of this statement is the role that health care professionals have in determining and managing educationally related services in the school setting. This policy statement is a revision of a previous statement, "Provision of Educationally Related Services for Children and Adolescents With Chronic Diseases and Disabling Conditions," published in February 2000 by the Committee on Children With Disabilities (http://aappolicy.aappublications.org/cgi/content/full/pediatrics;105/2/448).
Bigaj, Stephen J.; Bazinet, Gregory P.
Suggests a team approach for effectively and efficiently providing services for postsecondary students with disabilities. Reviews various teaming concepts and presents a framework for a postsecondary disability problem-solving team. (Author/JOW)
Breen, Lauren J; Wildy, Helen; Saggers, Sherry; Millsteed, Jeannine; Raghavendra, Parimala
Wellness approaches are not routine in childhood disability services, despite theoretical and empirical support and an increasing demand for them from health consumers and disability activists. We aimed to investigate how health professionals define or understand wellness and its practice in the context of childhood disability. A qualitative, interpretive approach was taken. Semi-structured interviews were conducted with 23 health professionals (allied health therapists and managers) providing early intervention and ongoing therapy within four Australian childhood health and disability services. Years of experience providing services to children with disabilities and their families ranged from 6 months to 30 years (M=9.41, SD=9.04). The data revealed a noteworthy impediment to incorporating wellness into practice - the difficulties in the allied health professionals reaching consensus in defining wellness. There appeared to be distinct differences between the four services, while there appeared to be no appreciable difference based on the individual professional's years of experience or allied health discipline. The effect of organisational culture should be considered in efforts to embed wellness in childhood health and disability services in order to address client well-being, empowerment, choice, independence and rights to meaningful and productive lives. © 2011 Informa UK, Ltd.
Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H; Khalil, Hesham S
The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Using the Arksey O'Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet.
Hunt, Xanthe; Carew, Mark T; Braathen, Stine Hellum; Swartz, Leslie; Chiwaula, Mussa; Rohleder, Poul
There is a body of theoretical work, and some empirical research, which suggests that non-disabled people assume people with physical disabilities are not suitable romantic partners, do not have sexual drives or desires, or are not sexually active. It has also been proposed that people with physical disabilities face barriers to sexual healthcare access which are structural as well as social. The present paper explores non-disabled South Africans' beliefs concerning the degree to which non-disabled respondents enjoy sexual and reproductive rights, and benefit from sexual and reproductive healthcare, compared to people without disability. Using a survey, we asked 1989 South Africans to estimate the degree to which people with physical disabilities and people without disability have sexual rights, and benefit from sexual and reproductive healthcare services, respectively. Respondents were more likely to support the idea that the population without disability were deserving of sexual rights compared to people with physical disabilities. Respondents were more likely to rate the degree to which people with physical disability benefit from sexual and reproductive healthcare as less than that for people without physical disabilities. These findings provide some of the first empirical support that non-disabled people perceive people with physical disabilities as having fewer sexual and reproductive rights, and deriving less benefit from sexual and reproductive health services, than the population without disability. To have diminished sexual rights, and benefit less from sexual and reproductive healthcare, we suggest, evinces a negation of the sexual and reproductive needs and capacity of people with physical disabilities.
Carter, Erik W.; Swedeen, Beth; Moss, Colleen K.
Service learning is an effective curricular approach to increase instructional relevance and engagement for all students. For students with significant disabilities in transition, meaningful service can be an especially useful avenue for exploring career interests, gaining and practicing important life skills, and connecting to the community in…
... facility, if the veteran: (1) Is in need of nursing home care for a VA adjudicated service-connected...' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Per Diem Payments § 51.41 Per diem for certain veterans based on service-connected disabilities...
Hare, Dougal Julian; Chapman, Melanie; Fraser, Janelle; Gore, Sarah; Burton, Mark
A survey of service providers for people with learning disabilities in the Manchester (England) region identified a total of 174 people with either a confirmed or a suspected autistic spectrum disorder. Discussion of current and historical factors in estimating incidence suggests that the usual 10% of service users represents the lowest estimate…
Evans, E.; Howlett, S.; Kremser, T.; Simpson, J.; Kayess, R.; Trollor, J.
Background: People with intellectual disability (ID) experience higher rates of major mental disorders than their non-ID peers, but in many countries have difficulty accessing appropriate mental health services. The aim of this paper is to review the current state of mental health services for people with ID using Australia as a case example, and…
Browning, Ellen R.; Caro, Patricia; Shastry, Sunita P.
Providing services for children with disabilities has been a part of the culture of India for generations. However service provision has been within the context of family and community rather than in the public sector and thus has been inclusive by its very nature. This article describes current educational provisions and practices in India for…
Smith, Robin M.
When students with disabilities are isolated socially and physically, their self-confidence and engagement may be low. Encouraging leadership and service in students who are often overlooked for these roles enhances peer relations, engagement, and self-confidence. Principles and strategies for fostering leadership and service are described.…
The American disability service system is predicated on underlying assumptions and beliefs which are dominant in the majority culture. Consequently, minority families, such as families from India, living in America sometimes experience dissonance with respect to the services provided to their family due to their varying cultural values. As such,…
Kung, Pei-Tseng; Tsai, Wen-Chen; Li, Ya-Hsin
Taiwan has provided free health checks for adults since 1995. However, very little previous research has explored the use of preventive health services by physically and mentally disabled adults. The present study aimed to understand this use of preventive health services and the factors that influence it. Research participants included disabled…
Brady, Nancy C.; Bruce, Susan; Goldman, Amy; Erickson, Karen; Mineo, Beth; Ogletree, Bill T.; Paul, Diane; Romski, Mary Ann; Sevcik, Rose; Siegel, Ellin; Schoonover, Judith; Snell, Marti; Sylvester, Lorraine; Wilkinson, Krista
The National Joint Committee for the Communication Needs of People with Severe Disabilities (NJC) reviewed literature regarding practices for people with severe disabilities in order to update guidance provided in documents originally published in 1992. Changes in laws, definitions, and policies that affect communication attainments by persons with severe disabilities are presented, along with guidance regarding assessment and intervention practices. A revised version of the Communication Bill of Rights, a powerful document that describes the communication rights of all individuals, including those with severe disabilities is included in this article. The information contained within this article is intended to be used by professionals, family members, and individuals with severe disabilities to inform and advocate for effective communication services and opportunities. PMID:26914467
People with learning disabilities are often marginalised in healthcare, including in hospice settings, and as a result may not receive effective end of life care. Research in hospice settings has identified that many staff lack confidence, skills and knowledge in caring for people with learning disabilities, which can have a negative effect on the care these individuals receive. To address these issues, the author has proposed a service improvement initiative, which she developed as part of her learning disability nursing degree programme. This proposed initiative aimed to enhance end of life care for people with learning disabilities through the implementation of a community learning disability link nurse in the hospice setting. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.
Hopf, Suzanne C; McLeod, Sharynne
The World Health Organization's World report on disability calls upon all nations to 'remove the barriers which prevent [people with disabilities] from participating in their communities; getting a quality education, finding decent work, and having their voices heard' (p. 5). People with communication disability (PWCD), as a consequence of their atypical communication, may be more likely to be excluded from society, and denied their basic human rights, than other people with disability. Fiji, a multicultural and multilingual nation in the south-western Pacific Ocean, has limited services for PWCD. Service providers in Fiji include disability care workers, special education teachers, traditional healers, and a small number of visiting volunteer speech-language pathologists. This paper outlines the historical and current barriers to, and drivers of change for, service development for PWCD in Fiji. Five barriers to service development for PWCD in Fiji were identified. (1) A major structural barrier is the small population size to develop appropriate infrastructure including professional education programs. (2) Geographical barriers include the dispersed geography across 300 islands, low population density, the rural-urban divide, and risk of disaster from cyclones and flooding. (3) Linguistic diversity, while culturally important, can present a barrier to the provision of quality services that are available in the languages spoken by PWCD. (4) Cultural barriers include historical political instability, although Fiji has become more stable due to the recent democratic elections. The social climate affects development of services that are appropriate for different dominant cultural groups. (5) Financial barriers include low gross domestic product, low financial security and low human development index; however, the financial outlook for Fiji is steadily improving due to the change in political stability. Three levels of drivers of change were identified. Macro
Dossa, P A
The literature refers to older people with developmental disabilities as the "new service population." How and why this population emerged as a special category is discussed conceptually with reference to social systems theory. A brief review of social systems theory and some basic systemic tenets are presented. Systemic tenets are employed in examining the historical development of social gerontology and present trends in the service-delivery system. I show that the systemic variable of the economic model of human development has significantly impacted on the making of older people with developmental disabilities a dependent population. In the conclusion the systems perspective is explored in relation to recognizing the liminal, in-between parts between components. It is argued that such a perception minimizes the dichotomy between older people with developmental disabilities and the non-disabled population, paving the way for a genuine encounter.
Fichten, Catherine Susan; Heiman, Tali; Havel, Alice; Jorgensen, Mary; Budd, Jillian; King, Laura
We have examined the sustainability of providing services for students with disabilities in higher education in Canada and Israel. The two countries differ in their approaches: Israel subscribes to the accommodations model of service delivery; Canada, to the universal design approach. Case examples of services to students with disabilities in…
Abdullah, Melissa Ng Lee Yen; Mey, See Ching; Eng, Tan Kok; Othman, Rosly; Omar, Ahmad Fairuz
Transition services are required by law for students with disabilities in many developed countries. In Malaysia, however, there is still no specific legislation mandating that school-to-work transition planning and services be provided to students with disabilities. This study investigated the state of the transition services provided by…
Roadhouse, C; Shuman, C; Anstey, K; Sappleton, K; Chitayat, D; Ignagni, E
Genetic counselors adopt seemingly contradictory roles: advocating for individuals with genetic conditions while offering prenatal diagnosis and the option of selective termination to prevent the birth of a child with a disability. This duality contributes to the tension between the disability and clinical genetics communities. Varying opinions exist amongst the disability community: some value genetic services while others are opposed. However, there is limited research exploring the opinions of individuals with a disability regarding issues related to reproduction and genetic services in the context of personal experience. This exploratory qualitative study involved interviews with seven women and three men who self-identify as having a disability. We sought to gain their perspectives on experiences with disability, thoughts about reproduction and parenting, and perceptions of genetic services. Transcripts of the interviews were analyzed thematically using qualitative content analysis. Data analysis showed that societal views of disability affected the lived experience and impacted reproductive decision-making for those with a disability. It also showed differing interest in genetic services. Concerns about the perceived collective implications of genetic services were also raised. These findings contribute to the understanding of the disability perspective toward reproductive decision-making and genetic services. A further goal is to promote a meaningful dialogue between the genetics and disability communities, with the potential to enhance the genetic and reproductive care provided to individuals with disabilities.
Juneja, Monica; Jain, Rahul; Singhal, Swati; Mishra, Devendra
To identify the problems faced by parents of children with developmental disabilities in availing rehabilitative services and to find their satisfaction level. This study was carried out at a Child Development Clinic (CDC) located in Northern India. Children with developmental disabilities, who were availing services at CDC for at least last 3 mo and had at least 3 follow-up visits, were enrolled. A questionnaire pertaining to the socio-demographic profile, problems faced in availing services and satisfaction level was filled by the parents of the enrolled children. During the study period, 161 parents filled the questionnaire. 77.6% had some problems in getting the services, the major being difficulty in commuting (50%) and financial constraint (21.7%). More than 80% parents use public transport to reach CDC with 19% travelling more than 50 Km. 29.8% had difficulty in bringing their child to the clinic, either due to severe behavioral problems or physical disability. However, majority of the families were well satisfied with the services as 95% of them graded their satisfaction level at 3 or more on the scale of 0-5. Parents of children with developmental disabilities face many problems in getting rehabilitative services. They travel long distances, face hardships in carrying their child, and lose their day's earnings, apart from spending time and money for their child's therapy. However, most of the parents are well satisfied with the services.
... the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES... disabilities who reside on Federal or State reservations, consistent with their individual strengths, resources...
Devkota, Hridaya Raj; Murray, Emily; Kett, Maria; Groce, Nora
Women with disabilities are less likely to receive maternal healthcare services compared to women without disabilities. While few studies have reviewed healthcare experience of women with disabilities, no studies have been conducted to understand provider's attitude towards disability in Nepal, yet the attitude and behaviour of healthcare providers may have a significant influence on aspects of care and the use of service by women with disabilities. This study examines healthcare provider's attitudes towards disability and explores the experience of women with disabilities in maternal healthcare service utilization during pregnancy and childbirth. The study used mixed method approach. An attitude survey was conducted among 396 healthcare providers currently working in public health facilities in Rupandehi district of Nepal. For additional insight, eighteen in-depth interviews with women with disabilities who used maternal healthcare services in a healthcare facility within the study district in their last pregnancy were undertaken. The Attitude Towards Disabled Persons (ATDP) scale score was used to measure the attitudes of healthcare providers. For quantitative data, univariate and multivariate analysis using ANOVA was used to understand the association between outcome and independent variables and qualitative analysis generated and described themes. Mean ATDP score among healthcare providers (78.52; SD = 14.75), was low compared to the normative score of 100 or higher. Nurses/auxiliary nurse midwives obtained the highest mean score (85.59, SD = 13.45), followed by general clinical health workers (Mean score = 82.64, SD 15.10). The lowest score was obtained by Female Community Health Volunteers (FCHV) (Score = 73.75, SD = 13.40) (P women with disabilities. The mean score difference between those who received disability training and who did not was also found statistically insignificant (P > 0.05). This may reflect the small number of individuals
Narayan, Jayanthi; Pratapkumar, Raja; Reddy, Sudhakara P
In resource poor settings innovative and bottom-up approaches are required to provide services to people with with disabilities. In this context, the present paper explains a community-based model of manpower development and coordination of services for people with intellectual disabilities in unified state of Andhra Pradesh in India. Women with disabilities from the village were identified, and those willing to be trained to work as community resource persons (CRPs) were selected and given hands-on training in a phased manner. A total of 130 women were trained in five groups of 25-30 per group and were deployed in the community to screen, identify and refer children with intellectual disabilities. The training content included basic stimulation and interface with functionaries of other government departments of health, education and welfare to ensure comprehensive service delivery. Neighbourhood centres (NHCs) were established where the CRPs could meet with families collectively. The results indicated that the CRPs were welcomed by the families. The NHCs established primarily as recreation centres, promoted inclusion and functioned as information dissemination centre. The services provided by the CRPs were owned and monitored by the Women's self-help group and the disability groups thus ensuring sustainability of the model.
Wylie, Karen; McAllister, Lindy; Davidson, Bronwyn; Marshall, Julie; Amponsah, Clement; Bampoe, Josephine Ohenewa
In low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community. A qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability. One hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors - including the Western healthcare, religious, and traditional sectors. Understanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the
Nondwe B. Mlenzana
Objectives: This article aimed to review the relevant literature regarding barriers to and facilitators of rehabilitation services for people with disabilities. Method: Articles for the period 1990–2010 using descriptors related to rehabilitation services, barriers, facilitators and the physically disabled population were retrieved for this review. Results: A total of 19 article titles were identified from references of other articles but following application of the inclusion criteria selected for this review, only six articles were chosen. Five of these articles were qualitative studies and one was a quantitative study. Barriers and facilitators regarding rehabilitation services highlighted by participants in the studies included a perception that health professionals have a lack of understanding of rehabilitation for people with disabilities and there was a lack of information sharing from health professionals about the rehabilitation process. On the other hand some participants reported that health professionals demonstrated confidence in the disability and rehabilitation process during consultation and highlighted that their needs were met by the rehabilitation professionals. Conclusion: Even though there were few studies highlighting the barriers to and facilitators of rehabilitation services, they highlighted that there are gaps in the process of rehabilitation services provided. It would be advisable for health professionals to take cognisance of the issues highlighted in this study in order to make rehabilitation services more effective.
Graungaard, Anette Hauskov; Skov, Liselotte; Andersen, John Sahl
Parents of a young child with severe disabilities are facing a large range of new challenges; furthermore, most of these families have extended social needs regarding information, financial support, day care facilities, disability aids, etc. Many parents with disabled children have been found to be dissatisfied with social services. This study explores parents' experiences with Danish social services during their transition to a new daily life after the birth of a severely disabled child. Repeated qualitative interviews were performed individually with 16 parents of a severely disabled young child during the first two years after the diagnosis of the child's disabilities. Data were analysed using grounded theory. We found that the encounter with the social services increased stress in the families. Parental expectations were not met, especially regarding information; parents felt clientized, and obtaining social support was very resource consuming. Parents' needs regarding practical support and empathic case-working were not met and they spent much time and effort due to lacking continuity between sectors. Parents have specific needs when becoming clients in the social service system whose organisation of social services needs improvement. Health care professionals are advised to identify problems and support cooperation between the parents and the social service system, as well as to report the health-related consequences of prolonged and inefficient case-working for the child and its parents. was received from Socialministeriet, Landsforeningen LEV, Ronald McDonalds Børnefond, Susie og Peter Robinsohns fond, Rosalie Petersens fond, PLU-fonden, Ville Heises fond, Sygesikringens forskningsfond, Helsefonden, Elsass fonden. not relevant.
Theodoratos, Oreste; McPherson, Lyn; Franklin, Catherine; Tonge, Bruce; Einfeld, Stewart; Lennox, Nicholas; Ware, Robert S
Adolescents with intellectual disability have increased rates of psychopathology compared with their typically developing peers and present to hospital more frequently for ambulant conditions. The aim of this study is to describe the psychopathology and related characteristics of a sample of adolescents with intellectual disability who presented to general hospital services. We investigated a cohort of adolescents with intellectual disability in South East Queensland, Australia between January 2006 and June 2010. Demographic and clinical data were obtained via mailed questionnaires and from general practice notes. Psychopathology was measured with the Short Form of the Developmental Behaviour Checklist. Of 98 individuals presenting to hospital, 71 (72.5%) had significant levels of psychopathology. Unknown aetiology for the intellectual disability was associated with presence of problem behaviours. Adolescents with more severe intellectual disability were more likely to have major problem behaviours. Co-morbid physical health issues were not associated with psychopathology. Only 12 (12.1%) adolescents had undergone specialized mental health intervention. The general hospital environment may offer opportunities for liaison psychiatry services to screen and provide management expertise for adolescent individuals with intellectual disability presenting for physical health issues.
Nix, Mary P.
There is always room for improvement in the delivery of health services. This article discusses the U.S. Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange (www.innovations.ahrq.gov), a comprehensive program that aims to increase awareness of innovative strategies to meet health service delivery challenges and…
Woodruff, Elizabeth A.; Sinelnikov, Oleg A.
While many scholars agree that service learning is beneficial to both the student and the community, the research on service learning in the physical education setting is limited. However, there are courses that can be aligned with the professional preparation needs of students and the broader needs of the community. Drawing on theory which has…
Full Text Available Purpose: The article describes the development of a practical model of joint, integrated inspection of managed care services for people with learning disabilities in Scotland. The model will give a reliable measure of the impact services are making to people's lives and the quality of service that individuals are actually receiving. Context of case: At present health, social services and education services for people with learning disabilities in Scotland are inspected separately, by up to nine different agencies. The first joint, integrated inspections of all services for people with learning disabilities in Scotland will take place in 2006. This is the first inspection of its kind in the UK, and the first to involve carers and people with learning disabilities on the inspection team. Data sources: Quality Outcome Indicators were developed in 21 different areas, or domains. Evidence based best practice, and evaluative data from previous inspections were the primary sources of data. Case description: This paper reviews the background and rationale for the integrated, joint inspection process. Strengths and constraints of this approach to inspection are discussed, including the crucial importance of commitment from services and from inspectors, rather than mere compliance with demands. Some guidance on how to fully involve staff, carers and services users in the inspection process is given. Conclusions and discussion: The model will produce data to inform decision-making for managers in integrated services and give services users clear information about how well local needs are being met, what areas need development, and what capacity the organisations have to improve. The model of inspection may be of interest to practitioners in a national and international context. The model will be evaluated, following the first joint inspection.
Tan, Seok Hong
Information on unmet health care needs reveal problems that are related to unavailability and inaccessibility of services. The study objectives were to determine the prevalence, and the reasons for unmet service needs among children with disabilities in the state of Penang, Malaysia. Caregivers of children with disabilities aged 0 to 12 years registered with the Penang Social Welfare Department in 2012 answered a self-administered mailed questionnaire. A total of 305 questionnaires were available for analysis (response rate 37.9%). Services that were very much needed and yet highly unmet were dental services (49.6% needed, 59.9% unmet), dietary advice (30.9% needed, 63.3% unmet), speech therapy (56.9% needed, 56.8% unmet), psychology services (25.5% needed, 63.3% unmet), and communication aids (33.0% needed, 79.2% unmet). Access problems were mainly due to logistic issues and caregivers not knowing where to obtain services. Findings from this study can be used to inform strategies for service delivery and advocacy for children with disabilities in Penang, Malaysia. © 2015 APJPH.
Jacobs, Myrthe; Downie, Helen; Kidd, Gill; Fitzsimmons, Lorna; Gibbs, Susie; Melville, Craig
Background: Children and young people with learning disabilities experience high rates of mental health problems. Methods: The present study reviewed the literature on mental health services for children with learning disabilities, to identify known models of service provision and what has been experienced as effective or challenging in providing…
... passengers with a disability for providing services and accommodations required by this rule? 382.31 Section... a disability for providing services and accommodations required by this rule? (a) Except as...) If your web site that passengers use to make reservations or purchase tickets is not accessible to a...
... to passengers with a disability are available only in a type or class of service or part of a vessel that are more expensive than the type or class of service or part of a vessel that the passenger... of the Secretary of Transportation TRANSPORTATION FOR INDIVIDUALS WITH DISABILITIES: PASSENGER...
Christensen, Lars Ballieu; Stevns, Tanja
This paper presents how SensusAccess has been adapted and is being used in higher education to create inclusive educational environments. Reflecting on challenges of providing alternate versions of educational material to students with disabilities, it also discusses how the service can benefit mainstream learners.
Fujiura, Glenn T.; Li, Henan; Magaña, Sandy
Health services and associated costs for adults with intellectual and developmental disabilities (IDD) were nationally profiled and the predictors of high expense users statistically modeled. Using linked data from the National Health Interview Survey and Medical Expenditure Panel Survey for the years 2002 through 2011, the study found a mixed…
Lambert, Matthew C.; Trout, Alexandra L.; Nelson, Timothy D.; Epstein, Michael H.; W. Thompson, Ronald
Background: Behavioral, social, emotional, and educational risks among children and youth with school identified disabilities served in residential care have been well documented. However, the health care needs and medical service utilization of this high-risk population are less well known. Given the risks associated with children with…
... DEPARTMENT OF EDUCATION Applications for New Awards; Technology and Media Services for Individuals With Disabilities--Stepping-Up Technology Implementation Correction In notice document 2012-12278 appearing on pages 29989 through 29995 in the issue of Monday, May 21, 2012 make the following correction...
Herman, Sandra E.; Marcenko, Maureen O.
This study examined effects of resource perceptions and respite use in a theoretical model of adaptation with 72 parents of children with developmental disabilities. Amount and quality of respite services indirectly affected parental depression. Both quality and respite use were related to helpfulness of the parent's social network. The strongest…
... Rights Division, Department of Justice. ACTION: Final rule; correction. SUMMARY: This document contains... of the rule relating to service animals. DATES: Effective Date: March 15, 2011. FOR FURTHER INFORMATION CONTACT: Barbara J. Elkin, Attorney Advisor, Disability Rights Section, Civil Rights Division, U.S...
Ng, Louisa; Talman, Paul; Khan, Fary
Motor neurone disease (MND) places considerable burden upon patients and caregivers. This is the first study, which describes the disability profile and healthcare needs for persons with MND (pwMND) in an Australian sample from the perspective of the patients and caregivers to identify current gaps in the knowledge and service provision. A…
O'Brien, Gerald V.; Ellegood, Christina
The 1990 Americans with Disabilities Act has had a profound influence on social workers and social services administrators in virtually all work settings. Because of the multiple elements of the act, however, assessing the validity of claims can be a somewhat arduous and complicated task. This article provides a "decision tree" for…
Gilham, Christopher M.; Tompkins, Joanne
In this article, two teacher educators describe and explain how they are reconceptualizing a pre-service teacher education course on inclusion using disability studies in education (DSE) scholarship. The DSE approach better connects the oft-separated field of diversity and inclusion, and builds on the program's overall focus on equity education.…
Beck, Tanja; Diaz del Castillo, Patricia; Fovet, Frederic; Mole, Heather; Noga, Brodie
This article presents out an outcome analysis of a Universal Design (UD) audit to the various professional facets of a disability service (DS) provider's office on a large North American campus. The context of the audit is a broad campus-wide drive to implement Universal Design for Learning (UDL) in teaching practices. In an effort for consistency…
Lawson, Janelle E.; Cmar, Jennifer L.
For over 25 years, students with disabilities in California received educationally related mental health services through interagency collaboration between school districts and county mental health agencies. After a major change in state policy that eliminated state-mandated interagency collaboration, school districts in California are now solely…
Al-Hilawani, Yasser A.
The purpose of this paper is to provide description, analyses, and insights with respect to the procedures and services currently available to students enrolled in the learning disability (LD) program in Oman. Traditionally, students in Oman were identified based on low academic achievement by the end of first grade without applying any…
Lin, Jin-Ding; Wu, Chia-Ling; Lin, Pei-Ying; Lin, Lan-Ping; Chu, Cordia M.
Although longevity among older adults with intellectual disabilities is increasing, there is limited information on their premature aging related health characteristics and how it may change with increasing age. The present paper provides information of the institutional manager's perception on early onset aging and service preparation for this…
Peter T. Sandy
Aim: To explore nurses' knowledge and understanding of the use of observation on patients who self-harm in a learning disability service in the United Kingdom. Design: and methods: This study adopted a qualitative approach, and utilised interpretative phenomenological analysis as a design and as a tool of analysis. The study was conducted in a secure learning disability service in the United Kingdom. Data were obtained from registered nurses using individual interviews (n = 20 and focus groups (n = 3 x 5 = 15. Data were analysed thematically using the principles of interpretative phenomenological analysis. Results: Three superordinate themes emerged from data analysis: 1 observation: its meaning, 2 observation: does it prevent self-harm? 3 Observation: making it work. Conclusion: Observation is a useful practice in in-patient learning disability services, which can be used to prevent or reduce the incidence of self-harm in these settings. This approach should therefore be an integral part of nurses' daily therapeutic activities in inpatient learning disability services.
Cook, Erin E.; Nickerson, Amanda B.; Werth, Jilynn M.; Allen, Kathleen P.
A sample of 124 service providers (e.g. mental health professionals, educators, administrators) completed a survey about bullying of individuals with disabilities and the use and perceived effectiveness of resources and strategies to address bullying. Providing support and performing an action in response to bullying were reported to be used more…
Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard
Background While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. Methods and Findings A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Conclusions Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and
Services for older adults and younger people with disabilities are increasingly merging, as reflected in the creation of Aging and Disability Resource Centers (ADRCs). Using ADRCs to coordinate services is challenging, primarily because these fields have different service delivery philosophies. Independent Living Centers, which serve people with disabilities, have a philosophy that emphasizes consumer control and peer mentoring. However, the aging service delivery philosophy is based in a case management or medical model in which the role of consumers directing their services is less pronounced. Using institutional logics theory and a qualitative research design, this study explored whether a unified service delivery philosophy for ADRCs was emerging. Based on focus groups and questionnaires with staff from ADRCs, findings revealed that competing service delivery models continue to operate in the aging and disability fields.
Ziviani, Jenny; Darlington, Yvonne; Feeney, Rachel; Rodger, Sylvia; Watter, Pauline
To gain insight into the special issues confronting parents when accessing early intervention for children with physical disabilities where child and/or family characteristics indicate complex needs within the unique Australian context. Qualitative interviews with families receiving early intervention for their children with physical disabilities (N=10). Families with complex circumstances such as having children with high support needs, those from culturally and linguistically diverse backgrounds, and single-parent families were recruited to the study. Families where parents had mental or health issues, parents/other family members had an identified disability, and/or where families lived in regional or rural locations were also purposively sampled. Participants highlighted issues around (i) the nature of early intervention services provided; (ii) the ways in which services were structured; and (ii) managing their child's needs/planning into the future. Parents stressed the importance of having access to a variety of early intervention services aside from therapy. They also emphasised the need for greater clarity about what to expect from services, the intensity of therapy, other services they could access and how long they would be able to receive these. Despite their complex circumstances and needs, participants' experiences of accessing early intervention services were largely consistent with the broader research literature. Of the parents interviewed, those with health problems and single mothers expressed most apprehension about managing their child's needs and planning for the future. © 2013 Occupational Therapy Australia.
Lai, Jin-Shei; Hammel, Joy; Jerousek, Sara; Goldsmith, Arielle; Miskovic, Ana; Baum, Carolyn; Wong, Alex W; Dashner, Jessica; Heinemann, Allen W
To develop a measure of perceived systems, services, and policies facilitators (see Chapter 5 of the International Classification of Functioning, Disability and Health) for people with neurologic disabilities and to evaluate the effect of perceived systems, services, and policies facilitators on health-related quality of life. Qualitative approaches to develop and refine items. Confirmatory factor analysis including 1-factor confirmatory factor analysis and bifactor analysis to evaluate unidimensionality of items. Rasch analysis to identify misfitting items. Correlational and analysis of variance methods to evaluate construct validity. Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place. Participants (N=571) had a diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18 years or older and English speaking. Not applicable. An item bank to evaluate environmental access and support levels of services, systems, and policies for people with disabilities. We identified a general factor defined as "access and support levels of the services, systems, and policies at the level of community living" and 3 local factors defined as "health services," "community living," and "community resources." The systems, services, and policies measure correlated moderately with participation measures: Community Participation Indicators (CPI) - Involvement, CPI - Control over Participation, Quality of Life in Neurological Disorders - Ability to Participate, Quality of Life in Neurological Disorders - Satisfaction with Role Participation, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role Participation, and PROMIS Isolation. The measure of systems, services, and policies facilitators contains items pertaining to health services, community living, and community resources. Investigators and clinicians can measure
Bashkireva, A S; Bogdanov, E A; Shestakov, V P; Svintsov, A A; Chernova, G I; Cherniakina, T S
The article presents a comparative analysis of the effectiveness of the individual rehabilitation programs among elderly citizens and disabled persons of the Astrakhan region, the part of the South Federal District of Russia. We analyzed the data of the statistical survey of the social services provided rehabilitation facilities for the elderly and disabled people in the Astrakhan region. Analytical results thus obtained shown that the network of agencies and centers of social rehabilitation in the Astrakhan region did not correspond to the needs of elderly people and disabled persons. The negative dynamics in the number of social care centers as well as in the number of people who were provided with their services revealed the need for optimization of the institutional structure and its management. These specific characteristics of the social rehabilitation services in the Astrakhan region thus identified should be taken into consideration in order to improve the rehabilitation programs among elderly citizens and disabled persons in the South Region of the Russian Federation.
Autonomy of mid-seriously and seriously intellectually disabled persons is encouraged both by legislations on human rights and the modern social care and services. The process leading to the maximum possible autonomy is illustrated by a developmental spiral in our model. Specialty of the development is that the personal educational projects are realized during everyday activities. The process requires conscious professionals with an empowering and motivating attitude, with adult relationship to the intellectually disabled persons and versatile skills and tools. In this educational relationship the social professional and the supported person are equal partners moving together along the spiral of human development. An innovative tool-battery has been developed aiding support-staff in the 'pedagogical' task embedded into everyday social services. The tool-battery and its first application in supported living services of the Hungarian Down Foundation are introduced in this paper.
The aim of this article is to examine the experiences of families with young adults with learning disabilities trying to access services. The landscape of disability services for this group is made up of day care, special vocational training and respite places. It aims to identify the extent of an implementation gap between government rhetoric and the degree to which services are characterised as being non-supportive interactions on the ground. Using Ireland as a case study, during a time when the economy is booming and government rhetoric claims unparalleled developments in allocating resources and extra respite 'places', this article identifies the main challenges faced by family carers associated with accessing appropriate services for their disabled adult child, in their attempt to achieve greater independence. This article reports the findings of a qualitative study in which individual semistructured interviews were held with family carers (n = 25) and representatives from national carer organisations (n = 6) in Ireland. These were people caring for an adult (18-30 years) with a learning disability and their experiences were also useful in cross-checking the carer organisation interviews. The findings show that there is limited flexibility, choice and availability in meeting the preferences of the service-users, and throughout the study, services were characterised as being non-supportive interactions. This is not simply symptomatic of a lack of resources. Despite improved funding, supportive attitudes and flexibility are still crucial in meeting user requirements at the level of delivery; thus highlighting that often the system works for the system, not for the user.
BACKGROUND: People with Multiple Sclerosis have a life long need for physiotherapy and exercise interventions due to the progressive nature of the disease and their greater risk of the complications of inactivity. The Multiple Sclerosis Society of Ireland run physiotherapy, yoga and exercise classes for their members, however there is little evidence to suggest which form of physical activity optimises outcome for people with the many and varied impairments associated with MS. METHODS AND DESIGN: This is a multi-centre, single blind, block randomised, controlled trial. Participants will be recruited via the ten regional offices of MS Ireland. Telephone screening will establish eligibility and stratification according to the mobility section of the Guys Neurological Disability Scale. Once a block of people of the same strand in the same geographical region have given consent, participants will be randomised. Strand A will concern individuals with MS who walk independently or use one stick to walk outside. Participants will be randomised to yoga, physiotherapy led exercise class, fitness instructor led exercise class or to a control group who don\\'t change their exercise habits.Strand B will concern individuals with MS who walk with bilateral support or a rollator, they may use a wheelchair for longer distance outdoors. Participants will be randomised to 1:1 Physiotherapist led intervention, group intervention led by Physiotherapist, group yoga intervention or a control group who don\\'t change their exercise habits. Participants will be assessed by physiotherapist who is blind to the group allocation at week 1, week 12 (following 10 weeks intervention or control), and at 12 week follow up. The primary outcome measure for both strands is the Multiple Sclerosis Impact Scale. Secondary outcomes are Modified Fatigue Impact Scale, 6 Minute Walk test, and muscle strength measured with hand held dynamometry. Strand B will also use Berg Balance Test and the Modified
Lin, Jin-Ding; Wu, Chia-Ling; Lin, Pei-Ying; Lin, Lan-Ping; Chu, Cordia M
Although longevity among older adults with intellectual disabilities is increasing, there is limited information on their premature aging related health characteristics and how it may change with increasing age. The present paper provides information of the institutional manager's perception on early onset aging and service preparation for this population. We used purposive sampling to recruit 54 institutional managers who care for people with intellectual disabilities in Taiwan. The present study employed a cross-sectional design using a self-administrative structured questionnaire that was completed by the respondents in November 2009. The results showed that more than 90% of the respondents agreed with earlier onset aging characteristics of people with ID. However, nearly all of the respondents expressed that the government policies were inadequate and the institution is not capable of caring for aging people with ID, and more than half of them did not satisfy to their provisional care for this group of people. With regard to the service priority of government aging policy for people with ID, the respondent expressed that medical care, financial support, daily living care were the main areas in the future policy development for them. The factors of institutional type, expressed adequacy of government's service, respondent's job position, age, and working years in disability service were variables that can significantly predict the positive perceptions toward future governmental aging services for people with ID (adjusted R(2) = 0.563). We suggest that the future study strategy should underpin the aging characteristics of people with intellectual disabilities and its differences with general population to provide the useful information for the institutional caregivers. Copyright © 2010 Elsevier Ltd. All rights reserved.
Full Text Available To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54% were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction
Full Text Available Purpose: The article summarises the process and the results of the first, integrated inspection of managed care services for people with learning disabilities in Scotland. The multi-agency model used was developed to be congruent with the existing performance inspection models, used by single agency inspection. The inspection activities and main outcomes are described, and suggestions are made for improvements. Context of case: In 2006 an inspection model was devised to assess the quality of health, social services and education services for people with learning disabilities in one geographical area of Scotland, as a precursor to a programme of inspections nationally. The first joint, integrated inspection of all services for people with learning disabilities in Scotland took place in June 2006, and the report was published in March 2007. This was the first multi-agency inspection of its kind in the UK, and the first to involve carers and people with learning disabilities on the inspection team. Data sources: A number of data sources were used to check existing practice against agreed Quality Outcome indicators. Primary sources of data were social work records, health records, education records, staff surveys, carer surveys, interviews with staff, family carers and people with learning disabilities, and self evaluations completed by the services being inspected. Eleven different domains, each with sub-indicators were investigated. Case description: This paper summarises the process of an integrated, multi-agency inspection, how the inspection activities were conducted and the main findings of this inspection. Practical improvements to the process are suggested, and these may be of use to other services and inspectorates. Conclusions and discussion: The integrated inspection was a qualified success. Most major objectives were achieved. The sharing of data amongst inspection agencies, establishing the level of commitment to integrated inspection
Du Mont, Janice; Macdonald, Sheila; White, Meghan; Turner, Linda
Little is known about the characteristics of women with disabilities who have experienced abuse and their satisfaction with care received from specialized healthcare providers working in hospital-based violence services. To address this gap, we surveyed clients presenting to 30 sexual assault/domestic violence treatment centers (SA/DVTCs) in Ontario. Of the 920 women aged 12 years or older who completed a survey, 194 (21%) reported having a disability. Bivariate analyses revealed that women with a disability who experienced abuse were more likely than those without a disability to be older, separated, widowed or divorced, and unemployed; to live alone or to be homeless or living in a shelter; and to report less support from family and friends or colleagues. Women with disabilities were less likely to have been assaulted by acquaintances known for Women with disabilities were also more likely than those without disabilities to sustain physical injuries in the assault. Despite these significant differences, almost all women with disabilities rated the care received as excellent or good (97%) and reported that they received the care needed (98%); were able to choose the preferred care (95%); felt safe during the visit (96%); and were treated sensitively (97%), respectfully (96%), and in a nonjudgmental manner (96%). Furthermore, 96% stated that they would recommend the services to others. Women with disabilities were overwhelmingly satisfied with SA/DVTC services. However, given their distinct vulnerabilities and increased risk of being injured, attending health providers should receive training relevant to working with this population.
Full Text Available Background: There is dearth of studies related to pattern of disability among persons who availed psychosocial rehabilitation services in India. We studied the pattern of disability among persons who availed half-way home-care services for psychosocial rehabilitation. Materials and Methods: Out of 130 case files of discharged patients, 50 files were randomly selected for data collection. Indian Disability Evaluation and Assessment Schedule was used to assess the pattern of disability in the sample. Results: The study revealed that only one-third (35% of the residents had disability in self-care, 41% in communication and understanding and 47% in interpersonal relationship. Overall, majority (76% of the respondents had moderate level of psychiatric disability at the time of discharge from half-way home. There was no significant relationship between gender and type of psychiatric illness with the level of disability. The overall disability correlated positively with the duration of illness (rs=0.39. Conclusion: Three-fourth of the residents who availed half-way home-care services had moderate level of disability.
Chapman, Melanie; Lacey, Huma; Jervis, Nicola
Background: Dementia prevalence rates are higher amongst people with learning disabilities than the general population. People with Down's syndrome are at even greater risk of developing dementia and of developing dementia at an earlier age. This study, conducted as part of a wider service evaluation, explored community learning disability team…
Schnitzler, A; D'Apolito, A C; Roche, N; Genêt, F; Ameille, J; Azouvi, P
Mediclen is an occupational health service in charge of following-up 36,736 workers (divided among 1770 companies) in 3 cities of an area near Paris. The employment rate of disabled people among the French population is not well known (rough estimate 4.4%), and few studies have reported on the situation of workers with a motor impairment. The recent computerization of medical records allowed us to identify 195 workers considered disabled by the French administration (i.e. 0.55% of the 36,736 workers followed up in 2002). Among these, 26 had a motor impairment. Twenty-one neurological disabilities were central and 5 were peripheral or neuromuscular. The workers were 44-years-old. Only two workers had a severe handicap. Companies had to adapt workstations for half of the workers, with the advice of neurologists (7 of 10 advice given) and once a physical medicine doctor. The integration of people with motor impairments into the world of work is rare and difficult. This practical experience showed the difficulties people with motor impairment face. Close collaboration of physical medicine services with occupational health services is necessary to improve the integration of this population into the world of work.
Zhang, Lei; Li, Wenfei; Zhu, Jieping; Huang, Tingting; Zhu, Lin; Chen, Gong; Zheng, Xiaoying
To investigate the status and associated factors of demand satisfaction (DS) of services for older adults with visual disability (OAVD). Based on the 2nd National Sample Survey on Disability in 2006, a total number of 24 017 OAVD cases were included. Associated relationships among demographic, health-related, social, economic factors and services of DS, including health demand (Type I), basic livelihood demand (Type II), and environmental support demand (Type III) were analyzed. The proportions of DS of Type I, II, III services for OAVD were 35.1% , 9.3% and 4.3% respectively. Eight factors as:having pension insurance (OR = 1.64), living in urban areas (OR = 1.54), per capita household income at ≥5 000 or over Yuan (OR = 1.46)were favorable ones on OAVD DS while at age ≥80 or above (OR = 0.90), being male (OR = 0.93)were adverse factors of Type I. Four factors as:being male (OR = 1.43), living in urban areas (OR = 1.15), subjects defined as grade II (OR = 1.36) and grade I (OR = 1.70) etc., were favorable factors on OAVD DS. Five factors as: range of age groups at 15-59 (OR = 0.57) or at ≥60 (OR = 0.45), per capita household income at 1 000-1 999 Yuan (OR = 0.77), 2 000-4 999 Yuan (OR = 0.58) and ≥5 000 Yuan (OR = 0.39) were adverse factors of Type II. Factors as: living in urban areas (OR = 1.23), defined as grade II (OR = 1.38) and grade I (OR = 1.34), having pension insurance (OR = 1.62) and per capita household income at ≥5 000 Yuan (OR = 1.42) etc., were favorable factors of Type III. The DS degree of older adults with visual disability was generally very low while factors as: per capita household income, situation on social insurance, age, degree of disability, age when disability was identified, areas of residence, gender, grade of disability, marriage status, levels of education etc., were significantly associated with the service on DS.
Houtrow, Amy J; Okumura, Megumi J; Hilton, Joan F; Rehm, Roberta S
The aims of this study were to profile and compare the health and health services characteristics for children with special health care needs (CSHCN), with and without disabilities, and to determine factors associated with unmet need. Secondary data analysis of the 2005-2006 National Survey of Children with Special Health Care Needs was conducted. The sociodemographics, health, and health services of CSHCN with and without disabilities were compared. Multivariable logistic regression was employed to examine factors associated with unmet need for health services. Children from minority racial and ethnic groups and children living in or near poverty were over-represented among CSHCN with disabilities, compared with other CSHCN. Statistically higher percentages of CSHCN with disabilities had behavioral problems (39.6% vs 25.2%), anxiety/depressed mood (46.1% vs 24.0%), and trouble making/keeping friends (38.1% vs 15.6%) compared with other CSHCN. Thirty-two percent of CSHCN with disabilities received care in a medical home compared with 51% of other CSHCN. CSHCN with disabilities had higher rates of need and unmet need than other CSHCN for specialty care, therapy services, mental health services, home health, assistive devices, medical supplies, and durable medical equipment. The adjusted odds of unmet need for CSHCN with disabilities were 71% higher than for other CSHCN. CSHCN with disabilities had more severe health conditions and more health services need, but they less commonly received care within a medical home and had more unmet need. These health care inequities should be amenable to policy and health service delivery interventions to improve outcomes for CSHCN with disabilities. Copyright Â© 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of
Worrall, Linda E; Howe, Tami; O'Callaghan, Anna; Hill, Anne J; Rose, Miranda; Wallace, Sarah J; Rose, Tanya; Brown, Kyla; Power, Emma; O'Halloran, Robyn; Rohde, Alexia
This commentary aims to extend the debate of the lead article authors (Wylie, McAllister, Davidson, and Marshall, 2013) by translating the nine recommendations of the World Report on Disability into a plan of action for the aphasia community. Solutions for the advancement of aphasia science and services are presented at international (macro), national (meso), and local (micro) levels. Implications for speech-language pathologists and aphasia service delivery are discussed. An overarching call to action is the need for speech-language pathologists to support a strong and vibrant aphasia community at all levels, so that the voices of people with aphasia can be heard.
Hees, S. van; Cornielje, H.; Wagle, P.; Veldman, E.
Purpose: Persons with disabilities face additional barriers in accessing primary healthcare services, especially in developing countries. Consequently the prevalence of secondary health conditions is higher among this population. This study aims to explore the perceived barriers to access primary
Herrman, Helen; Evert, Helen; Harvey, Carol; Gureje, Oye; Pinzone, Tony; Gordon, Ian
The prevalence of psychosis and needs for care among homeless people were studied in inner Melbourne. This was a two-stage nested study within the Australian National Survey of People Living with Psychotic Illness. A screen for psychosis was administered to a representative sample of men and women living in marginal housing in a mental health service catchment area. A selected subsample of 82 screen-positive respondents was interviewed using the Diagnostic Interview for Psychosis (DIP), a semistructured, standardized interview with three modules: (i) demography, functioning and quality of life; (ii) diagnosis; and (iii) service use. An unexpectedly high prevalence of people living with psychotic disorders (estimated lifetime prevalence 42%, 95% CI=37-47%) may reflect a concentration of vulnerable people in the shrinking marginal housing supply in the inner city areas. Disability in everyday, occupational and social functioning is greater for this subgroup than for other people living with psychosis in Australia. Most people were single and unemployed, and many reported social isolation and feeling unsafe. Substance use disorders were common. Most people were using health services, including specialist mental health services, but few were receiving rehabilitation, vocational or housing support. Despite high levels of contact with a well-organized, sectorized mental health service in an affluent country, this pocket of several hundred people had high levels of persisting disability and needs. The literature and local experience suggest that changing this situation is likely to require co-ordinated policy and practice between the health, welfare and housing sectors.
Fleming, Padraic; McGilloway, Sinead; Barry, Sarah
Background: Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery. Methods: National intellectual…
Hemmings, C. P.; Underwood, L. A.; Bouras, N.
Background: There remains a severe lack of evidence on the effectiveness of community services for adults with psychosis and intellectual disabilities (ID). There has been little consensus even of what services should provide for this service user group. Method: A consultation of multidisciplinary professionals was carried out by using a…
Chou, Li-Der; Lai, Nien-Hwa; Chen, Yen-Wen; Chang, Yao-Jen; Yang, Jyun-Yan; Huang, Lien-Fu; Chiang, Wen-Ling; Chiu, Hung-Yi; Shin, Haw-Yun
As Internet technologies evolve, their applications have changed various aspects of human life. Here, we attempt to examine their potential impact on services for families with developmentally delayed children. Our research is thus designed to utilize wireless mobile communication technologies, location services, and search technology in an effort to match families of specific needs with potential care providers. Based on the investigation conducted by our counselors, this paper describes a platform for smooth communication between professional communities and families with children with developmental disabilities (CDD). This research also looks into the impact of management of mobile social network services and training on the operation of these services. Interaction opportunities, care, and support to families with CDD are introduced.
Suzuki, Rie; Peterson, Jana J; Weatherby, Amanda V; Buckley, David I; Walsh, Emily S; Kailes, June Isaacson; Krahn, Gloria L
This article describes the development of Promoting Access to Health Services (PATHS), an intervention to promote regular use of clinical preventive services by women with physical disabilities. The intervention was developed using intervention mapping (IM), a theory-based logical process that incorporates the six steps of assessment of need, preparation of matrices, selection of theoretical methods and strategies, program design, program implementation, and evaluation. The development process used methods and strategies aligned with the social cognitive theory and the health belief model. PATHS was adapted from the workbook Making Preventive Health Care Work for You, developed by a disability advocate, and was informed by participant input at five points: at inception through consultation by the workbook author, in conceptualization through a town hall meeting, in pilot testing with feedback, in revision of the curriculum through an advisory group, and in implementation by trainers with disabilities. The resulting PATHS program is a 90-min participatory small-group workshop, followed by structured telephone support for 6 months.
Saulo, Bryson; Walakira, Eddy; Darj, Elisabeth
Disabled people are overlooked and marginalised globally. There is a lack of information on blind people and HIV-related services and it is unclear how HIV-services target blind people in a sub-Saharan urban setting. To explore how blind people are reached by HIV-services in Kampala, Uganda. A purposeful sample of blind people and seeing healthcare workers were interviewed, and data on their opinions and experiences were collected. The data were analysed by qualitative content analysis, with a focus on manifest content. Three categories emerged from the study, reaching for HIV information and knowledge, lack of services, and experiences of discrimination. General knowledge on HIV prevention/transmission methods was good; however, there was scepticism about condom use. Blind people mainly relied on others for accessing HIV information, and a lack of special services for blind people to be able to test for HIV was expressed. The health service for blind people was considered inadequate, unequal and discriminatory, and harassment by healthcare staff was expressed, but not sexual abuse. Concerns about disclosure of personal medical information were revealed. Access to HIV services and other healthcare related services for blind people is limited and the objectives of the National Strategic Plan for HIV/AIDS 2007-2012 have not been achieved. There is a need for alternative methods for sensitisation and voluntary counselling and testing (VCT) for blind people. Copyright © 2011 Elsevier B.V. All rights reserved.
Kattari, Shanna K; Walls, N Eugene; Speer, Stephanie Rachel
Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.
Darzi, Andrea J; Officer, Alana; Abualghaib, Ola; Akl, Elie A
The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes. We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale. Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively). The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their
Clark, Phillipa; Macarthur, Jude
To describe the reported experiences of the estimated 14 500 New Zealand children with a physical disability and those of their families and whanau (extended families). We have used data from the Household Disability Survey conducted in 2002 to obtain this information. These children and their carers reported a number of perceived unmet needs in all areas covered in the survey: service and assistance, transport, accommodation and education. Thus an estimated 24% reported an unmet need for equipment, and 10% an unmet need for home modification. Around 9% reported having to fund respite care themselves. Of particular note was the proportion of children who had difficulties joining in games and sport at school (59%), going on school outings or camps (28%), playing at school (47%), and or making friends (35%). In all, an estimated 67% of children had one or more problems taking part at school. More could be done to help such families and to facilitate the full participation of these children.
Full Text Available Introduction: Awareness of disability issues has gained considerable interest by advocacy groups in recent years. However, it is uncertain whether attitudes and perceptions of all service providers and society have adjusted accordingly towards the health care of people with disabilities. This study sought to examine the attitudes of health providers from the perspective of people with disabilities in the Kumasi Metropolis. Methods: A cross-sectional study using semi-structured questionnaires was conducted with people with disabilities (with physical, hearing and visual impairments, in the Kumasi Metropolis. The study used a multi-stage sampling involving cluster and simple random sampling to select 255 respondents split amongst the following five clusters of communities; Oforikrom, Subin, Asewase, Tafo and Asokwa. Data were analysed using STATA 14 and presented in descriptive and inferential statistics. Results: The study found that 71% of the respondents faced some form of discrimination including the use of derogatory remarks, frustration and unavailable required services on the basis of their disability, the type of services they need and the location. Women were 3.89 times more likely to face discrimination; Adjusted odds ratio (AOR = 3.89 (95% confidence interval [CI]; 1.41, 10.76, and visually impaired was more likely to be discriminated at the facility compared with physical disability; AOR = 5.05 (95% CI; 1.44, 17.65. However, respondents with some educational qualification and those who stayed with their family members were less likely to face discrimination; AOR = 0.08 (95% CI; 0.01, 0.39. Conclusion: The study recommends the provision of in-service training for service providers to update their knowledge on disability issues and improve access to services for people with disabilities.
Full Text Available This paper focused on the pivotal role of counseling services for parents, teachers and children with learning disabilities in primary schools with reference to Nigeria. This is with the view to educate the teachers to become more informed about what learning disabilities are and to create awareness and instill hope in the bewildered parents/guardians of children with learning disabilities to appreciate and serve as advocates for their wards. Consequently, a brief historical perspective of learning disabilities in terms of its origin, the need, characteristics and causes has been presented. It is discovered that learning disabilities is a condition with many manifestations and may be compounded by environmental factors such as the home and school. Contrary to people’s conception of the condition, individuals with learning disabilities are of above average intelligence and can be gifted and talented. The paper went further to examine specific areas of counseling services that are needed by pupils, parents and teachers of children with learning disabilities. These include but not limited to personal, social, and academic spheres. Possible challenges of providing effective guidance and counseling services in primary schools are highlighted. Among them are inadequate trained and certified counselors, poor facilities and non patronage by pupils and teachers in addition to parental ignorance. The paper then concluded with suggestions as a way forward.
at the time of disability evaluation. 3. Include variables to indicate date of initial diagnosis, onset of symptom , or injury in service members...inflammation 161 5.1 Noninfectious enteritis and colitis 449 3.1 Paralysis 157 4.9 Diabetes mellitus 434 3.0 Noninfectious enteritis and colitis 152...6.9 1.4 Lungs and chest (includes breast) 33 6.9 1.4 Psychiatric 66 5.2 1.0 Skin , lymphatic, allergies 22 4.6 0.9 Lungs and chest (includes
Thanh, Nguyen Xuan; Moffatt, Jessica; Jacobs, Philip; Chuck, Anderson W; Jonsson, Egon
To estimate the break-even effectiveness of the Alberta Fetal Alcohol Spectrum Disorder (FASD) Service Networks in reducing occurrences of secondary disabilities associated with FASD. The secondary disabilities addressed within this study include crime, homelessness, mental health problems, and school disruption (for children) or unemployment (for adults). We used a cost-benefit analysis approach where benefits of the service networks were the cost difference between the two approaches: having the 12 service networks and having no service network in place, across Alberta. We used a threshold analysis to estimate the break-even effectiveness (i.e. the effectiveness level at which the service networks became cost-saving). If no network was in place throughout the province, the secondary disabilities would cost $22.85 million (including $8.62 million for adults and $14.24 million for children) per year. Given the cost of network was $6.12 million per year, the break-even effectiveness was estimated at 28% (range: 25% to 32%). Although not all benefits associated with the service networks are included, such as the exclusion of the primary benefit to those experiencing FASD, the benefits to FASD caregivers, and the preventative benefits, the economic and social burden associated with secondary disabilities will "pay-off" if the effectiveness of the program in reducing secondary disabilities is 28%.
Heyman, Bob; Swain, John; Gillman, Maureen
This paper explores the role of complexity and simplification in the delivery of health care for adults with learning disabilities, drawing upon qualitative data obtained in a study carried out in NE England. It is argued that the requirement to manage complex health needs with limited resources causes service providers to simplify, standardise and routinise care. Simplified service models may work well enough for the majority of clients, but can impede recognition of the needs of those whose characteristics are not congruent with an adopted model. The data were analysed in relation to the core category, identified through thematic analysis, of secondary complexity arising from organisational simplification. Organisational simplification generates secondary complexity when operational routines designed to make health complexity manageable cannot accommodate the needs of non-standard service users. Associated themes, namely the social context of services, power and control, communication skills, expertise and service inclusiveness and evaluation are explored in relation to the core category. The concept of secondary complexity resulting from organisational simplification may partly explain seemingly irrational health service provider behaviour.
Elliot, Timothy R.; Patnaik, Ashweeta; Naiser, Emily; Fournier, Constance J.; McMaughan, Darcy K.; Dyer, James A.; Phillips, Charles D.
We report on the nature and timing of services provided to children with an intellectual disability (ID) identified by a new comprehensive assessment and care planning tool used to evaluate children's needs for Medicaid Personal Care Services (PCS) in Texas. The new assessment procedure resulted from a legal settlement with the advocacy community.…
Prof. dr. Jean Pierre Wilken; Zsolt Bugarszki; Karin Hanga; Dagmar Narusson; Koidu Saia; Marju Medar
This article explores the way mental health services and social services are orientated on assisting people with a psychiatric disability to participate in different areas of community life. A large research project about community participation in three different countries (Estonia, Hungary and the
Dura-Vila, G.; Hodes, M.
Background: An emerging literature suggests that ethnic and cultural factors influence service utilisation among people with intellectual disability (ID), but this has not previously been reviewed. Aims: To investigate possible ethnic variation in uptake of mental health services in children, adolescents and adults with ID in high-income…
Matanga, Zephania; Freeze, Rick; Duchesne, Hermann; Nyachoti, Martin
A novel participatory workshop methodology was adopted in this qualitative study of the intersection of disability and diversity in the lives of individuals. Social service recipients, parents, educators, service providers, and policy makers in three Canadian cities were conjoined in daylong discussions designed to investigate if the realities of…
Lakhani, Ali; McDonald, Donna; Zeeman, Heidi
Self-directed disability support policies aim to encourage greater choice and control for service users in terms of the health and social care they receive. The proliferation of self-directed disability support policies throughout the developed world has resulted in a growing amount of research exploring the outcomes for service users, and their families and carers. Our understanding of the issues faced by people with disabilities, particularly how they make health and social care decisions and the key areas that determine their engagement with service providers within a self-directed environment is limited. A synthesis of research is timely and can provide knowledge for service users and health and social care support providers to ensure their successful participation. A systematic review guided by the PRISMA approach explored (i) the key areas determining service users' engagement with self-directed disability services and supports, and (ii) how service users make informed decisions about providers. In October 2014 and April 2016, three databases - MEDLINE, CINAHL and Web of Science - were searched for research and review articles. Eighteen sources met the search criteria. Findings were mapped into either: key areas determining service user engagement, or service users' informed decision-making. Findings concerning key areas determining engagement fell into three themes - personal responsibility for budgeting, personalised approaches, and a cultural shift in practice and delivery among service providers. Findings about decision-making yielded two themes - supporting informed decision-making and inhibiting informed decision-making. Literature suggests that self-directed models of care may provide service users with increased control over the services that they receive. Increased control for some service users and their families requires independent external decision-making support, particularly around the domains of budgeting, planning and hiring. Future research
Berry, Ruth; Firth, Graham; Leeming, Catherine; Sharma, Vishal
Intensive Interaction was initially developed in the 1980s as an educational approach for developing social communication and engagement with people with severe or profound intellectual disabilities and/or autism. Intensive Interaction has subsequently been adopted by a range of practitioners and professionals working in learning disability services and has a broad multi-disciplinary acceptance, being recommended in a number of UK governmental guidance documents. Despite this, there has been limited work on developing a deeper psychological understanding of the approach. This study utilises a qualitative description/thematic analysis approach to explore how clinical psychologists conceptualise the approach with regard to currently accepted psychological theories, as well as looking at other factors that influence their adoption and advocacy. The sample deliberately consisted of eight NHS (National Health Service) clinical psychologists known to be using or advocating the use of Intensive Interaction with people with a learning disability. The results of this study indicate that although the participants referred to some theories that might explain the beneficial outcomes of Intensive Interaction, these theories were rarely explicitly or clearly referenced, resulting in the authors having to attribute specific theoretical positions on the basis of inductive analysis of the participants' responses. Moreover, the participants provided varying views on how Intensive Interaction might be conceptualised, highlighting the lack of a generally accepted, psychologically framed definition of the approach. In conclusion, it was felt that further research is required to develop a specifically psychological understanding of Intensive Interaction alongside the formation of a Special Interest Group, which might have this task as one of its aims. There appeared to be a limited recognition amongst the participants of the specific psychological theories that can be seen to explain
Brady, Laura Thompson; Fong, Lisa; Waninger, Kendra N; Eidelman, Steven
As leaders from the Baby Boomer generation prepare for retirement over the next decade, emerging leaders must be identified and supported in anticipation of a major organizational transition. Authentic leadership is a construct that informs the development of values-driven leaders who will bring organizations into the future, just as the previous generation of leaders oversaw the movement of services away from state institutions and into networks of community-based service delivery organizations. The purpose of this exploratory study was to examine executive and emerging leaders' opinions about the unique leadership values, skills, and challenges in organizations that serve individuals with intellectual and developmental disabilities. Themes of defining, developing, and sustaining leaders emerged from the data and are explored through an authentic leadership framework.
Holanda, Cristina Marques de Almeida; De Andrade, Fabienne Louise Juvêncio Paes; Bezerra, Maria Aparecida; Nascimento, João Paulo da Silva; Neves, Robson da Fonseca; Alves, Simone Bezerra; Ribeiro, Kátia Suely Queiroz Silva
This study seeks to identify the formation of social support networks of people with physical disabilities, and how these networks can help facilitate access to health services and promote social inclusion. It is a cross-sectional study, with data collected via a form applied to physically disabled persons over eighteen years of age registered with the Family Health Teams of the municipal district of João Pessoa in the state of Paraíba. It was observed that the support networks of these individuals predominantly consist of family members (parents, siblings, children, spouses) and people outside the family (friends and neighbors). However, 50% of the interviewees declared that they could not count on any support from outside the family. It was observed that the support network contributes to access to the services and participation in social groups. However, reduced social inclusion was detected, due to locomotion difficulties, this being the main barrier to social interaction. Among those individuals who began to interact in society, the part played by social support was fundamental.
Mheta, Doreen; Mashamba-Thompson, Tivani P
The Sustainable Development Goals (SDGs) emphasises the increasing equitable coverage of quality health care and provision of integrated services as means of reducing maternal mortality. Despite so much effort being placed on improved access to maternity health care, studies show that women with disabilities are being systemically excluded from the mainstream maternal health services. The proposed scoping review aims to map literature on the barriers and facilitators of access to maternal services for women with disabilities. The search strategy for this scoping review study will involve electronic databases including Pubmed, MEDLINE via EBSCOhost, CINAHL Plus with full text via EBSCOhost, Africa-Wide Info via EBSCOhost, JSTOR and Proquest Health and Medical Complete. Articles will also be searched through the "Cited by" search as well as citations included in the reference lists of included articles. A two-stage mapping strategy would be conducted. Stage 1 would be to screen studies through examining their titles. Furthermore, we will screen abstracts of the identified studies descriptively and by focus and method as stipulated by the inclusion and exclusion criteria. In stage 2, we will extract data from the included studies. A parallel screening and data extraction will be undertaken by two reviewers. We will access the quality of the included studies using the mixed methods appraisal tool (MMAT). We will use NVIVO version 10 to extract the relevant outcomes and thematic analysis of the studies. We anticipate to find relevant studies reporting evidence on the barriers and facilitators of access to maternal health services in Sub-Saharan Africa. The evidence obtained from the included studies when summarised will help guide future research. The study findings will be disseminated electronically and in print. In addition, it will be presented at conferences related to sexual reproductive health, maternal health care and reproductive health.
Siegel, Ellin B; Maddox, Laura L; Ogletree, Billy T; Westling, David L
Speech-language pathologists in school settings were surveyed with an instrument created from the National Joint Committee for the Communication Needs of Persons with Severe Disabilities' quality indicators self-assessment tool. Participants valued practice indicators of quality communication assessment and intervention to a higher degree than their actual practice. These findings appear to suggest that SLPs may not provide best practice services to individuals with severe disabilities. Suggestions for enhancing inservice training and intervention practices of SLPs and team members who work with individuals with severe disabilities are provided. The reader will be able to; (1) understand the value of using the NJC quality indicators to guide SLP practices with individuals with severe disabilities in schools; (2) recognize that research indicates that SLPs working with individuals with severe disabilities in schools may not provide best practice services to the extent that they value these practices; (3) discuss possible strategies to increase the quality of services provided to individuals with severe disabilities in schools.
Same, Anne; Lee, Elinda Ai Lim; McNamara, Beverley; Rosenwax, Lorna
Little is known about the significance of gardening services for frail elderly people. This study explored the value of a gardening service for frail older people and people with a disability living in the community. Using qualitative and quantitative data collected from pre-gardening ( n = 38) and post-gardening service delivery interviews ( n = 35) and the Housing Enabler, the value of a gardening service was examined. Findings suggest that the service had a positive impact on the independence and emotional well-being of frail aged people and younger people with a functional disability, with little impact on physical health. Results indicate that gardening services should be fundamental to planning for these populations to remain or return to living in the community.
Unwin, Gemma; Larkin, Michael; Rose, John; Kroese, Biza Stenfert; Malcolm, Stephen
(Please see www.Toolsfortalking.co.uk for an easy read summary of the project.) The Tools for Talking are a set of resources that were developed through collaboration between Black, Asian and minority ethnic people with learning disabilities and researchers at the University of Birmingham. The resources were designed to be used by people with learning disabilities and service providers to facilitate culturally-sensitive communication and information sharing, service planning and delivery. They comprise illustrative videos and exploratory activities relating to five topics, namely, culture, activities, support from staff, important people, choices and independence. These topics emerged as important to people with learning disabilities during the 'Access to Social Care-Learning Disabilities' (ASC-LD) study which involved interviews with 32 adults with learning disabilities from Black, Asian and minority ethnic communities. The results of the ASC-LD study were used to develop a set of draft resources which were then co-developed through collaboration with people with learning disabilities and service providers. A 'Partnership event' was convened to involve stakeholders in the development of the resources. This paper describes the refinement of these materials by people with learning disabilities from Black, Asian and minority ethnic backgrounds in cooperation with a range of other stakeholders. Background Black, Asian and minority ethnic people with learning disabilities face inequities in health and social care provision. Lower levels of service uptake and satisfaction with services have been reported, however, this is largely based on the views of carers. The 'Access to Social Care: Learning Disabilities (ASC-LD)' study sought to explore the views and experiences of social support services among adults with learning disabilities from Black, Asian and minority ethnic communities. Interviews with 32 Black, Asian and minority ethnic adults with learning disabilities
Sripada, Rebecca K; Hannemann, Claire M; Schnurr, Paula P; Marx, Brian P; Pollack, Stacey J; McCarthy, John F
To determine patterns of mental health service use before and after VA disability compensation awards for posttraumatic stress disorder (PTSD). A 10 percent random sample of VHA-enrolled Veterans with new or increased PTSD service connection between 2012 and 2014 (n = 22,249). We used latent trajectory analysis to identify utilization patterns and multinomial logistic regression to assess associations between Veteran characteristics and trajectory membership. We assessed receipt of VHA mental health encounters in each of the 52 weeks prior to and following PTSD disability rating or rating increase. The best fitting model had five groups: No Use (36.6 percent), Low Use (37.7 percent), Increasing Use (9.4 percent), Decreasing Use (11.2 percent), and High Use (5.1 percent). Adjusting for demographic characteristics and compared with the No Use group, Veterans in the other groups were more likely to reside closer to a VHA facility, receive a higher PTSD disability rating, and screen positive for military sexual trauma. Service use remained stable (80 percent) or increased (9 percent) for the vast majority of Veterans. Service utilization declined for only 11 percent. Data did not indicate substantial service discontinuation following rating. Low VHA service utilization suggests opportunities to enhance outreach for Veterans with PTSD-related disability benefits. © Published 2018. This article is a U.S. Government work and is in the public domain in the USA.
King, Gillian; McPherson, Amy; Kingsnorth, Shauna; Stewart, Debra; Glencross-Eimantas, Tanya; Jones-Galley, Kimberlea; Morrison, Andrea; Isihi, Ana Maria; Gorter, Jan Willem
Residential immersive life skills (RILS) programs are designed to equip youth with physical disabilities with the foundational life skills required to assume adult roles. The objective was to determine RILS service providers' perceptions of the active ingredients of the intervention change process. Thirty-seven service providers from various disciplines completed measures to assess expertise status and participated in qualitative interviews. Qualitative themes were derived, and similarities and differences in themes were identified for blinded groups of novices, intermediates, and experts. The three main themes, reflecting change processes, were: (a) creating a supportive program atmosphere with multiple opportunities for learning, (b) using strategies to support, encourage, and engage youth, and (c) intentionally fostering youth experiences of skill development, social interaction, and pride in accomplishment. In contrast to the novices, experts displayed a more holistic perspective and paid attention to higher-order issues such as providing opportunities and enabling youth. The findings indicate how RILS service providers work to create a program atmosphere and employ strategies to intentionally foster particular youth experiences. The findings explicate service providers' theories of practice, the intentional design of RILS program environments to bring about client change, and the value of service provider expertise. Implications for Rehabilitation Service providers of youth independence-oriented life skills programs can intentionally create a learning-oriented and supportive program atmosphere by using non-directive, coaching/guiding, and engagement strategies Youth experiences of skill development, shared experience with others, and pride in accomplishment can be cultivated by providing a range of learning opportunities, including choice making, problem-solving, and skill mastery Compared to more novice service providers, experts discussed managing the
Crook, Bradley; Tomlins, Rose; Bancroft, Ann; Ogi, Laura
The importance of making research participation accessible for people with learning disabilities is emphasised in government and NHS research strategies. This evaluation explored the realities of this goal from the perceptions of people with learning disabilities and clinicians within an NHS learning disability service. People with learning…
Jeon, Boyoung; Noguchi, Haruko; Kwon, Soonman; Ito, Tomoko; Tamiya, Nanako
With rapid aging, many of the elderly suffer from poverty and high healthcare needs. In Korea, there is a means-tested and non-contributory public assistance, the National Basic Livelihood Security System (NBLSS). The purpose of this study is to show older population's condition of disability and poverty, to evaluate the impact of NBLSS on health services utilization, and to examine the differential effect of the NBLSS by disability status among the elderly. This study used the Korea Welfare Panel Study data 2005-2014 with the final sample of 40,365, who were 65 years and older. The participants were divided into people with mild disability, severe disability, and without disability according to the Korean disability registration system. The income-level was defined to the low-income with NBLSS, the low-income without NBLSS, and the middle and high income, using the relative poverty line as a proxy of the low-income. The dependent variables were the number of outpatient visits and inpatient days, experience of home care services, total healthcare expenditure, and financial burden of healthcare expenditure. We performed Generalized Estimating Equations population-averaged model using the ten years of panel data. The result showed that within the same disability status, the low-income without NBLSS group used the least amount of inpatient care, but their financial burden of health expenditure was the highest among the three income groups. The regression model showed that if the elderly with severe disability were in the low-income without NBLSS, they reduced the outpatient and inpatient days; but their financial burden of healthcare became intensified. This study shows that the low-income elderly with disability but without adequate social protection are the most disadvantaged group. Policy is called for to mitigate the difficulties of this vulnerable population. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Children and adolescents with chronic diseases and disabling conditions often need related services. As medical home professionals, pediatricians can assist children, adolescents, and their families with the complex federal, state, and local laws, regulations, and systems associated with these services. Expanded roles for pediatricians in Individual Family Service Plan, Individualized Education Plan, and 504 Plan development and implementation are recommended. The complex range of federal, state, and local laws, regulations, and systems for special education and related services for children and adolescents in public schools is beyond the scope of this statement. Readers are referred to the policy statement "The Pediatrician's Role in Development and Implementation of an Individual Education Plan (IEP) and/or an Individual Family Services Plan"(1) by the American Academy of Pediatrics for additional background materials.
Campens, J; Schiettecat, T; Vervliet, M; Van Heck, L; Lesseliers, J; Goethals, I; De Witte, N
Considering the increasing life expectancy of people with intellectual disabilities (ID), the importance of cooperation between services for people with ID and elderly care services has been stressed in Flanders and the Netherlands, as well as internationally. However, the prevalence, intensity and content of such a cooperation are yet unknown. In order to gain information to address this issue, an online-survey was delivered to directors of all nursing homes in Flanders (n = 781). 229 surveys were completed.In more than 75% of the nursing homes, people with ID were among the residents over the past decade. However, at the same time a lack of expertise has been identified as a barrier to provide them optimal care and support. Hence, the respondents point out that a cooperation with ID care services could be beneficial. Nevertheless, those partnerships only arose in a quarter of the nursing homes so far, primarily for the purpose of exchange of expertise. Intersectoral multidisciplinary consultations and intersectoral care team consultations have been taking place as well, be it mainly in the context of a persons' transition from an ID care service to a nursing home. Until now, radical cooperations which involve an exchange of staff, seem to be rather rare.
Horner-Johnson, Willi; Dobbertin, Konrad; Lee, Jae Chul; Andresen, Elena M
To examine differences in access to health care and receipt of clinical preventive services by type of disability among working-age adults with disabilities. Secondary analysis of Medical Expenditure Panel Survey (MEPS) data from 2002 to 2008. We conducted cross-sectional logistic regression analyses comparing people with different types of disabilities on health insurance status and type; presence of a usual source of health care; delayed or forgone care; and receipt of dental checkups and cancer screening. We pooled annualized MEPS data files across years. Our analytic sample consisted of adults (18-64 years) with physical, sensory, or cognitive disabilities and nonmissing data for all variables of interest. Individuals with hearing impairment had better health care access and receipt than people with other disability types. People with multiple types of limitations were especially likely to have health care access problems and unmet health care needs. There are differences in health care access and receipt of preventive care depending on what type of disability people have. More in-depth research is needed to identify specific causes of these disparities and assess interventions to address health care barriers for particular disability groups. © Health Research and Educational Trust.
Frilander, Heikki; Lallukka, Tea; Viikari-Juntura, Eira; Heliövaara, Markku; Solovieva, Svetlana
Disability retirement causes a significant burden on the society and affects the well-being of individuals. Early health problems as determinants of disability retirement have received little attention. The objective was to study, whether interrupting compulsory military service is an early indicator of disability retirement among Finnish men and whether seeking medical advice during military service increases the risk of all-cause disability retirement and disability retirement due to mental disorders and musculoskeletal diseases. We also looked at secular trends in these associations. We examined a nationally representative sample of 2069 men, who had entered military service during 1967-1996. We linked military service health records with cause-specific register data on disability retirement from 1968 to 2008. Secular trends were explored in three service time strata. We used the Cox regression model to estimate proportional hazard ratios and their 95% confidence intervals. During the follow-up time altogether 140 (6.8%) men retired due to disability, mental disorders being the most common cause. The men who interrupted service had a remarkably higher cumulative incidence of disability retirement (18.9%). The associations between seeking medical advice during military service and all-cause disability retirement were similar across the three service time cohorts (overall hazard ratio 1.40 per one standard deviation of the number of visits; 95% confidence interval 1.26-1.56). Visits due to mental problems predicted disability retirement due to mental disorders in the men who served between 1987 and 1996 and a tendency for a similar cause-specific association was seen for musculoskeletal diseases in the men who served in 1967-1976. In conclusion, health problems-in particular mental problems-during late adolescence are strong determinants of disability retirement. Call-up examinations and military service provide access to the entire age cohort of men, where
Proctor, S N; Azar, S T
There is evidence to suggest that parents with an intellectual disability (ID) constitute a higher proportion of child-protective services (CPS) cases than would be expected based on the prevalence of ID in the general population. Researchers have suggested that the stereotypic assumptions and expectations that CPS workers have about parents with an ID might influence decisions and responses made to such parents. This study examined whether parental ID (having an ID vs. not) had an effect on CPS workers' emotional reactions, attributions and decisions about risk to the child, whether to remove the child and workers' general willingness to help the parent. Two hundred and twelve CPS workers read vignettes describing parents who were labelled as either having or not having an ID. Workers responded to the vignettes by making ratings of their emotional reactions, attributions and decisions regarding risk, removal and helping. CPS workers made significantly higher ratings of pity, willingness to help and risk for parents with an ID than for parents without an ID. Lower ratings of anger and disgust were found for parents with an ID than for parents without an ID. Parents' intellectual status did not have a direct effect on workers' attributions or removal decisions. The results show evidence for the influence of stereotypes regarding parental ID due to its differential effect on CPS workers' emotional reactions and decisions about child risk and their willingness to help. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.
This paper draws upon a study completed in 2000 that focused upon health and welfare provision for people with learning disabilities in one English county. This study drew upon the theoretical insights of Michel Foucault to provide an analysis of the micro politics of care planning. This involved the analysis of text from two sources: the academic literature and interview material gained from a number of professionals working in health and welfare services for people with learning disabilities. Drawing upon this research material, the first part of this paper briefly explores the relationship between policy, professional practice and the people who are the subjects of that practice. The discussion then moves on to consider Foucault's five methodological precautions and the way power produces a localised web of activity that identifies specific targets for management. In this process power draws into the web a range of informal and formal practices that initially lie outside of the web. The discourse produced through the activity surrounding care planning provides the evidence of this flow of power. This discourse then takes on the status of science (truth), which reproduces this activity.
Full Text Available Hidehiro Sugisawa,1 Toshio Shinoda,2 Yumiko Shimizu,3 Tamaki Kumagai,4 Hiroaki Sugisaki,5 Seiji Ohira6,† 1Department of Gerontology, Graduate School of Gerontology, J. F. Oberlin University, Tokyo, 2Department of Medical Care Technology, Faculty of Medical and Health Science, Tsukuba International University, Tsuchiura, 3Department of Community Health Nursing, The Jikei University School of Nursing, Chofu, 4Department of Fundamental Nursing, Graduate School of Nursing, Osaka City University, Osaka, 5Hachioji Azumacho Clinic, Hachioji, Tokyo, 6Sapporo Kita Clinic, Sapporo, Hokkai-do, Japan †Professor Dr. Seiji Ohira passed away on September 5, 2017 Background: This study aimed to investigate the levels of unmet needs for home and community-based services (HCBS evaluated by case managers (CMs among disabled patients on hemodialysis (DPHD and to examine factors related to unmet needs. Unmet needs for HCBS were defined as situations in which patients do not use or underuse HCBS despite needing them. Candidates for the factors relating to unmet needs for HCBS included three dimensions: predisposing, enabling, and need factors.Methods: Self-administrated questionnaires were collected from 391 CMs of DPHD certified with long-term care insurance. These were introduced by the dialysis facilities that a member of the Japanese Association of Dialysis Physicians belonged to. CMs were asked questions about their management of each individual case. HCBS included home help, visiting nursing, daycare, and short stay.Results: The prevalence of unmet needs for each HCBS ranged from 32% for home help to 48% for short stay. Barriers to service usage in the patients were associated with unmet needs for all four services. The patients with more severe cognitive malfunction were more likely to have unmet needs for visiting nursing and short stay. Heavier burden with caregiving was associated with more likelihood of unmet needs for home help and short stay
Andersen, Helle Elisabeth
This project is based on five weeks’ ethnographically inspired fieldwork in May 2006 in the Republic of Uganda. The study started out with the hypothesis that there was some kind of discrimination going on in the interaction between health workers at HIV/AIDS clinics, and person with disabilities...... (PWDs) coming for HIV/AIDS testing or treatment. However, problems with discriminatory attitudes towards PWDs could not be confirmed from my fieldwork observations at five different HIV/AIDS clinics in Uganda. That observation was confirmed in my interviews with PWDs and health workers. Health workers...... said that PWDs were entitled to the same care and treatment as everybody else. However, I observed that only few PWDs seem to attend those HIV/AIDS services, and the question arose why that is so. Problems with access and confidence (for example lack of sign language interpreters) are often reported...
Objectives: This study aimed to use an explanatory model of illness framework to document experiences of illness, disability and recovery amongst service users with schizophrenia and their caregivers in a poorly resourced area in the North West Province. Data were used to provide recommendations for a contextually appropriate non-specialist facilitated group psychosocial rehabilitation intervention. Method: Eighteen in-depth individual interviews were conducted: nine with schizophrenia service users and nine with caregivers. Interviews were conducted by two trained field researchers; both clinical psychologists fluent in the first language of participants. All interviews were recorded, translated and transcribed. Data were thematically analysed using NVivo 9. Results: Participants linked the illness to witchcraft, poverty and stress. Family conflict was recognised in the course of the illness, causing stress and challenges for emotional well-being. Knowledge of diagnosis and biomedical treatment was minimal. Key factors recognised by service users as promoting recovery were the ability to work, and the support of traditional healers and religious structures. Conclusion: Based on the findings of this study, a group psychosocial rehabilitation intervention emerged as a recommendation, with the incorporation of psycho-education, adherence support, coping skills, and opportunities for income generation and productive activity. The importance of also enlisting the support of religious leaders and traditional healers in supporting recovery is emphasised.
Lauer, Emily; McCallion, Philip
Background: Monitoring population trends including mortality within subgroups such as people with intellectual and developmental disabilities and between countries provides crucial information about the population's health and insights into underlying health concerns and the need for and effectiveness of public health efforts. Methods: Data from…
Clare, I C H; Madden, E M; Holland, A J; Farrington, C J T; Whitson, S; Broughton, S; Lillywhite, A; Jones, E; Wade, K A; Redley, M; Wagner, A P
In the UK, the closure of 'long-stay' hospitals was accompanied by the development of community teams (CTs) to support people with intellectual disabilities (IDs) to live in community settings. The self-reported experiences of staff working in such teams have been neglected. Focusing on a single county-wide service, comprising five multi-disciplinary and inter-agency CTs, we measured perceptions among the health care and care management Team members of (1) their personal well-being; (2) the functioning of their team; and (3) the organisation's commitment to quality, and culture. Almost three-quarters of the questionnaires were returned (73/101; 72%). The scores of health care practitioners and care managers were very similar: (1) the MBI scores of more than half the respondents were 'of concern'; (2) similarly, almost four in ten respondents' scores on the Vision scale of the TCI were 'of concern'; (3) the perceived commitment to quality (QIIS-II Part 2) was uncertain; and (4) the organisational culture (QIIS-II, Part 1) was viewed as primarily hierarchical. The perceived absence of a vision for the service, combined with a dominant culture viewed by its members as strongly focussed on bureaucracy and process, potentially compromises the ability of these CTs to respond proactively to the needs of people with IDs. Given the changes in legislation, policy and practice that have taken place since CTs were established, it would be timely to revisit their role and purpose. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Full Text Available For people with lower limb amputation, a user-specific human-machine interaction with their prostheses is required to ensure safe and comfortable assistance. Especially during dynamic turning manoeuvres, users experience high loads at the stump, which decreases comfort and may lead to long-term tissue damage. Preliminary experiments with users wearing a configurable, passive torsional adaptor indicate increased comfort and safety achieved by adaptation of torsional stiffness and foot alignment. Moreover, the results show that the individual preference regarding both parameters depend on gait situation and individual preference. Hence, measured loads in the structure of the prosthesis and subjective feedback regarding comfort and safety during different turning motions are considered in a user-specific human-machine interaction strategy for a prosthetic shank adaptor. Therefore, the interrelations of gait parameters with optimal configuration are stored in an individual preference-setting matrix. Stiffness and foot alignment are actively adjusted to the optimal parameters by a parallel elastic actuator. Two subjects reported that they experienced appropriate variation of stiffness and foot alignment, a noticeable reduction of load at the stump and that they could turn with less effort.
Muenke, Raychel C.
The purpose of this exploratory study was to analyze the perceptions (through survey data) of Disability Support Services (DSS) personnel regarding the transition process for students with Autism Spectrum Disorder (ASD) from secondary to postsecondary institutions. Participants from 408 postsecondary institutions completed the survey with 60.4%…
... SMALL BUSINESS ADMINISTRATION 13 CFR Parts 121, 124, 125, 126, and 134 RIN 3245-AF65 Small Business, Small Disadvantaged Business, HUBZone, and Service-Disabled Veteran-Owned Protest and Appeal Regulations AGENCY: U.S. Small Business Administration. ACTION: Proposed rule. SUMMARY: The U.S. Small...
Beyer, Stephen; Brown, Tony; Akandi, Rachel; Rapley, Mark
Background: Policy objectives for people with intellectual disabilities include day service modernization and the promotion of paid employment and quality of life. Quality of life is under represented as an outcome measure in vocational research. This research compares subjective and objective quality of life, and quality of work environment for…
Participant direction allows people with intellectual and developmental disabilities (IDD) and/or their families to direct services; in doing so, participant direction shifts participants from passive recipients to active consumers. Medicaid encourages, but does not require, states to allow participant direction. The aim of this study was to…
Brown, Kirsten R.
Students with Autism Spectrum Disorder (ASD) are participating in postsecondary education at an increasing rate. Yet, we know little about what types of accommodations or services disability resource providers employ to support students with ASD. The purpose of this study was to examine how postsecondary institutions are fostering the academic…
Alexander, R. T.; Green, F. N.; O'Mahony, B.; Gunaratna, I. J.; Gangadharan, S. K.; Hoare, S.
Aim: To establish any differences between patients with and without a diagnosis of personality disorders, being treated in a secure inpatient service for offenders with intellectual disability (ID) in the UK. Method: A cohort study involving a selected population of people with ID and offending behaviours. Results: The study included a total of…
Esan, Fola; Chester, Verity; Gunaratna, Ignatius J.; Hoare, Sudeep; Alexander, Regi T.
Background: To describe the characteristics of those with autism spectrum disorder (ASD) treated within a forensic intellectual disability hospital and to compare them with those without ASD. Method: Service evaluation of a cohort of 138 patients treated over a 6-year period. Results: Of the 138, 42 had an ASD. Personality disorders and harmful…
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What definitions are important in... Business Credit and Assistance SMALL BUSINESS ADMINISTRATION GOVERNMENT CONTRACTING PROGRAMS Definitions for the Service-Disabled Veteran-Owned Small Business Concern Program § 125.8 What definitions are...
Luiselli, James K.; St. Amand, CarrieAnne; MaGee, Christine; Sperry, James M.
We describe a training program to teach applied behavior analysis (ABA) knowledge competencies to paraprofessional staff (N = 47) at a habilitation services agency for adults with developmental disabilities. Before and following training, staff completed assessment of knowledge tests for three content areas: basic learning principles,…
Peters-Scheffer, N.C.; Didden, H.C.M.; Mulders, M.; Korzilius, H.P.L.M.
This study evaluated the effectiveness of low intensity behavioral treatment (on average 6.5 h per week) supplementing preschool services in 3-6-year-old children with autism spectrum disorder and severe to mild intellectual disability. Treatment was implemented in preschools (i.e., daycare centers)
McDougall, Janette; Horgan, Karen; Baldwin, Patricia; Tucker, Mary Ann; Frid, Pamela
In 2001, the World Health Organization published the International Classification of Functioning, Disability and Health (ICF). The ICF is just beginning to be used in a variety of clinical and research settings in Canada and worldwide. The purpose of the present article is to describe the initial use of the ICF at an Ontario children's rehabilitation centre, and to consider further uses both within and outside the centre for enhancing services for children and youth with chronic physical health conditions and disabilities, as well as for their families. A description is provided on how the ICF has been used at the centre to guide clinical thinking and practice, and to justify and steer research directions. Plans underway to use the ICF to collect and record functional data at the centre are also described. Finally, recommendations for the use of the ICF to enhance communication among child health professionals across service settings are provided. Used in conjunction with the International Classification of Diseases - Tenth Revision, the ICF's conceptual framework and classification system shows great promise for enhancing the quality of services for children with chronic conditions and their families. This information may assist paediatric specialists, other child health professionals, researchers and administrators to use the ICF in similar settings. It may also stimulate exploration of the use of the ICF for general paediatricians and other service providers in the larger community.
Hamdani, Yani; Proulx, Meghann; Kingsnorth, Shauna; Lindsay, Sally; Maxwell, Joanne; Colantonio, Angela; Macarthur, Colin; Bayley, Mark
LIFEspan is a service delivery model of continuous coordinated care developed and implemented by a cross-organization partnership between a pediatric and an adult rehabilitation hospital. Previous work explored enablers and barriers to establishing the partnership service. This paper examines healthcare professionals' (HCPs') experiences of 'real world' service delivery aimed at supporting transitional rehabilitative care for youth with disabilities. This qualitative study - part of an ongoing mixed method longitudinal study - elicited HCPs' perspectives on their experiences of LIFEspan service delivery through in-depth interviews. Data were categorized into themes of service delivery activities, then interpreted from the lens of a service integration/coordination framework. Five main service delivery themes were identified: 1) addressing youth's transition readiness and capacities; 2) shifting responsibility for healthcare management from parents to youth; 3) determining services based on organizational resources; 4) linking between pediatric and adult rehabilitation services; and, 5) linking with multi-sector services. LIFEspan contributed to service delivery activities that coordinated care for youth and families and integrated inter-hospital services. However, gaps in service integration with primary care, education, social, and community services limited coordinated care to the rehabilitation sector. Recommendations are made to enhance service delivery using a systems/sector-based approach.
...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... appointment of people with mental retardation, severe physical disabilities, and psychiatric disabilities. As... a particular work environment. Persons with disabilities today, however, often have work...
With the passing of disability legislation, more individuals with disabilities are attending postsecondary institutions (Hall & Belch, 2000). Across the postsecondary landscape, Minority Serving Institutions (MSIs) enroll 14% of all students enrolled in postsecondary institutions (Harmon, 2012). As more students with disabilities enroll in…
Barelds, Anna; van de Goor, Ien; van Heck, Guus; Schols, Jos
Care and service trajectories for people with intellectual disabilities (i.e. people with mental retardations) are routes within the healthcare delivery system that consist of all the steps that people with intellectual disabilities and their families have to take in order to realise the needed care and services. This article aims to identify the quality aspects of trajectories that are considered important by people with intellectual disabilities and their parents/relatives. In addition, it examines how these aspects are related to quality determinants mentioned in the literature on integrated care and to authoritative models for quality assessment of care and service delivery. Quality aspects were collected during eight focus group discussions with people with intellectual disabilities or their parents/relatives. In addition, quality determinants of integrated care and authoritative models for quality assessment were selected by means of a thorough review of the literature. Finally, the quality aspects identified using focus groups were compared to the determinants and models found in the literature. The quality aspects presented by people with intellectual disabilities referred particularly to the immediate situation in receiving care and services, such as 'keeping appointments' and 'time and attention', whereas parents/relatives also referred to broader 'organisational issues', such as 'access to support' and 'problems with placement'. The quality aspects, however, are minimally related to the quality determinants of integrated care, probably because clients and their parents/relatives find it difficult to have an overview of the coherence between the various actions that have to be performed, when going through the trajectories. In contrast, the quality aspects seem to fit into the domains of the authoritative models for quality assessment, probably because of the minimal focus of the models on long-term aspects in care and service delivery.
McLaughlin, Dorry; Barr, Owen; McIlfatrick, Sonja; McConkey, Roy
Evidence from European and American studies indicates limited referrals of people with learning (intellectual) disabilities to palliative care services. Although professionals' perceptions of their training needs in this area have been studied, the perceptions of people with learning disabilities and family carers are not known. This study aimed to elicit the views of people with learning disabilities, and their family carers concerning palliative care, to inform healthcare professional education and training. A qualitative, exploratory design was used. A total of 17 people with learning disabilities were recruited to two focus groups which took place within an advocacy network. Additionally, three family carers of someone with a learning disability, requiring palliative care, and two family carers who had been bereaved recently were also interviewed. Combined data identified the perceived learning needs for healthcare professionals. Three subthemes emerged: 'information and preparation', 'provision of care' and 'family-centred care'. This study shows that people with learning disabilities can have conversations about death and dying, and their preferred end-of-life care, but require information that they can understand. They also need to have people around familiar to them and with them. Healthcare professionals require skills and knowledge to effectively provide palliative care for people with learning disabilities and should also work in partnership with their family carers who have expertise from their long-term caring role. These findings have implications for educators and clinicians. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Full Text Available Biometric systems based on uni-modal traits are characterized by noisy sensor data, restricted degrees of freedom, non-universality and are susceptible to spoof attacks. Multi-modal biometric systems seek to alleviate some of these drawbacks by providing multiple evidences of the same identity. In this paper, a user-score-based weighting technique for integrating the iris and signature traits is presented. This user-specific weighting technique has proved to be an efficient and effective fusion scheme which increases the authentication accuracy rate of multi-modal biometric systems. The weights are used to indicate the importance of matching scores output by each biometrics trait. The experimental results show that our biometric system based on the integration of iris and signature traits achieve a false rejection rate (FRR of 0.08% and a false acceptance rate (FAR of 0.01%.
Crockett, Jennifer; Finlayson, Janet; Skelton, Dawn A.; Miller, Gillian
Background: People with intellectual disabilities experience high rates of falls. Balance and gait problems are common in people with intellectual disabilities, increasing the likelihood of falls; thus, tailored exercise interventions to improve gait and balance are recommended. The present authors set up a physiotherapy-led falls pathway service…
Francis, Linda E; Colson, Paul W; Mizzi, Pamela
Involvement of mental health service consumers in the provision of mental health services is a growing model in community mental health. It is, however, a complicated issue, made ever more so by the passage of the Americans with Disabilities Act. In this ethnographic case study, we seek to explore the changes one social services agency has made to adjust to the requirements of the ADA and the impact of these changes on their consumer employees. Our results indicate potential for positive progress as a result of the ADA, but also unexpected pitfalls as organizational cultures change as well.
Olsson, Lena M.; Elgmark Andersson, Elisabeth; Granlund, Mats; Huus, Karina
Background: Children with a mild intellectual disability (ID) and their families often require social services; however, because of the characteristics of the formal service system, these families may be at risk of not receiving necessary services. The aim of this study was to obtain knowledge regarding the types and number of services that…
Ozer, D; Nalbant, S; Aǧlamıș, E; Baran, F; Kaya Samut, P; Aktop, A; Hutzler, Y
This study investigated attitudes towards teaching students with intellectual disability (ID) within a representative sample of secondary school physical education (PE) teachers, and to determine the effects of age, gender, teaching experience, and having acquaintance with ID and students with ID on their attitudes. Participants were 729 secondary school PE teachers who worked in 81 major cities of Turkey. The Teachers Attitudes towards Children with Intellectual Disability Scale was administered. The statistical analysis revealed that there was no significant effect on factors and total attitudes scores of gender and having students with ID. Significant effects on factors and total attitudes score were found in teaching experiences and having acquaintance with ID. It is encouraged to maintain and further develop in-service education programmes of adapted physical activity for PE teachers. © 2012 The Authors. Journal of Intellectual Disability Research © John Wiley & Sons Ltd, MENCAP & IASSID.
Van Dort, Sandra; Coyle, Julia; Wilson, Linda; Ibrahim, Hasherah Mohd
The lead article by Wylie, McAllister, Davidson, and Marshall (2013) puts forward pertinent issues facing the speech-language pathology profession raised by the World Report on Disability. This paper continues the discussion by reporting on a capacity building action research study on the development, implementation, and evaluation of a new approach to early intervention speech-language pathology through clinical education in Malaysia. This research evaluated a student-led service in community-based rehabilitation that supplemented existing and more typical institution-based services. A Malaysian community-based rehabilitation project was chosen due to its emphasis on increasing the equitability and accessibility of services for people with disabilities which was a catalyst for this research. Also, expanding awareness-building, education, and training activities about communication disability was important. The intention was to provide students with experience of working in such settings, and facilitate their development as advocates for broadening the scope of practice of speech-language pathology services in Malaysia. This article focuses on the findings pertaining to the collaborative process and the learning experiences of the adult participants. Through reflection on the positive achievements, as well as some failures, it aims to provide deeper understanding of the use of such a model.
Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV\\/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV\\/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV\\/AIDS interventions. This paper explores the multiple access barriers to HIV\\/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV\\/AIDS and drug use was an important barrier to IDUs accessing HIV\\/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV\\/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV\\/AIDS services in Ukraine and Kyrgyzstan, this does not equate with
Andersen, Helle Elisabeth
Abstract This project is based on five weeks’ ethnographically inspired fieldwork in May 2006 in the Republic of Uganda. The study started out with the hypothesis that there was some kind of discrimination going on in the interaction between health workers at HIV/AIDS clinics, and person with dis......Abstract This project is based on five weeks’ ethnographically inspired fieldwork in May 2006 in the Republic of Uganda. The study started out with the hypothesis that there was some kind of discrimination going on in the interaction between health workers at HIV/AIDS clinics, and person...... with disabilities (PWDs) coming for HIV/AIDS testing or treatment. However, problems with discriminatory attitudes towards PWDs could not be confirmed from my fieldwork observations at five different HIV/AIDS clinics in Uganda. That observation was confirmed in my interviews with PWDs and health workers. Health...... workers said that PWDs were entitled to the same care and treatment as everybody else. However, I observed that only few PWDs seem to attend those HIV/AIDS services, and the question arose why that is so. Problems with access and confidence (for example lack of sign language interpreters) are often...
Full Text Available The paper discusses the potential of assistive service robots to support disabled and elderly people. It shows that they have considerable untapped potential in this area, but also that inappropriate implementations could increase isolation, reduce independence and lead to users feeling as though they are under surveillance. The main body of the paper presents an overview of existing applications and discusses their benefits and potential problems. This is organized by an extension of the common classification into socially and physically assistive robots by the two categories of sensory assistive and mixed assistance robots. Another more detailed classification is also presented. This discussion is introduced by an overview of many of the technological components of smart mobile robots. It is followed by a discussion of user acceptance. The problems of existing models based on either solely positive or solely negative factors are noted and a model containing both types of factors is proposed. The need for continuing research is noted and various proposals are made.
Kennedy, Jae; Wood, Elizabeth Geneva; Frieden, Lex
The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as...
Maddison, Jane; Beresford, Bryony
Satisfaction with service-related choices has not received much research attention, especially beyond medical/health-related decisions. This paper reports findings from an analysis of parents' accounts of making service-related choices with, or on behalf of, a disabled son or daughter with a degenerative condition. It focuses particularly on factors and processes, which contribute to parents' satisfaction. This is particularly interesting given that sub-optimal outcomes or negative consequences are often experienced following a service-related choice being implemented. The data reported here were collected as part of a larger, longitudinal study (the Choice and Change project) of service users' experiences of choice-making, including the outcomes and consequences of those choices. Parents of disabled young people with degenerative conditions formed part of this sample. The accounts of 14 of these parents, collected over three interviews during a two and a half-year period, all of whom expressed satisfaction with the medium- to long-term outcomes of a service-related choice, were selected for specific analyses to understand what underlies satisfaction with service-related choices. Clarity of the desired outcome for the young person supported effective decision-making and led parents to feel confident that the best possible choice was being made. Evidence of desired outcomes being attained were used by parents to 'trade off' the negative consequences of a choice. These included the considerable demands placed on parents' personal, financial and practical resources to operationalise a choice, and the emotional impact incurred by significant changes such as the loss of the carer role. The passage of time was important in allowing evidence of positive outcomes to emerge, psychological or emotional adjustments to be made, and for parents to develop trust in new service providers. The findings suggest that practitioners can have an important role in both practical and
Pimdee, Atipong; Nualnetr, Nomjit
Home health care is an essential service for home-bound patients in Thailand. In this action research study, we used the International Classification of Functioning, Disability and Health (ICF) framework to modify home health care services provided by a university hospital. Staff responsible for delivering the services (physical therapist, nurses, and Thai traditional medicine practitioners) participated in the development of an ICF-based assessment tool and home health care service procedure. After an 8-month trial of implementing these changes, professional satisfaction and empowerment were high among the home health care team members. Patients and their caregivers were also satisfied with the services. In conclusion, the ICF is an effective means of guiding home health care.
Russell, Andrew T.; Hahn, Joan Earle; Hayward, Katharine
The purpose of this study was to describe the medication management and treatment provided in a specialty outpatient psychiatry clinic for 198 community-residing children and adults with intellectual disability and other developmental disabilities (IDD) referred to the clinic and discharged between 1999 and 2008. Using a descriptive design, data…
Beadle-Brown, Julie; Murphy, Bev; Positive Behaviour Support Academy; Mencap
This resource provides an overview of what good support looks like in services for people with learning disabilities and/or autism. The definition of “good” is based on both research and good practice and emphasises the nature and quality of the support needed to ensure good quality of life outcomes for people with learning disabilities and/or autism.
Datta, Poulomee; Talukdar, Joy
This study investigated the influence of the support services on the test anxiety of students and/or their ability to submit assignments in each of the two disability groups, those with vision impairment and those with intellectual disability, who were placed in specialist and mainstream educational settings in South Australia. Interviews were…
Van Riper, Cynthia L; Wallace, Lee Shelly
It is the position of the American Dietetic Association that nutrition services provided by registered dietitians (RDs) and dietetic technicians, registered (DTRs), are essential components of comprehensive care for all people with developmental disabilities and special health care needs. Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community-based, and culturally competent. People with developmental disabilities and special health care needs frequently have nutrition concerns, including growth alterations (failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, medication-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Individuals with special needs are also more likely to develop comorbid conditions such as obesity or endocrine disorders that require nutrition interventions. Poor health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Health maintenance and avoidance of complications can be promoted by timely and cost-effective nutrition interventions. Public policy for individuals with special needs has evolved over time, resulting in a transition from institutional facilities and programs to community living. The expansion of public access to technology and health information on the Internet challenges RDs and DTRs to provide accurate scientific information for those with developmental disabilities and special health care needs. Nationally credentialed RDs and DTRs are best prepared to provide appropriate nutrition information for wellness and quality of life.
Francescutti, Carlo; Frattura, Lucilla; Troiano, Raffaella; Gongolo, Francesco; Martinuzzi, Andrea; Sala, Marina; Meucci, Paolo; Raggi, Alberto; Russo, Emanuela; Buffoni, Mara; Gorini, Giovanna; Conclave, Mario; Petrangeli, Agostino; Solipaca, Alessandro; Leonardi, Matilde
To report on the preliminary results of an Italian project on the implementation of an ICF-based protocol for providing public services and benefits for persons with disabilities. The UN Convention on the Rights of persons with disabilities (UNC) was mapped to the ICF, and core elements were implemented in an ICF-based evaluation protocol. A person-environment interaction classification (PEIC) tree was also developed for defining evaluation outputs. The PEIC and the ICF-based protocol are the guideline and the data interpretation source, respectively, for providing public services and benefits. They enable to assign persons to different services, from surveillance and monitoring to facilitator provision or sustain over time, to barrier removal or to the reorganisation of environmental factors provision. A detailed description of the target intervention is made available through the implementation of a protocol, which points out the effect of personal support and other environmental factors. The detailed description of functioning and disability provided by our methodology can help policy makers and administrators in decision making, on the basis of a description of real needs, and in targeting person-tailored interventions.
Holland, Deirdre M
Medication reconciliation is a basic principle of good medicines management. With the establishment of the National Acute Medicines Programme in Ireland, medication reconciliation has been mandated for all patients at all transitions of care. The clinical pharmacist is widely credited as the healthcare professional that plays the most critical role in the provision of medication reconciliation services.
Alzate, Elvis Siprián Castro; Martínez, Alejandro Castillo
According to the World Health Organization (WHO), the aftermaths of suicide attempts are the sixth leading cause of poor health and disability in the world. Establish the level of disability and related factors in terms of restrictions regarding participation and activity limitations in cases of suicidal attempts attended by the Public Service Network Health of Santiago de Cali, from September 2009 to June 2010. A cross-section, observational study was applied to 126 people between 15 and 65 who had attempted suicide and were treated at the Public Health Service in Santiago de Cali. A Spanish version of the Disability Assessment Scale of the World Health Organization 30 disability-adjusted life years (DALYs) were calculated together with a disability prevalence of 95.3%. 4.6% of the sample did not show disability while 41.27% had mild disability, 38.1%, moderate disability, and 15.87%, severe disability. Factors related with disability were: Age, occupation, presence of mental illness, current depressive symptoms, lethal methods, use of psychiatric drugs, activity limitations, participation restrictions and lack of religious practice. The prevalence of disability in people who have committed suicidal attempts treated at the public health services in Santiago de Cali, was 95.3%. The results are consistent with the study of global burden of disease that establishes a high score for mental disorders in suicidal attempts. The presence of a deficiency after the suicide attempt increases the burden of disability. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Harvey, Carol; Brophy, Lisa; Parsons, Samuel; Moeller-Saxone, Kristen; Grigg, Margaret; Siskind, Dan
People with psychosocial disability are an important, although often neglected, subgroup of those living with severe and persistent mental illness. Rehabilitation, provided through clinical and non-government organisations in Australia, may contribute to their personal recovery goals. We hypothesised that people with psychoses with the greatest disability and complex needs would receive services from both sectors, reflecting treatment and rehabilitation needs. Participants in the 2010 Australian national survey of psychosis (n = 1825) were interviewed to assess demographic, functional, mental and physical health characteristics and service use in the previous year. Two subgroups were created and compared: those using services from community mental health with, and without, non-governmental organisation involvement. Group membership was predicted by hierarchical logistic regression using variables selected on a priori grounds. Usefulness of the final model was examined by calculating improvement over the rate of accuracy achievable by chance alone. The model was statistically significant but fell just short of useful (criterion 71.6%, model achieved 70.6%). Four independent variables contributed uniquely to predicting whether participants received both services (never married, childhood trauma, group accommodation, poor global functioning) consistent with the hypothesis. However, severe dysfunction in socialising was less likely to predict membership of the combined services group when compared with no dysfunction (p = 0.001, odds ratio = 0.384, confidence interval = [0.218, 0.677]), as was current smoking compared with none (p = 0.001, odds ratio = 0.606, confidence interval = [0.445, 0.824]). Findings suggest services provided by non-governmental organisations are targeted to those with the greatest disability although targeting could be improved. A subgroup of people with psychosis and severe disability in community mental health
Maynard, Charles; Trivedi, Ranak; Nelson, Karin; Fihn, Stephan D
The association between disability and cause of death in Veterans with service-connected disabilities has not been studied. The objective of this study was to compare age at death, military service and disability characteristics, including disability rating, and cause of death by year of birth. We also examined cause of death for specific service-connected conditions. This study used information from the VETSNET file, which is a snapshot of selected items from the Veterans Benefits Administration corporate database. We also used the National Death Index (NDI) for Veterans which is part of the VA Suicide Data Repository. In VETSNET, there were 758,324 Veterans who had a service-connected condition and died between the years 2004 and 2014. Using the scrambled social security number to link the two files resulted in 605,493 (80%) deceased Veterans. Age at death, sex, and underlying cause of death were obtained from the NDI for Veterans and military service characteristics and types of disability were acquired from VETSNET. We constructed age categories corresponding to period of service; birth years 1938 and earlier corresponded to Korea and World War II ("oldest"), birth years 1939-1957 to the Vietnam era ("middle"), and birth years 1958 and later to post Vietnam, Gulf War, and the more recent conflicts in Iraq and Afghanistan ("youngest"). Sixty-two percent were in the oldest age category, 34% in the middle group, and 4% in the youngest one. The overall age at death was 75 ± 13 yr. Only 1.6% of decedents were women; among women 25% were in the youngest age group, while among men only 4% were in the youngest group. Most decedents were enlisted personnel, and 60% served in the U.S. Army. Nearly 61% had a disability rating of >50% and for the middle age group 54% had a disability rating of 100%. The most common service-connected conditions were tinnitus, hearing loss, and post-traumatic stress disorder (PTSD). In the oldest group, nearly half of deaths were due to
.... In the Veterans Entrepreneurship and Small Business Development Act of 1999 (P.L. 106-50), Congress stated that too little had been done to help veterans particularly service-disabled veterans, in starting small businesses...
Full Text Available Purpose: This action research aimed at developing an action plan to improve the accessibility to home health care and assistive devices for persons with disabilities in a rural community, and to evaluate changes in the numbers of such persons who received appropriate home health care and assistive devices after a three-month implementation of the action plan.Method: The study was conducted at a sub-district of Maha Sarakham Province, Thailand. The main beneficiaries were 99 persons with disabilities (mean age55.4±18.7 years. Group meetings were organised for persons with disabilities, caregivers, and various community members. An action plan for improving the accessibility of persons with disabilities to home health care and assistive devices was collaboratively formulated and implemented for three months.Results: The main strategy for improving accessibility was to increase the competency of village health volunteers in providing home health care and assistive devices to persons with disabilities. After the three-month action plan implementation, the number of persons with disabilities who received appropriate home health care, i.e. at least once a month, significantly increased from 33.3% to 72.2% (Chi-square test, PConclusions: Under the supervision of physical therapists and/or other allied health professionals, the village health volunteer is likely to be a key person for improving the accessibility to home health care and assistive devices for persons with disabilities in a rural community.Limitations: The study was limited to only one sub-district. No comparable areas were studied. Further, since the study recruited persons with disabilities from a rural community, applicability of the findings to persons with disabilities in an urban community should be considered judiciously.
Michielsen, Adriana J
Inflammatory mediators in the tumour microenvironment promote tumour growth, vascular development and enable evasion of anti-tumour immune responses, by disabling infiltrating dendritic cells. However, the constituents of the tumour microenvironment that directly influence dendritic cell maturation and function are not well characterised. Our aim was to identify tumour-associated inflammatory mediators which influence the function of dendritic cells. Tumour conditioned media obtained from cultured colorectal tumour explant tissue contained high levels of the chemokines CCL2, CXCL1, CXCL5 in addition to VEGF. Pre-treatment of monocyte derived dendritic cells with this tumour conditioned media inhibited the up-regulation of CD86, CD83, CD54 and HLA-DR in response to LPS, enhancing IL-10 while reducing IL-12p70 secretion. We examined if specific individual components of the tumour conditioned media (CCL2, CXCL1, CXCL5) could modulate dendritic cell maturation or cytokine secretion in response to LPS. VEGF was also assessed as it has a suppressive effect on dendritic cell maturation. Pre-treatment of immature dendritic cells with VEGF inhibited LPS induced upregulation of CD80 and CD54, while CXCL1 inhibited HLA-DR. Interestingly, treatment of dendritic cells with CCL2, CXCL1, CXCL5 or VEGF significantly suppressed their ability to secrete IL-12p70 in response to LPS. In addition, dendritic cells treated with a combination of CXCL1 and VEGF secreted less IL-12p70 in response to LPS compared to pre-treatment with either cytokine alone. In conclusion, tumour conditioned media strongly influences dendritic cell maturation and function.
Greenstein, Caroline; Lowell, Anne; Thomas, David Piers
To compare the outcomes of two cycles of continuous quality improvement (CQI) at a paediatric physiotherapy service with findings from interviews with clients and their carers using the service. Case study based at one paediatric physiotherapy service Community-based paediatric allied health service in Northern Australia. Forty-nine clinical records and four staff at physiotherapy service, five Indigenous children with physical disability aged 8-21 years, and nine carers of Indigenous children aged 0-21 years (current or previous clients). The CQI process based on the Audit and Best Practice for Chronic Disease involved a clinical audit; a workshop where clinicians assessed their health care systems, identified weaknesses and strengths, and developed goals and strategies for improvement; and reassessment through a second audit and workshop. Twelve open-ended, in-depth interviews were conducted with previous or current clients selected through purposive and theoretical sampling. CQI and interview results were then compared. Comparison of findings from the two studies Both CQI and interview results highlighted service delivery flexibility and therapists' knowledge, support and advocacy as service strengths, and lack of resources and a child-friendly office environment as weaknesses. However, the CQI results reported better communication and client input into the service than the interview results. The CQI process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients and underlined the importance of including clients in the CQI process. © 2015 National Rural Health Alliance Inc.
Giangreco, Michael F
When speech-language pathologists provide educationally related services for students with lowincidence disabilities who are placed in inclusive classrooms, they are asked to work with a variety of other adults. The ways in which these adults make decisions about individualizing a student's educational program, determine related services, and coordinate their activities have an impact on educational outcomes for students as well as on interprofessional interactions. This article summarizes a team process for making related services decisions called VISTA (Vermont Interdependent Services Team Approach) and a series of nine research studies pertaining to the use and impact of VISTA. It also addresses related topics, such as team size, consumer perspectives, and paraprofessional supports. Five major implications from these studies are offered concerning (a) developing a disposition of being an ongoing learner, (b) developing a shared framework among team members, (c) having a research-based process to build consensus, (d) clarifying roles, and (e) increasing involvement of families and general education teachers.
Nixon, Stephanie A; Cameron, Cathy; Hanass-Hancock, Jill; Simwaba, Phillimon; Solomon, Patricia E; Bond, Virginia A; Menon, Anitha; Richardson, Emma; Stevens, Marianne; Zack, Elisse
Introduction Despite the emerging body of literature on increased vulnerability to HIV among people with disabilities (PWDs), there is a dearth of evidence related to experiences of PWDs who have become HIV-positive. This priority was identified by a disability advocacy organization in Lusaka, Zambia, where the prevalence of HIV and of disability is each approximately 15%. The purpose of this study was to explore perceptions and experiences of HIV-related health services for PWDs who are also living with HIV in Lusaka, Zambia. Methods This qualitative, interpretive study involved in-depth, semi-structured, one-on-one interviews with two groups of participants in Lusaka, Zambia: 21 PWDs who had become HIV-positive, and 11 people working in HIV and/or disability. PWDs had physical, hearing, visual and/or intellectual impairments. Interviews were conducted in English, Nyanja, Bemba or Zambian sign language. Descriptive and thematic analyses were conducted by a multidisciplinary, international research team. Results Participants described their experiences with HIV-related health services in terms of the challenges they faced. In particular, they encountered three main challenges while seeking care and treatment: (1) disability-related discrimination heightened when seeking HIV services, (2) communication barriers and related concerns with confidentiality, and (3) movement and mobility challenges related to seeking care and collecting antiretroviral therapy. These experiences were further shaped by participants’ profound concerns about poverty and unmet basic needs. Discussion This study demonstrates how PWDs who are HIV-positive have the same HIV care, treatment and support needs as able-bodied counterparts, but face avoidable barriers to care. Many challenges mirror concerns identified with HIV prevention, suggesting that efforts to promote inclusion and reduce stigma could have widespread benefits. Conclusions Despite the growing body of literature on increased
Nixon, Stephanie A; Cameron, Cathy; Hanass-Hancock, Jill; Simwaba, Phillimon; Solomon, Patricia E; Bond, Virginia A; Menon, Anitha; Richardson, Emma; Stevens, Marianne; Zack, Elisse
Despite the emerging body of literature on increased vulnerability to HIV among people with disabilities (PWDs), there is a dearth of evidence related to experiences of PWDs who have become HIV-positive. This priority was identified by a disability advocacy organization in Lusaka, Zambia, where the prevalence of HIV and of disability is each approximately 15%. The purpose of this study was to explore perceptions and experiences of HIV-related health services for PWDs who are also living with HIV in Lusaka, Zambia. This qualitative, interpretive study involved in-depth, semi-structured, one-on-one interviews with two groups of participants in Lusaka, Zambia: 21 PWDs who had become HIV-positive, and 11 people working in HIV and/or disability. PWDs had physical, hearing, visual and/or intellectual impairments. Interviews were conducted in English, Nyanja, Bemba or Zambian sign language. Descriptive and thematic analyses were conducted by a multidisciplinary, international research team. Participants described their experiences with HIV-related health services in terms of the challenges they faced. In particular, they encountered three main challenges while seeking care and treatment: (1) disability-related discrimination heightened when seeking HIV services, (2) communication barriers and related concerns with confidentiality, and (3) movement and mobility challenges related to seeking care and collecting antiretroviral therapy. These experiences were further shaped by participants' profound concerns about poverty and unmet basic needs. This study demonstrates how PWDs who are HIV-positive have the same HIV care, treatment and support needs as able-bodied counterparts, but face avoidable barriers to care. Many challenges mirror concerns identified with HIV prevention, suggesting that efforts to promote inclusion and reduce stigma could have widespread benefits. Despite the growing body of literature on increased risk of exposure to HIV among HIV-negative PWDs, this is
Bauer, Sarah E; Schumacher, Jessica R; Hall, Allyson; Marlow, Nicole M; Friedel, Claudia; Scheer, Danielle; Redmon, Susan
Research has not fully characterized barriers to health care faced by persons with disabilities (PWD) which constitutes a critical gap given the increased risk of chronic illness faced by PWD. To understand the current barriers to seeking health care-related services for PWD in Florida. The study was based on a random-digit-dial telephone interview survey of respondents aged 18 and over (n = 1429). Multivariable logistic regression assessed the relationship between disability and physical and communication barriers. One thousand four hundred and twenty-nine Florida residents participated in the survey. Thirty-three percent of respondents (n = 471) reported having a disability. PWD were significantly older (mean age 68 vs. 61) and had lower levels of income and education than persons without disabilities (PWOD) (p barrier (Odds Ratio [OR] = 16.6 95% CI: 7.9, 34.9), a clinical experience barrier (OR = 13.9 95% CI: 6.9, 27.9) a communication and knowledge barrier (OR = 6.7 95% CI: 4.0, 11.3) and a barrier coordinating care (OR = 5.7 95% CI: 3.4, 9.6) compared to persons without disabilities (PWOD). PWD disproportionately face health care access difficulties that can impede the receipt of high quality care within and between provider visits. Efforts to reduce physical barriers and improve communication between providers and PWD may improve functional status and quality of life for these patients. Copyright © 2016 Elsevier Inc. All rights reserved.
The equitable provision of home enteral nutrition (HEN) in the community can have a transformative effect on patient experience and family life for adults and children alike. While optimising quality of life in HEN patients can be challenging, the initiation of HEN positively impacts this measure of healthcare provision.1 Quality of life scores have been shown to improve in the weeks after hospital discharge, and HEN is physically well tolerated. However, it may be associated with psychological distress, and sometimes reluctance among HEN patients to leave their homes.2 Globally, HEN can attenuate cumulative projected patient care costs through a reduction in hospital admission and complications including hospital acquired infections.3 In an era where the cost of disease related malnutrition and associated prolonged hospital stay is being tackled in our healthcare systems, the role of HEN is set to expand. This is a treatment which has clear clinical and social benefits, and may restore some independence to patients and their families. Rather than the indications for HEN being focused on specific diagnoses, the provision of months of quality life at home for patients is adequate justification for its prescription.4 Previously, a review of HEN service provision in 39 cases demonstrated that patients want structured follow-up after hospital discharge, and in particular, would like one point of contact for HEN education and discharge.5 Management structures, funding challenges and the need for further education, particularly within the primary care setting may limit optimal use of HEN. The Irish Society for Clinical Nutrition and Metabolism (IrSPEN) aims to develop a national guideline document, drawing on international best practice, forming a template and standards for local policy development in the area of HEN service provision, training and follow-up. The first step in guideline development was to investigate patient experience for adults and children alike. Care
Harrington, Amanda L; Hirsch, Mark A; Hammond, Flora M; Norton, H James; Bockenek, William L
To determine what percentage of persons with disabilities have a primary care provider, participate in routine screening and health maintenance examinations, and identify perceived physical or physician barriers to receiving care. A total of 344 surveys, consisting of 66 questions, were collected from adults with disabilities receiving care at an outpatient rehabilitation clinic. A total of 89.5% (95% CI 86.3%-92.8%) of participants reported having a primary care physician. Younger persons (P brain injury (P use, and safety with relationships at home ranged from 26.6% to 37.5% compared with screening for depression, diet, exercise, and smoking (64.5%-70%). Completion rates of age- and gender-appropriate health maintenance examinations ranged from 42.4% to 90%. A total of 2.67% of participants reported problems with physical access at their physician's office, and 36.4% (95% CI 30.8%-42.1%) of participants reported having to teach their primary care physician about their disability. Most persons with disabilities have a primary care physician. In general, completion rates for routine screening and health maintenance examinations were high. Perceived deficits in primary care physicians' knowledge of disability issues seem more prevalent than physical barriers to care.
Kleinberg, I; Scior, K
The impact of staff and service user gender on responses of staff in intellectual disability (ID) services is poorly understood. The present study set out to assess the role of gender in influencing staff emotions, attributions and behavioural intentions in response to aggression displayed by adults with ID. A new scale measuring staff behavioural intentions was developed. A two × two (staff gender × service user gender) between subjects design was used to compare the responses of day and residential support staff to physical aggression by a hypothetical service user. In response to a vignette depicting a service user with ID assaulting a member of staff, 160 respondents completed measures of affective responses, causal attributions and behavioural intentions while imagining themselves as the target of the service user's assault. Female participants reported feeling more fear/anxiety, more depression/anger and less confident/relaxed than male participants. The longer staff had worked with people with ID, the more likely they were to favour safety-focused behaviours. More confident female participants were less likely to favour safety-focused behaviours, but confidence had no effect on male participants' endorsement of these behaviours. Increased confidence in both was associated with lower agreement of safety-focused behaviours in relation to the female vignette, regardless of participant gender. The more control women believed the service user had over their behaviour, the more likely they were to choose safety-focused behaviours. Punitive behaviours were favoured more in response to the male rather than the female service user. Punitive behaviours were also favoured more by more junior staff and by participants who expected feeling more depressed/angry in response to the vignettes. Both staff and service user gender influenced staff responses to aggression, yet the latter played a smaller role than expected. The role of gender in staff-service user
Whitford, David L
BACKGROUND: There has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families. METHODS\\/DESIGN: In a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage. DISCUSSION: The main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more
Katz, Gregorio; Márquez-Caraveo, Maria E; Lazcano-Ponce, Eduardo
Intellectual disability is a public health issue, which has largely been overlooked in Mexico. The magnitude of this problem is unknown; few programs exist for adults and mental health professionals focus mainly on identifying treatable comorbidities. In Mexico, there is an example of a best practice in social integration. This program has benefited hundreds of adults with intellectual disability by teaching four basic abilities: practical academic skills; vocational skills; independent living skills; and skills for community integration. In a sociocultural and economic context such as Mexico's, social integration programs are feasible and necessary in order to provide an organized social response to the health, social, and vocational needs of people with intellectual disability and should become part of public policy.
Lin, Sue C; Gold, Robert S
Assistive technology (AT) enhances the ability of individuals with disabilities to be fully engaged in activities at home, at school, and within their communities-especially for children with developmental disabilities (DD) with physical, sensory, learning, and/or communication impairments. The prevalence of children with DD in the United States has risen from 12.84% in 1997 to 15.04% in 2008. Thus, it is important to monitor the status of their AT needs, functional difficulties, services utilization, and coordination. Using data from the 2009-2010 National Survey on Children with Special Health Care Needs (NS-CSHCN), we conducted bivariate and multivariate statistical analysis, which found that 90% or more of parents of both children with DD and other CSHCN reported that their child's AT needs were met for vision, hearing, mobility, communication, and durable medical equipment; furthermore, children with DD had lower odds of AT needs met for vision and hearing and increased odds for meeting AT needs in mobility and communication. Our findings outline the current AT needs of children with DD nationally. Fulfilling these needs has the potential to engender positive lifelong effects on the child's disabilities, sense of independence, self-confidence, and productivity.
Fesko, Sheila Lynch; Hall, Allison Cohen; Quinlan, Jerrilyn; Jockell, Catherine
As individuals with intellectual and developmental disabilities become more engaged in community employment, it will be critical to consider how their employment experience changes as they age. Similar to other seniors, individuals will need to consider whether they want to maintain their employment, reduce their work commitment, or retire…
Mallik, Kalisankar; Yuspeh, Sheldon
A 1-year demonstration project involving 24 developmentally disabled students (9- to 20-years-old) with severe physical limitations was conducted to increase their educational and vocational possibilities by using cost-effective bio-engineering techniques to modify their physical environment and develop improved adaptive devices. Phase I of the…
McMorris, Carly A.; Weiss, Jonathan A.; Cappelletti, Gabriella; Lunsky, Yona
Carers of individuals with an intellectual disability are often responsible for managing their children's psychiatric crises when they arise. The purpose of this study was to examine the experiences of families using crisis and short-term transitional supports from the perspectives of families and of crisis and transitional support staff. Three…
Hatton, Chris; Wigham, Sarah; Craig, Jaime
Background: There is an absence of research concerning the assessment of housing support worker job performance, particularly in the development of job performance measures that reflect the priorities of people with intellectual disabilities and their families. Method: A worker-oriented job analysis method was used to develop four short job…
Miller, Maury; Gresham, Pamela
The search for "markers", or indicators of learning disabilities, has shown that teachers can be good indicators, but literature has not shown which markers or indicators are most noticed or receiving most of teachers' attention. This investigation asked preservice teachers to describe their own first memories of students with learning…
Swift, Charlotte; Waites, Erin; Goodman, Wendy
Background: Domestic violence abuse (DVA) has been identified by the UK Government as a priority to address. Whilst there is a growing body of research into perpetrators of DVA from the mainstream population, there is scant research into perpetrators of DVA who have an intellectual disability. This lack of an evidence base suggests there may be a…
McCarron, Mary; O'Dwyer, Marie; Burke, Eilish; McGlinchey, Eimear; McCallion, Philip
There are limited studies on the prevalence of epilepsy and co-morbid conditions in older adults with an ID. To begin to address this prevalence of epilepsy was estimated for participants in the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing. Associations with demographic variables and co morbid health conditions were…
Merineau-Cote, J.; Morin, D.
Background: Some individuals with intellectual disabilities (IDs) exhibit aggressive behaviour directed towards themselves, others or the environment. Displaying aggressive behaviour is associated with a number of negative consequences such as the exposure to restrictive interventions. This study aims to identify personal and environmental factors…
Hilton, Alan; Gerlach, Kent
Presents a position statement of the Board of Directors of the Division on Mental Retardation and Developmental Disabilities that reviews the employment, preparation, and management of paraeducators. The statement addresses role definition, employment and management, legal and ethical responsibilities, job descriptions, paraeducator training, and…
Ingham, Barry; Riley, Jenny; Nevin, Helen; Evans, Gemma; Gair, Elodie
The emotional responses to challenging behaviour of direct care staff who support people with intellectual disabilities is thought to be an important mediating factor within the stress experienced by staff and a potential maintaining factor in challenging behaviour. A brief workshop to improve direct care staff resilience was developed and…
Yamaki, Kiyoshi; Wing, Coady; Mitchell, Dale; Owen, Randall; Heller, Tamar
States have increasingly transitioned Medicaid enrollees with disabilities from fee-for-service (FFS) to Medicaid Managed Care (MMC), intending to reduce state Medicaid spending and to provide better access to health services. Yet, previous studies on the impact of MMC are limited and findings are inconsistent. We analyzed the impact of MMC on…
Butterly, Felicity; Percy, Carol; Ward, Gillian
The aim of this study was to identify the outcomes expected and assessed by those providing service dogs to children with developmental disabilities. Seventeen registered service dog providers were invited to complete a mixed methods online survey. Five providers, who prepared dogs to work with a wide range of conditions and behaviours, mainly…
Wilhelm, Gretchen Marie
This study examined the perceived value of academic support service types for post-secondary students with learning disabilities in the Christian higher education milieu. Grounded in a model of service utilization (Pescosolido, 1992), the research methodology applied in this study addressed the following research question: What is the perceived…
Lin, Jin-Ding; Hsu, Shang-Wei; Yen, Chia-Feng; Chou, Ying-Ting; Wu, Chia-Ling; Chu, Cordia M.; Loh, Ching-Hui
Aims: The aims of the present study were to explore the perceptions of general practitioners (GPs) in the provision of health care services for people with intellectual disabilities and to analyse GPs' priorities in the delivery of health care services to this group of people in Taiwan. Methods: The study employed a cross-sectional design and was…
Abstract Service providers and service users often have different perspectives on health and social care services. We have undertaken a systematic review of empirical data between 1988 and March 2011 relating to ALS service users\\' perspectives on health and social care services. Forty-seven texts were extracted and a narrative synthesis conducted. Few studies have explored ALS patients\\' experiences in relation to their satisfaction with services. Our review showed that ALS patients expect dignified care but they are often dissatisfied with health care services and have unmet expectations of their care. Most studies of decision-making and preferences for care have focused on end-of-life intervention. Various factors influence preferences for care from the service user perspective and people with ALS may adjust their use of services as they negotiate change. In conclusion, further research on the timeliness of services to meet changing needs of service users is required. The service user experience of allied health care services prior to end-of-life care also warrants investigation. Service providers need to support people with ALS as they negotiate feelings of acceptance and independence. Research to identify the key parameters of the ALS patient experience of services is required.
Veitch, Craig; Dew, Angela; Bulkeley, Kim; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Griffiths, Scott
The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues. Five broad themes resonated across participants' roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to
Eklund, Mona; Eklund, Lisa
Day centres can prepare for open-market employment, and attendees' work motivation is key in this. Adopting a gender perspective, this study investigated (1) motivation for day centre attendance, satisfaction with the day centre services, number of hours spent there, and number and type of occupations performed; and (2) whether those factors were related with motivation for open-market employment. Women (n = 164) and men (n = 160) with psychiatric disabilities completed self-report questionnaires. There were no gender differences regarding satisfaction with the day centre services or number of hours spent there, but women engaged in more occupations. More women than men performed externally-oriented services and textile work, while men were in the majority in workshops. Externally oriented services, working in workshops, and low satisfaction with the day centre services were associated with higher motivation for employment. Women and men were equally motivated for employment. Women scored higher on motivation for attending the day centre, something that may deter transition into open-market employment. For men, less motivation for attending day centres may reduce their possibilities of gaining skills that can facilitate transitioning to open-market employment. Thus, the possibility for transitioning from day centre activities to open-market employment may be gendered.
Tomasone, Jennifer R; Arbour-Nicitopoulos, Kelly P; Pila, Eva; Lamontagne, Marie-Eve; Cummings, Isabelle; Latimer-Cheung, Amy E; Routhier, François
In Canada, two counseling services are offered to facilitate physical activity participation among persons with physical disabilities, yet both have encountered concerns related to the recruitment and retainment of clients. The purpose of this paper is to explore factors related to service adoption among nonusers, and the barriers and facilitators to maintaining service participation among adopters. Individuals who had never enrolled in the services (nonusers, n = 13) as well as current/previous service clients (adopters, n = 26) participated in interviews based on the Theoretical Domains Framework. Transcripts were subjected to deductive thematic analysis according to participant group. Fifteen themes relating to service adoption within 10 of the 12 theoretical domains were identified for nonusers, while 23 themes relating to maintenence of service participation were identified across all 12 theoretical domains for adopters. The findings provide strategies to improve recruitment, adoption, and retention of clients in counseling services and to enhance the experiences of targeted service users. Implications for Rehabiliation Peer support and education for equipment use should be built into physical activity programs to encourage participation among persons with physical disabilities. Programs that encourage physical activity among individuals with disabilities should be designed by practitioners to be responsive to a variety of needs, which are addressed in the program's advertisements and offerings. The Theoretical Domains Framework is a useful framework for providing valuable insight about clients' experiences of adoption and maintenance of a behavior change service, suggesting merit in other rehabilitation settings.
Evaluation System (DES) process follows guidelines laid out by the Department of Defense (DoD) and public law. Disability evaluation is administered... osteoarthritis ) 13,738 12.2 Posttraumatic stress disorder 3,880 13.4 Musculoskeletal analogous code (5099) 13,160 11.7 Degenerative arthritis of the...spine 2,352 8.1 Musculoskeletal analogous code (5299) 7,794 6.9 Arthritis, degenerative (hypertrophic or osteoarthritis ) 1,814 6.3 Posttraumatic
... there is a need for special education and related services for a child, as early as the child's third... special education and these related services: (1) Audiology services, including identification of children... supervised students in such fields as child development, special education, child psychology, various...
Malik, Kulsoom Jawaid; Unwin, Gemma; Larkin, Michael; Kroese, Biza Stenfert; Rose, John
Carers and service users with intellectual disabilities from minority ethnic groups have typically been reported to be dissatisfied with the social care services they receive. However, service users themselves have rarely been asked directly about their experiences of social care. This paper aims to understand the meaning of social care services in the lives of South Asian women with intellectual disabilities, in the United Kingdom. 10 British South Asian women with mild-moderate intellectual disabilities were interviewed about their experiences of social care services. The transcripts were analysed using interpretative phenomenological analysis. The analysis produced three super-ordinate themes, which focus on how services facilitate the development of complex identities, how the participants explored their sense of being 'stuck' between cultures as they negotiated their journeys towards independence, and the triple disadvantage which they experienced as a consequence of the intersection between gender, ethnicity and disability. The participants were broadly satisfied with the role which services played in these domains, and appeared to find them valuable and helpful. The results suggest that the participants successfully managed complex identity issues, such as acculturation processes, with the support of services. It may be helpful to give more explicit consideration to the positive role which good services can play in supporting people with intellectual disabilities in the development of their identities and goals, alongside the more traditionally 'concrete' objectives of such social care. Engagement with families in 'positive risk-taking' is likely to be an important component of success. Copyright © 2017 Elsevier Ltd. All rights reserved.
Reppermund, Simone; Srasuebkul, Preeyaporn; Heintze, Theresa; Reeve, Rebecca; Dean, Kimberlie; Emerson, Eric; Coyne, David; Snoyman, Phillip; Baldry, Eileen; Dowse, Leanne; Szanto, Tracey; Sara, Grant; Florio, Tony; Trollor, Julian N
People with intellectual disability are a minority group who experience poorer physical and mental health than the general population and have difficulty accessing healthcare services. There is lack of knowledge about healthcare service needs and gaps experienced by people with intellectual disability. This study aims to interrogate a large linked administrative data set containing hospital admissions, presentations to emergency departments (ED) and mortality data to provide evidence to inform the development of improved health and mental health services for this population. A retrospective cohort of people with intellectual disability (n=51 452) from New South Wales (NSW), Australia, to explore health and mental health profiles, mortality, pattern of health service use and associated costs between 2005 and 2013. The cohort is drawn from: the Disability Services Minimum Data Set; Admitted Patients Data Collection; Emergency Department Data Collection, Australian Bureau of Statistics Death Registry and Registry of Births, Deaths and Marriages. Mental health service usage among those with intellectual disability will be compared to a cohort of people who used mental health services (n=1 073 139) and service usage other than for mental health will be compared with published data from the general population. The median age of the cohort was 24 at the time of the last hospital admission and 21 at the last ED presentation. The cohort has a higher proportion of men than women and accounts for 0.6% of the NSW population in 2011. Over 70% had up to 5 ED presentations and hospitalisations between 2005 and 2012. A high proportion of people with intellectual disability live in the most disadvantaged neighbourhoods. Results will be used to inform the development of more responsive healthcare, including improved interactions between health, social and disability supports. More generally, the results will assist the development of more inclusive policy frameworks for people
Tailoring the delivery of disability services to the preferences and requirements of service users allows for more effective partnerships. The aim of this research was to explore parents' perceptions and the expectations of their child's speech-language pathology (SLP) within an intellectual disability service. Parents of school-aged children with intellectual disability who received a SLP service in Ireland participated in the research: 17 parents participated in focus groups and 103 parents answered questionnaires. The core themes from the focus groups, which subsequently informed the questionnaire design, were: experience of the SLP service, communication difficulties, expectations of the SLP service, and future developments. The key questionnaire results indicated that parents viewed their SLP as the "expert" and viewed school-based and clinic-based services differently. Parents were more likely to believe that their child would always need therapy if they received a school-based service. Whereas, parents were more likely to think that their child's speech was improving as they got older and were more likely to be aware of therapy activities if therapy was clinic-based. The findings have implications for the delivery of SLP services suggesting that clarification of parents' roles and expectations are required.
Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire
This cross-sectional study examined perceived access to services, quality of care, and family impact reported by caregivers of children aged 3-17 years with autism spectrum disorders, as compared to caregivers of children with other developmental disabilities and other mental health conditions. The 2009-2010 National Survey of Children with Special Health Care Needs was utilized to examine the association between child's special needs condition and three outcomes (N = 18,136): access to services (difficulty using services, difficulty getting referrals, lack of source of care, and inadequate insurance coverage), quality of care (lack of care coordination, lack of shared decision making, and no routine screening), and family impact (financial, employment, and time-related burden). Multivariate logistic regressions were performed to compare caregivers of children with autism spectrum disorders to caregivers of children with developmental disabilities (cerebral palsy, Down syndrome, developmental delay, or intellectual disability), mental health conditions (attention deficit hyperactivity disorder, anxiety, behavioral/conduct problems, or depression), or both developmental disabilities and mental health conditions. Caregivers of children with autism spectrum disorders were significantly more likely to report difficulty using services, lack of source of care, inadequate insurance coverage, lack of shared decision making and care coordination, and adverse family impact as compared to caregivers of children with developmental disabilities, mental health conditions, or both. © The Author(s) 2013.
McCarthy, Michael J
As a component of a training development project for intercity air travel providers, we investigated the capacity of the airline industry to meet the needs of travelers with disabilities by exploring: (1) the level of sensitivity among personnel to travelers' needs, (2) training currently provided, (3) areas in which additional training might be beneficial, and (4) organisational/systems-level commitment to dignified assistance to all travelers. Forty-four airline/vendor employees participated in nine focus groups in four US cities. Groups were audio recorded and transcribed. A grounded-theory approach was used to develop a coding system which was then applied to transcripts to identify themes. Factors influencing capacity grouped broadly into four areas: characteristics of the job/system, characteristics of current training, characteristics of providers themselves, and characteristics of travelers. At an interpersonal level, providers were empathetic and desired to provide dignified services. They lacked training and adequate equipment in some cases, however, and organisational commitment varied between companies. Traveler characteristics were also shown to impact service delivery. Results are promising but additional regulatory and organisational policies are needed to ensure quality services. Providers and consumers of intercity air travel services may benefit from the findings and recommendations of this study.
Full Text Available Question: What are the experiences of Indigenous children with physical disability and their carers of their community-based physiotherapy service? What factors influence their experiences of the physiotherapy service and how could the service be improved? Design: A qualitative study using in-depth, semi-structured open-ended interviews consistent with the researchers’ interpretivist perspectives and ethical principles of Indigenous health research. Interviews were audio recorded, transcribed and coded for themes with qualitative research software using inductive analysis. The interviews were then checked for transcription accuracy and the themes were confirmed with the participants. Participants: Nine parents and foster carers of children with physical disability aged 0 to 21 years, five children and youth with physical disability aged 8 to 21 years. Results: The data generated three themes, which informed practice recommendations: carers of children with physical disability experience increased demands and complexity in their lives; relationships involving caring, consistency and communication are important to consumers using the physiotherapy service; and being Indigenous influences consumers’ experiences in ways that may not be obvious to non-Indigenous service providers. The issue of communication underpinned the participants’ experiences throughout these themes. Conclusion: The research highlighted the importance of effective communication, developing relationships, viewing the child wholistically and recognising the influence of being Indigenous on clients’ healthcare needs and experiences. The results suggested that community-based physiotherapists adopt a family/person-centred, context-specific approach when working with Indigenous children with a physical disability and their carers. [Greenstein C, Lowell A, Thomas D (2016 Communication and context are important to Indigenous children with physical disability and their carers
Services are becoming a key focus in the current era. Organizations globally are facing rapid changes in providing services. Despite this alarming growth, the advancement in Information and Communications Technology (ICT) has created so many opportunities but considerable challenges for the service industry. Information and Communication Technologies (ICT) have become part of everyday life in recent years. ICT can provide dignity and well-being to people through self-facilitation. ICT lik...
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Hirpara, Kieran Michael
Cervical spondylosis is a common and disabling condition. It is generally felt that the initial management should be nonoperative, and these modalities include physiotherapy, analgesia and selective nerve root injections. Surgery should be reserved for moderate to severe myelopathy patients who have failed a period of conservative treatment and patients whose symptoms are not adequately controlled by nonoperative means. A review of the literature supporting various modalities of conservative management is presented, and it is concluded that although effective, nonoperative treatment is labour intensive, requiring regular review and careful selection of medications and physical therapy on a case by case basis.
Smith, Madison; Wilder, David A
The Performance Diagnostic Checklist-Human Services (PDC-HS) is an informant-based tool designed to identify the variables responsible for performance problems. To date, the PDC-HS has not been examined with individuals with intellectual disabilities. In the current study, two supervisors with intellectual disabilities completed the PDC-HS to assess the productivity of two supervisees with disabilities who performed a pricing task in a thrift store. The PDC-HS suggested that performance deficits were due to a lack of training; a PDC-HS-indicated intervention was effective to increase accurate pricing. • The PDC-HS is an informant-based tool designed to identify the variables responsible for employee performance problems in human service settings. • The PDC-HS can be completed by some individuals with intellectual disabilities in a supervisory position to identify the variables responsible for problematic job performance among their supervisees. • A PDC-HS indicated intervention was demonstrated to be effective to improve the job performance of individuals with disabilities. • The PDC-HS may be a useful tool to support performance improvement and job maintenance among individuals with intellectual disabilities.
... EDUCATION VOCATIONAL REHABILITATION SERVICE PROJECTS What Conditions Must Be Met by a Grantee? § 369.42 What... rehabilitation services provided in projects assisted under these programs must be provided in the same manner as... under its project, or as appropriate, the parents, family members, guardians, advocates, or authorized...
Noblet, Andrew; Graffam, Joseph; McWilliams, John
This study examined the role of working conditions in predicting the psychological health, job satisfaction and organisational commitment of personnel responsible for helping people with disabilities gain employment in the mainstream Australian labour market. The working conditions were assessed using two theories: the Job Strain Model (job demand, social support and job control) and Psychological Contract Theory (unwritten reciprocal obligations between employers and employees). In the case of the Job Strain Model, the generic dimensions had been augmented by industry-specific sources of stress. A cross-sectional survey was undertaken in June and July 2005 with 514 staff returning completed questionnaires (representing a response rate of 30%). Comparisons between respondents and non-respondents revealed that on the basis of age, gender and tenure, the sample was broadly representative of employees working in the Australian disability employment sector at that time. The results of regression analyses indicate that social support was predictive of all of the outcome measures. Job control and the honouring of psychological contracts were both predictive of job satisfaction and commitment, while the more situation-specific stressors--treatment and workload stressors--were inversely related to psychological health (i.e. as concern regarding the treatment and workload stressors increased, psychological health decreased). Collectively, these findings suggest that strategies aimed at combating the negative effects of large-scale organisational change could be enhanced by addressing several variables represented in the models--particularly social support, job control, psychological contracts and sector-specific stressors.
Oliver, P C; Piachaud, J; Done, J; Regan, A; Cooray, S; Tyrer, P
In an era of evidence-based medicine, practice is constantly monitored for quality in accordance with the needs of clinical governance (Oyebode et al. 1999). This is likely to lead to a dramatic change in the treatment of those with intellectual disability (ID), in which evidence for effective intervention is limited for much that happens in ordinary practice. As Fraser (2000, p. 10) has commented, the word that best explains "the transformation of learning disability practice in the past 30 years is 'enlightenment'." This is not enough to satisfy the demands of evidence, and Fraser exhorted us to embrace more research-based practice in a subject that has previously escaped randomized controlled trials (RCTs) of treatment because of ethical concerns over capacity and consent, which constitute a denial of opportunity which "is now at last regarded as disenfranchising". The present paper describes the difficulties encountered in setting up a RCT of a common intervention, i.e. assertive community treatment, and concludes that a fundamental change in attitudes to health service research in ID is needed if proper evaluation is to prosper.
Ruiz, Sarah; Urdapilleta, Oswaldo; Clark-Shirley, Leanne J; Howard, Jennifer; Poey, Judith
This article explores how rebalancing efforts can support the needs of individuals aging with a lifelong disability. The National Balancing Indicator project examined the overall long-term supports and services system (LTSS) progress in five indicators within the Sustainability, Coordination and Transparency, and Prevention principles toward a balanced LTSS system for those aging with a lifelong disability. In assessing state efforts to create a balanced participant-directed LTSS system with the National Balancing Indicators, the findings suggest states are better equipping the system to handle a burgeoning population of individuals aging with a lifelong disability, but more progress is still needed. Overall, states need to continue to create a seamless system that allows individuals with lifelong disabilities to transition smoothly through the life course.
Malcolm, Matthew P; Roll, Marla C
The outcomes of assistive technology (AT) support services for post-secondary education students with disabilities are under-reported, and little is known about use-profiles and user experiences when AT interventions are applied to this rapidly growing population. We examined AT service outcomes related to performance and satisfaction of common academic tasks (using the Canadian Occupational Performance Measure [COPM]), as well as how students with disabilities use and experience AT and AT services (employing an AT-use survey). Three-hundred fifty-three students with disabilities completed the AT-use survey, with a subset of these (n = 216) also participating with pre-post AT intervention COPM assessment. COPM performance and satisfaction ratings significantly increased from pre- to post-AT intervention in all academic task categories (reading, writing, note-taking, test-taking, and studying; p impacted their academic success, and believed they would continue using AT post-graduation. The study findings contribute to evidence-base for AT services with a hope we may improve AT services to best meet the changing needs of the growing number of college students with disabilities.
Full Text Available Abstract Background The PRISMA Model is an innovative coordination-type integrated-service-delivery (ISD network designed to manage and better match resources to the complex and evolving needs of elders. The goal of this study was to examine the impact of this ISD network on unmet needs among disabled older persons living in the community. Methods Using data from the PRISMA study, we compared unmet needs of elders living in the community in areas with or without an ISD network. Disabilities and unmet needs were assessed with the Functional Autonomy Measurement System (SMAF. We used growth-curve analysis to examine changes in unmet needs over time and the variables associated with initial status and change. Sociodemographic characteristics, level of disability, self-perceived health status, cognitive functioning, level of empowerment, and the hours of care received were investigated as covariates. Lastly, we report the prevalence of needs and unmet needs for 29 activities in both areas at the end of the study. Results On average, participants were 83 years old; 62% were women. They had a moderate level of disability and mild cognitive problems. On average, they received 2.07 hours/day (SD = 1.08 of disability-related care, mostly provided by family. The findings from growth-curve analysis suggest that elders living in the area where ISD was implemented and those with higher levels of disability experience better fulfillment of their needs over time. Besides the area, being a woman, living alone, having a higher level of disability, more cognitive impairments, and a lower level of empowerment were linked to initial unmet needs (r2 = 0.25; p Conclusions In spite of more than 30 years of home-care services in the province of Quebec, disabled older adults living in the community still have unmet needs. ISD networks such as the PRISMA Model, however, appear to offer an effective response to the long-term-care needs of the elderly.
Prabhu, Neeta T
The goal of this study was to elicit the views of patients or parents\\/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients\\/parents\\/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent\\/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.
This study explored registered psychiatric nurses\\' (RPNs\\') interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD). A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the "staff-patient interaction response scale" (SPIRS). Four themes emerged following data analysis: "challenging and difficult," "manipulative, destructive and threatening behaviour," "preying on the vulnerable resulting in splitting staff and other service users," and "boundaries and structure." Additionally, low levels of empathy were evident in the majority of participants\\' responses to the SPIRS. The findings provide further insight on nurses\\' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.
Diabetes is an increasingly prevalent chronic illness that places a huge burden on the individual, the health system and society. Patients with active foot disease and lower limb amputations due to diabetes have a significant amount of interaction with the health care services. The purpose of this study was to explore the attitudes and experiences of foot care services in Ireland among people with diabetes and active foot disease or lower limb amputations.
Beadle-Brown, J; Mansell, J; Ashman, B; Ockenden, J; Iles, R; Whelton, B
We hypothesised that a key factor determining the quality of active support was 'practice leadership' - provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support. Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons. There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support. A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
... inclusion of individuals with disabilities on the teams that develop the cloud and Web technologies... Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects... Rehabilitative Services announces a priority under the Disability Rehabilitation Research Projects and Centers...
Full Text Available Emerging green-energy transportation, such as hybrid electric vehicles (HEVs and plug-in HEVs (PHEVs, has a great potential for reduction of fuel consumption and greenhouse emissions. The lithium-ion battery system used in these vehicles, however, is bulky, expensive and unreliable, and has been the primary roadblock for transportation electrification. Meanwhile, few studies have considered user-specific driving behavior and its significant impact on (PHEV fuel efficiency, battery system lifetime, and the environment. This paper presents a detailed investigation of battery system modeling and real-world user-specific driving behavior analysis for emerging electric-drive vehicles. The proposed model is fast to compute and accurate for analyzing battery system run-time and long-term cycle life with a focus on temperature dependent battery system capacity fading and variation. The proposed solution is validated against physical measurement using real-world user driving studies, and has been adopted to facilitate battery system design and optimization. Using the collected real-world hybrid vehicle and run-time driving data, we have also conducted detailed analytical studies of users’ specific driving patterns and their impacts on hybrid vehicle electric energy and fuel efficiency. This work provides a solid foundation for future energy control with emerging electric-drive applications.
Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire
This cross-sectional study examined perceived access to services, quality of care, and family impact reported by caregivers of children aged 3-17 years with autism spectrum disorders, as compared to caregivers of children with other developmental disabilities and other mental health conditions. The 2009-2010 National Survey of Children with…
Shooshtari, Shahin; Brownell, Marni; Mills, Rosemary S. L.; Dik, Natalia; Yu, Dickie C. T.; Chateau, Dan; Burchill, Charles A.; Wetzel, Monika
Background: Little information exists on health of children with developmental disabilities (DDs) in the Canadian province of Manitoba. Method: The present authors linked 12 years of administrative data and compared health status, changes in health and access to health and social services between children with (n = 1877) and without (n = 5661) DDs…
Strnadová, Iva; Bernoldová, Jana; Adamcíková, Zdenka; Klusácek, Jan
Background: This study examined the attitudes, knowledge and experiences of practitioners in social services and child welfare working with mothers with intellectual disability. Method: The authors used a national survey, which was completed by 329 participants. Descriptive statistics and frequency tables were generated, and the associations…
Smith, Penny; Ooms, Ann; Marks-Maran, Di
A teaching session about service users' experiences of accessing and receiving health and social care was designed and delivered by service users to first year BSc Nursing students. The aim was to enhance students' knowledge, skills and confidence in caring for people with a learning disability. An evaluation research study was undertaking at one university in London into the perceived effectiveness of the teaching session, including students' perceptions of the extent to which the service users' teaching session was useful, the impact of the session, its benefits and challenges and the sustainability of teaching sessions delivered by service users. Data were collected through an online questionnaire. Quantitative analysis was undertaken of Likert-style questions and qualitative analysis was undertaken using the Framework Method. The session impacted on students' knowledge and understanding of people with a learning disability. Students reported that they felt more comfortable and confident interacting with people with a learning disability. In addition, they reflected on their feelings about caring for people with a learning disability. Copyright © 2015 Elsevier Ltd. All rights reserved.
Gyimah, Emmanuel Kofi; Amoako, R.
The study aimed at exploring the perceptions tutors in Colleges of Education have on how the Colleges of Education Curriculum adequately prepare pre-service teachers to enable them to identify and assess children with special educational needs and disabilities for effective inclusive education in Ghana. A descriptive survey design was adopted and…
Hempe, Eva-Maria; Morrison, Cecily; Holland, Anthony
There are arguments that a specialist service for adults with intellectual disabilities is needed to address the health inequalities that this group experiences. The boundary of such a specialist service however is unclear, and definition is difficult, given the varying experiences of the multiple stakeholder groups. The study reported here quantitatively investigates divergence in stakeholders' views of what constitutes a good specialist service for people with intellectual disabilities. It is the first step of a larger project that aims to investigate the purpose, function and design of such a specialist service. The results are intended to support policy and service development. A Delphi study was carried out to elicit the requirements of this new specialist service from stakeholder groups. It consisted of three panels (carers, frontline health professionals, researchers and policymakers) and had three rounds. The quantification of stakeholder participation covers the number of unique ideas per panel, the value of these ideas as determined by the other panels and the level of agreement within and between panels. There is some overlap of ideas about of what should constitute this specialist service, but both carers and frontline health professionals contributed unique ideas. Many of these were valued by the researchers and policymakers. Interestingly, carers generated more ideas regarding how to deliver services than what services to deliver. Regarding whether ideas are considered appropriate, the variation both within and between groups is small. On the other hand, the feasibility of solutions is much more contested, with large variations among carers. This study provides a quantified representation of the diversity of ideas among stakeholder groups regarding where the boundary of a specialist service for adults with learning disabilities should sit. The results can be used as a starting point for the design process. The study also offers one way to measure the
Food allergies are common in preschool children. This study’s aims are to establish prevalence, to clarify management practices, levels of preparedness and the perceived role of General Practitioners amongst Early Years Services providers. This study is an anonymous, quantitative, cross sectional study. An online questionnaire was distributed to 282 Early Years Service providers. Data were analysed using SPSS. Response rate was 35% (n=98). Prevalence of food allergy was 3% (n=119). Allergic reactions to food had occurred on site in 16% (n=15). Written emergency action plans were available in 47% of facilities (n=46). Medications were not kept on site in 63% (n=62) of facilities. General practitioners were felt to have an important role in the management of food allergies by 76% of respondents (n=61). This study identifies significant areas for improvement in the management of food allergic child in Early Years Services
To inform the strategic and operational development of a community based service model at the Crann Centre, Cork, Ireland for SB children, adults, their families and providers. A needs assessment was conducted by gathering the views of multiple stakeholder perspectives within the SB community in the geographical region the Centre will serve. The intention is to create project deliverables that are responsive to the needs highlighted through this research. The study used a multi method design with a participatory research approach to explore the needs of SB individuals, families and providers. This involved in depth interviews, focus groups and online surveys. One hundred and fifty-nine respondents contributed to this qualitative needs assessment. The research established a range of psychosocial, clinical, vocational and educational issues causing ongoing difficulties for SB individuals and families. Providers highlighted supports that would benefit the social and clinical wellbeing of persons with SB. Collectively participants in the study reported that there was an absence of coordinated, continuous and comprehensive service delivery for the SB community in the region. This was amplified by geographical location of services and access to relevant supports. Consensus across stakeholders in this research pointed to the necessity for an innovative model of community based provision at the Crann Centre. This was described as offering a service with family at the core of an assets based model of practice. A key finding was the lack of importance placed on the social and emotional development of SB individuals. Traditionally participants described a singular focus on physical health through clinically defined treatment models. The desire for a social model of disability that informed health and wellbeing of SB individuals and families emerged as a prominent recommendation from the research.
This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\
Recent policy and service provision recommends a woman-centred approach to maternity care. Midwife-led models of care are seen as one important strategy for enhancing women\\'s choice; a core element of woman-centred care. In the Republic of Ireland, an obstetric consultant-led, midwife-managed service model currently predominates and there is limited exploration of the concept of women centred care from the perspectives of those directly involved; that is, women, midwives, general practitioners and obstetricians. This study considers women\\'s and clinicians\\' views, experiences and perspectives of woman-centred maternity care in Ireland.
Kennedy, Jae; Wood, Elizabeth Geneva; Frieden, Lex
The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as their previously limited insurance options. However, most published research on this population does not systematically look at effects before and after full implementation of the ACA. As the US Congress considers new health policy reforms, current and accurate data on this vulnerable population are essential. Weighted estimates, trend analyses and analytic models were conducted using the 1998-2016 National Health Interview Surveys (NHIS) and the 2014 Medical Expenditure Panel Survey. Compared with working-age adults without disabilities, those with disabilities are less likely to work, more likely to earn below the federal poverty level, and more likely to use public insurance. Average health costs for this population are 3 to 7 times higher, and access problems are far more common. Repeal of key features of the ACA, like Medicaid expansion and marketplace subsidies, would likely diminish health care access for working-age adults with disabilities.
Fellin, Melissa; Desmarais, Chantal; Lindsay, Sally
Although collaborative, culturally competent care has been shown to increase positive health outcomes and client satisfaction with services, little is known about the ways that clinicians implement service delivery models with immigrant families having a child with a disability. The purpose of this study is to examine the experiences of clinicians working with immigrant families raising a child with a physical disability and to examine the views and experiences of clinicians providing collaborative, culturally competent care to immigrant families raising a child with a physical disability. This study draws on in-depth interviews with 43 clinicians within two pediatric centers in Toronto and Quebec. Our findings show that clinicians remove or create barriers for immigrant families in different ways, which affect their ability to provide culturally competent care for immigrant families raising a child with a physical disability. Our findings suggest that there is a need for more institutional support for collaborative, culturally competent care to immigrant families raising a child with a physical disability. There is a lack of formal processes in place to develop collaborative treatment plans and approaches that would benefit immigrant families. Implications for Rehabilitation Clinicians need greater institutional support and resources to spend more time with families and to provide more rehabilitative care in families' homes. Building rapport with families includes listening to and respecting families' views and experiences. Facilitate collaboration and culturally competent care by having team meetings with parents to formulate treatment plans.
Mérida R. Rodríguez
Full Text Available Objective: this study’s goal was to determine the most prevalent mental disorders and the impact on the perception of disability and suicidal ideation among the population from a primary health care center in the city of Cali. Methodology: a cross sectional study was conducted on 254 patients who were screened with the prime-md instrument. Descriptive statistics was used in the analysis to determine the most frequent disorders. Similarly, a multiple analysis with logistic and Poisson regressions using robust variance was conducted to determine the influence of mental disorders on disability and suicidal ideation. Results: most patients were female, young, and mature adults. Depression was present in 66.8% of all cases, followed by somatization disorder and anxiety. Half of the patients had had suicidal ideations at some point in their lives, and three out of four patients claimed to suffer from some kind of disability. Upon adjusting for the covariables, depression and anxiety disorders had a strong association with suicidal ideation and perceived disability that was overestimated by the logistic regression. Conclusion: depression and anxiety were the most common disorders and showed a strong association with suicidal ideation and disability. This is why it is necessary to screen for those disorders among adults using primary health care services. Likewise, we suggest considering Poisson regression with robust variance in cross-sectional studies in health services.
Greenstein, Caroline; Lowell, Anne; Thomas, David
What are the experiences of Indigenous children with physical disability and their carers of their community-based physiotherapy service? What factors influence their experiences of the physiotherapy service and how could the service be improved? A qualitative study using in-depth, semi-structured open-ended interviews consistent with the researchers' interpretivist perspectives and ethical principles of Indigenous health research. Interviews were audio recorded, transcribed and coded for themes with qualitative research software using inductive analysis. The interviews were then checked for transcription accuracy and the themes were confirmed with the participants. Nine parents and foster carers of children with physical disability aged 0 to 21 years, five children and youth with physical disability aged 8 to 21 years. The data generated three themes, which informed practice recommendations: carers of children with physical disability experience increased demands and complexity in their lives; relationships involving caring, consistency and communication are important to consumers using the physiotherapy service; and being Indigenous influences consumers' experiences in ways that may not be obvious to non-Indigenous service providers. The issue of communication underpinned the participants' experiences throughout these themes. The research highlighted the importance of effective communication, developing relationships, viewing the child wholistically and recognising the influence of being Indigenous on clients' healthcare needs and experiences. The results suggested that community-based physiotherapists adopt a family/person-centred, context-specific approach when working with Indigenous children with a physical disability and their carers. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.
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Yoon, Hee-Yoon; Kim, Sin-Young
One of the most important issues for world libraries at the present time is to extend copyright limitations and exceptions for reproduction, for library preservation and distribution services including lending and ILL/DDS, the printout and transmission of Internet information resources, copying of library materials which are rarely available…
Young, John; Morgan, Robert L.; Callow-Heusser, Catherine A.; Lindstrom, Lauren
This study examined effects of two parent-training approaches to increase knowledge of transition resources by (a) giving parents a brochure describing local transition services or (b) providing the same brochure plus 60 min of small-group training. We randomly assigned parents to groups who completed pre- and posttests on knowledge of transition…
Background: Supported decision-making and personal budgets for services are the new paradigms. Method: Supported decision-making proposals from the Australian State of Victoria are analysed against international trends to determine the viability of laws reflecting new international norms of the United Nations Convention on the Rights of Persons…
Tuffrey-Wijne, Irene; Goulding, Lucy; Giatras, Nikoletta; Abraham, Elisabeth; Gillard, Steve; White, Sarah; Edwards, Christine; Hollins, Sheila
To identify the factors that promote and compromise the implementation of reasonably adjusted healthcare services for patients with intellectual disabilities in acute National Health Service (NHS) hospitals. A mixed-methods study involving interviews, questionnaires and participant observation (July 2011-March 2013). Six acute NHS hospital trusts in England. Reasonable adjustments for people with intellectual disabilities were identified through the literature. Data were collected on implementation and staff understanding of these adjustments. Data collected included staff questionnaires (n=990), staff interviews (n=68), interviews with adults with intellectual disabilities (n=33), questionnaires (n=88) and interviews (n=37) with carers of patients with intellectual disabilities, and expert panel discussions (n=42). Hospital strategies that supported implementation of reasonable adjustments did not reliably translate into consistent provision of such adjustments. Good practice often depended on the knowledge, understanding and flexibility of individual staff and teams, leading to the delivery of reasonable adjustments being haphazard throughout the organisation. Major barriers included: lack of effective systems for identifying and flagging patients with intellectual disabilities, lack of staff understanding of the reasonable adjustments that may be needed, lack of clear lines of responsibility and accountability for implementing reasonable adjustments, and lack of allocation of additional funding and resources. Key enablers were the Intellectual Disability Liaison Nurse and the ward manager. The evidence suggests that ward culture, staff attitudes and staff knowledge are crucial in ensuring that hospital services are accessible to vulnerable patients. The authors suggest that flagging the need for specific reasonable adjustments, rather than the vulnerable condition itself, may address some of the barriers. Further research is recommended that describes and
Nishigaki, Kaori; Yoneyama, Akira; Ishii, Mitsuko; Kamibeppu, Kiyoko
Limited time away from the child is cited as the main factor that increases the burden for the primary caregiver of severely disabled children. The aim of this study was to quantitatively elucidate the factors related to the desire to use social services and the actual use of respite care services by the primary caregivers of severely disabled children in Japan. In this study, we investigated the use of respite care services in accordance with the primary caregivers' wishes by examining inhibiting or promoting factors associated with respite care service use only among those who wished to use social services. A total of 169 Japanese mothers participated and answered the questionnaires. We conducted a logistic regression analysis and a multiple regression analysis to investigate the factors related to respite care service use. The most important factors affecting a primary caregiver's desire to use social services were the belief that the child would enjoy using social services and the family's approval of the social service use. The most important factors affecting respite care service use were the family's approval of the use and a large care burden on the primary caregiver. Respite care services should be sought out before the care burden becomes too great to enable the primary caregiver to more easily contribute to the continuation of home care. A background of mother-child separation anxiety disrupted the use of respite care. However, believing that the child enjoys using social services may reduce primary caregivers' psychological resistance to being separated from their child, which is supported by tradition. Thus, it is also important for respite care service providers to provide information about the children to their primary caregivers and families while they are using respite care services. © 2016 John Wiley & Sons Ltd.
AJ Cronin (1896-1981) was a Scottish-born doctor-turned-novelist whose most famous novel is The Citadel, published in 1937. The book describes the struggles of an idealistic young doctor working in Wales and London in the 1920s and 30s. The novel was a global bestseller and its portrayal of a largely ineffective, corruption-ridden system of healthcare is thought to have directly influenced the foundation of the National Health Service in 1948. The Citadel anticipates such phenomena as evidence-based medicine and continuing medical education. This paper argues that the novel was never intended as propaganda for a state-controlled national health service. On the contrary, Cronin was against state control. Analysis of the novel is informed by recent biographical revelations about Cronin and the blurring of the margin between fact and fiction in Cronin\\'s life and work is examined.
AJ Cronin (1896-1981) was a Scottish-born doctor-turned-novelist whose most famous novel is The Citadel, published in 1937. The book describes the struggles of an idealistic young doctor working in Wales and London in the 1920s and 30s. The novel was a global bestseller and its portrayal of a largely ineffective, corruption-ridden system of healthcare is thought to have directly influenced the foundation of the National Health Service in 1948. The Citadel anticipates such phenomena as evidence-based medicine and continuing medical education. This paper argues that the novel was never intended as propaganda for a state-controlled national health service. On the contrary, Cronin was against state control. Analysis of the novel is informed by recent biographical revelations about Cronin and the blurring of the margin between fact and fiction in Cronin\\'s life and work is examined.
Lin, Yi-Jiun; Huang, I-Chun; Wang, Yun-Tung
The aim of this exploratory study is to gain an understanding of the outcomes of home-based employment service programs for people with disabilities and their related factors in Taiwan. This study used survey method to collect 132 questionnaires. Descriptive and two-variable statistics including chi-square (χ(2)), independent sample t-test and analysis of variance were employed. The results found that 36.5% of the subjects improved their employment status and 75.8% of them improved in employability. Educational level and and vocational categories including "web page production", "e-commerce", "internet marketing", "on-line store" and "website set-up and management" were significantly "positively" associated with either of the two outcome indicators - change of employment status and employability. This study is the first evidence-based study about the outcomes of home-based employment service programs and their related factors for people with disabilities in Taiwan. The outcomes of the home-based employment service programs for people with disabilities were presented. Implications for Rehabilitation Home-based rehabilitation for people with disabilities can be effective. A programme of this kind supports participants in improving or gaining employment status as well as developing employability skills. Further consideration should be given to developing cost-effective home-based programmes and evaluating their effectiveness.
Which factors most influence referral for restorative dental treatment under sedation and general anaesthesia in children with complex disabilities: caries severity, child functioning, or dental service organisation?
Norderyd, Johanna; Faulks, Denise; Molina, Gustavo; Granlund, Mats; Klingberg, Gunilla
The UN Convention on the Rights of the Child gives all children right to the highest standard of services for treatment and rehabilitation. For children with disabilities, sedation and general anaesthesia (GA) are often indicated for dental treatment; however, accessibility to this varies. The International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) enables a biopsychosocial description of children undergoing dental treatment. To investigate conscious sedation and GA in children with complex disabilities and manifest caries and analyse how caries, child functioning, and dental service organisation relate to dental GA (DGA), comparing Argentina, France, and Sweden using the ICF-CY. Quantitative, cross-sectional; data collected through structured interviews, observation, and dental records. Sedation and DGA were common. Children with limitations in interpersonal interactions and relationships were more likely to have had DGA (OR: 5.3, P = 0.015). Level of caries experience was strongly correlated with experience of DGA. There were significant differences between countries regarding caries prevalence, sedation, DGA, and functional and environmental factors. Although caries experience and child functioning are important, dental health service organisation had the most impact on the incidence of DGA, and for the use of conscious sedation, for children with complex disabilities. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
The principal aim was to assess the utility of three needs assessment\\/dependency tools for use in community-based palliative care services. Specific objectives were to assess a sample of patients receiving specialist palliative care community nursing using these tools, to assess the predictive ability of each tool, and to explore the utility of prioritizing and measuring patient dependency from a clinical nurse specialist (CNS) perspective.
Brabazon, E D
The use of routinely available electronic sources of healthcare data on the spread of influenza has the potential to enhance current surveillance activities. This study aimed to develop a method for identifying influenza-related records from general practitioner(GP) out-of-hours (OOH) services in Ireland. Data from one such service were interrogated for keywords relating to influenza-like illness (ILI) and a proxy measure of influenza activity in the community setting was developed. Comparison of this syndromic surveillance measure with national data on ILI consultation rates demonstrated a statistically significant temporal correlation.In five out of six influenza seasons investigated,peaks in the GP OOH influenza-related calls appeared at least one week ahead of peaks in the national ILI consultation rates. The method described in this paper has been extended to nine OOH services in Ireland (covering 70% of the Irish population) to provide weekly figures on self-reported illness for influenza in the community and its data have been incorporated into the national weekly influenza reports produced by the Health Protection Surveillance Centre. These data should provide early warnings of both seasonal and pandemic influenza in Ireland.
Clifford Simplican, Stacy; Shivers, Carolyn; Chen, June; Leader, Geraldine
People with intellectual disabilities continue to underutilize technology, in part due to insufficient training. Because support staff professionals provide instructional support, how they perceive integrating new technologies is important for people with intellectual disabilities. The authors conducted a sequential mixed-methods exploratory study (quan→QUAL) including quantitative data from online surveys completed by 46 staff members and qualitative data from five focus groups attended by 39 staff members. Quantitative results show strong support for diverse technologies. In contrast, qualitative results suggest that staff members' support of technology decreases when they perceive that technology may jeopardize service users' safety or independence. Although staff members identified increasing independence as the main reason to use new technologies with service users, they also worried that technologies used to increase the social inclusion of service users may pose undue risk and thus may limit their embrace of technology. © 2017 John Wiley & Sons Ltd.
The Dublin Eye and Ear Hospital Act, 1897 came in to force on 15th July 1897. The Act provided for the amalgamation of the National Eye and Ear Hospital in Molesworth Street (founded in 1814) and St Mark\\'s Ophthalmic Hospital in Lincoln Place founded in 1844 by Sir William R. Wilde) and established this Hospital. We are therefore celebrating this year the completion of one hundred year of service by the Hospital to the citizens of Dublin and indeed to people from all parts of Ireland.
Day, Mary Rose
Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation, but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.
Mc Manus, Vicki
BACKGROUND: Cerebral palsy (CP) is the most common cause of physical disability in children but its impact on quality of life is not well understood. This study examined participation in everyday activities among children without CP and children with mild, moderate and severe impairment due to CP. We then examined ten domains of quality of life in children with CP and investigated whether participation in everyday activities was associated with improved quality of life independent of gender, age and level of impairment. METHODS: This was a cross-sectional study of children aged 8-12 years based on two questionnaires, frequency of participation (FPQ) and KIDSCREEN, completed by parents of 98 children on the South of Ireland Cerebral Palsy Register (response rate = 82%) and parents of 448 children attending two Cork city schools (response rate = 69%) who completed one questionnaire (FPQ). Multiple linear regression was used: firstly to estimate the effect of severity of CP on participation in everyday activities independent of age and gender and secondly we estimated the effect of participation on quality of life independent of age gender and level of impairment. RESULTS: Participation in 11 of the 14 everyday activities examined varied across the children without CP and the children with varying severity of CP. In general, increased impairment decreased participation. Independent of age and gender, there was a highly significant decrease in overall participation with a fall of -6.0 (95% CI = -6.9 to -5.2) with each increasing level of impairment. The children with CP generally had high quality of life. Increased impairment was associated with diminished quality of life in just two domains - Physical well-being and Social support and peers. Overall participation in everyday activities was significantly associated with quality of life in 3 of the 10 domains (Physical well-being, Social support and peers & Moods and emotions) in analysis adjusted for gender age and
Full Text Available In 2002-2007 public employment services enlarged the range of service offers within the frames of active policy of labour market for handicapped persons living in the city of Poznań and the poviat (commune. The attempt was successful despite permanent and not very high expenditure on solving the handicapped persons’ problems. Simultaneously there was an observable increase of expenditure on the whole active policy of Poznań agglomeration labour market. Owing to the law changes a lot of positive progress was achieved which introduced professional activation of handicapped people in the forms inaccessible to this group of citizens so far. It should be mentioned here that it came about also thanks to undertakings cofinanced with European funds, alongside with the assistance of private and non-governmental institutions. A constant ratio of the handicapped persons’ employment as well as slightly changeable number of handicapped persons registered at Poznań District Work Office, prove that the present situation does not develop in handicapped youth the necessary skills to actively search work, and it strengthens attitudes of professional passivity.
Neille, Joanne; Penn, Claire
Persons with disabilities make up approximately 15% of the world's population, with vulnerable communities disproportionately affected by the incidence of disability. Research reflects that persons with disabilities are vulnerable to stigma and discrimination, social isolation, and have physical barriers to accessing support services, all of which serve to perpetuate a sense of uncertainty and vulnerability within their lives. Recently a number of policies and models of intervention have been introduced intended to protect the rights of those affected by disability, yet limited research has been conducted into the lived experiences of persons with disabilities, particularly in rural contexts. This implies that little is known about the impact of the rural context on the lived experience of disability and the ways in which context impacts on the implementation of policies and practices. The current study employed a qualitative design underpinned by the principles of narrative inquiry and participant observation. Thirty adults with a variety of congenital and acquired disabilities (15 men and 15 women, ranging in age from 19 to 83 years) living in 12 rural communities in the Mpumalanga Province of South Africa were recruited through snowball sampling. Data collection comprised a combination of narrative inquiry and participant observation. Narratives were collected in SiSwati with the assistance of a SiSwati-speaking research mediator and were transcribed and translated into English. Data were analysed inductively according to the principles of thematic analysis. Findings confirmed that the experience of living with a disability in a rural area is associated with discrimination, social exclusion, and isolation and barriers to accessing services, underpinned by numerous context-specific experiences, including mortality rates, exposure to numerous and repeated forms of violence across the lifespan, and corruption and lack of transparency in the implementation of
For most people, home is the preferred place of care and death. Despite the development of specialist palliative care and primary care models of community based service delivery, people who are dying, and their families\\/carers, can experience isolation, feel excluded from social circles and distanced from their communities. Loneliness and social isolation can have a detrimental impact on both health and quality of life. Internationally, models of social and practical support at the end of life are gaining momentum as a result of the Compassionate Communities movement. These models have not yet been subjected to rigorous evaluation. The aims of the study described in this protocol are: (1) to evaluate the feasibility, acceptability and potential effectiveness of The Good Neighbour Partnership (GNP), a new volunteer-led model of social and practical care\\/support for community dwelling adults in Ireland who are living with advanced life-limiting illness; and (2) to pilot the method for a Phase III Randomised Controlled Trial (RCT).
The provision of high quality healthcare information about pregnancy is important to women and to healthcare professionals and it is 1 driven, in part, by a desire to improve clinical outcomes,. The objective of this study was to examine the use of digital media by women\\' to access pregnancy information. A questionnaire was distributed to women attending a large maternity hospital. Of the 522 respondents, the mean age was 31.8 years, 45% (235\\/522) were nulliparous, 62% (324\\/522) lived in the capital city and 29% (150\\/522) attended the hospital as private patients. Overall 95% (498\\/522) used the internet for pregnancy information, 76% (399\\/522) had a smartphone and 59% (235\\/399) of smartphone owners had used a pregnancy smartapp. The nature of internet usage for pregnancy information included discussion forums (70%), social networks (67%), video media (48%), e-books (15%), blogs (13%), microblogs (9%) and podcasts (4%). Even women who were socially disadvantaged reported high levels of digital media usage. In contemporary maternity care women use digital media extensively for pregnancy information. All maternity services should have a digital media strategy.
Abstract Background In order to reduce fatal self-poisoning legislation was introduced in the UK in 1998 to restrict pack sizes of paracetamol sold in pharmacies (maximum 32 tablets) and non-pharmacy outlets (maximum 16 tablets), and in Ireland in 2001, but with smaller maximum pack sizes (24 and 12 tablets). Our aim was to determine whether this resulted in smaller overdoses of paracetamol in Ireland compared with the UK. Methods We used data on general hospital presentations for non-fatal self-harm for 2002 - 2007 from the Multicentre Study of Self-harm in England (six hospitals), and from the National Registry of Deliberate Self-harm in Ireland. We compared sizes of overdoses of paracetamol in the two settings. Results There were clear peaks in numbers of non-fatal overdoses, associated with maximum pack sizes of paracetamol in pharmacy and non-pharmacy outlets in both England and Ireland. Significantly more pack equivalents (based on maximum non-pharmacy pack sizes) were used in overdoses in Ireland (mean 2.63, 95% CI 2.57-2.69) compared with England (2.07, 95% CI 2.03-2.10). The overall size of overdoses did not differ significantly between England (median 22, interquartile range (IQR) 15-32) and Ireland (median 24, IQR 12-36). Conclusions The difference in paracetamol pack size legislation between England and Ireland does not appear to have resulted in a major difference in sizes of overdoses. This is because more pack equivalents are taken in overdoses in Ireland, possibly reflecting differing enforcement of sales advice. Differences in access to clinical services may also be relevant.
Barchitta, M; Fragapane, S; Consoli, M T; Pennisi, C; Agodi, A
The growing needs of people with disabilities require to integrate this issue into public health in order to improve political feasibility and to ensure that disability will not be left off from any strategic table. The main aim of the "Care for Work" project was to provide training contents to help workers and unemployed people to adapt their knowledge, skills and competencies to the care services sector in order to facilitate their insertion in a new employment source. The partners participating in the project are Organizations from 5 European countries. The project has been divided into seven Work Packages (WPs): three transversal WPs and four specific WPs, each addressing specific activities necessary to achieve the final objectives of the project. The "Care for Work" learning environment contains specific information and training on the techniques for caring people with acquired physical disabilities, as text documents and short training films. The project combines e-learning (Web 2.0) and mobile learning providing a flexible training platform for workers of care services sector. The "Care for Work" project offers specific training addressed to meet the new existing needs of workers of the care services sector and/or unemployed people. All the information and results of the project are available on the web page: www.careforwork.eu, and the present article is part of the WP "Valorization".
The aim of this study is to explore whether/which job coach factors were significantly associated with the community-based employment service (CBES) programme outcome measures in Taiwan. This study used the 2003-2005 CBES programme for People with Disabilities Database in Taipei City in Taiwan (n = 3924) to do a secondary data analysis using hierarchical multiple linear regression. This study found that 'occurrences of the services provided by the job coaches' variable was definitely the dominant predictor and explained additional 19.6% and 27.8% of the variances of annual salary and annual working month outcome measures, respectively. In addition, among six composition variables of 'occurrences of the services provided by the job coaches', 'occurrences of follow-up guidance', 'occurrences of intensive guidance', and 'occurrences of consultation before interviews with employer/director of human resources' were more powerful than the other three in predicting outcomes. Job coach factors in this study were significantly correlated with CBES programme outcome measures for people with disabilities in Taiwan after controlling for the socio-demographic variables. It indicates that the more inputs in the people with disabilities made by job coaches equates to better outcomes in this Taiwan case study.
Skempes, Dimitrios; Bickenbach, Jerome
Rehabilitation care is fundamental to health and human dignity and a human right enshrined in the United Nations Convention on the Rights of Persons with Disabilities. The provision of rehabilitation is important for reducing the need for formal support and enabling persons with disabilities to lead an independent life. Increasingly scholars and advocacy groups voice concerns over the significant barriers facing people with disabilities in accessing appropriate and quality rehabilitation. A growing body of research highlights a "respond-need" gap in the provision of rehabilitation and assistive technologies and underscore the lack of indicators for assessing performance of rehabilitation systems and monitoring States compliance with human rights standards in rehabilitation service planning and programming. While research on human rights and health monitoring has increased exponentially over the last decade far too little attention has been paid to rehabilitation services. The proposed research aims to reduce this knowledge gap by developing a human rights based monitoring framework with indicators to support human rights accountability and performance assessment in rehabilitation. Concept mapping, a stakeholder-driven approach will be used as the core method to identify rights based indicators and develop the rehabilitation services monitoring framework. Concept mapping requires participants from various stakeholders groups to generate a list of the potential indicators through on line brainstorming, sort the indicators for conceptual similarity into clusters and rate them against predefined criteria. Multidimensional scaling and hierarchical cluster data analysis will be performed to develop the monitoring framework while bridging analysis will provide useful insights about patterns of agreement or disagreement among participants views on indicators. This study has the potential to influence future practices on data collection and measurement of compliance with
Full Text Available Uganda is among the first to use the Washington Group Short Set of Questions on Disability to identify persons with disabilities in its Demographic and Health Survey. In this paper, we review the HIV Knowledge, Attitudes and Behaviour component of the 2011 Ugandan Demographic and Health Survey, analysing a series of questions comparing those with and without disabilities in relation to HIV/AIDS knowledge, attitudes and practices. We found comparable levels of knowledge on HIV/AIDS for those with and those without disabilities in relation to HIV transmission during delivery (93.89%, 93.26% and through breastfeeding (89.91%, 90.63%, which may reflect increased attention to reaching the community of persons with disabilities. However, several gaps in the knowledge base of persons with disabilities stood out, including misconceptions of risk of HIV infection through mosquito bites and caring for a relative with HIV in own household (34.39%, 29.86%; p<0.001; 91.53%, 89.00%; p = 0.001, respectively. The issue is not just access to appropriate information but also equitable access to HIV/AIDS services and support. Here we found that persons with multiple disabilities were less likely than individuals without disabilities to return to receive results from their most recent HIV test (0.60[0.41-0.87], p<0.05. HIV testing means little if people do not return for follow-up to know their HIV status and, if necessary, to be connected to available services and supports. Additional findings of note were that persons with disabilities reported having a first sexual encounter at a slightly younger age than peers without disabilities; and persons with disabilities also reported having a sexually transmitted disease (STD within the last 12 months at significantly higher rates than peers without disabilities (1.38[1.18-1.63], p<0.01, despite reporting comparable knowledge of the need for safer sex practices. This analysis is among the first to use HIV
One of the greatest challenges facing healthcare professionals is the ability to directly and efficiently access relevant data from the patient's healthcare record at the point of care; specific to both the context of the task being performed and the specific needs and preferences of the individual end-user. In radiology practice, the relative inefficiency of imaging data organization and manual workflow requirements serves as an impediment to historical imaging data review. At the same time, clinical data retrieval is even more problematic due to the quality and quantity of data recorded at the time of order entry, along with the relative lack of information system integration. One approach to address these data deficiencies is to create a multi-disciplinary patient referenceable database which consists of high-priority, actionable data within the cumulative patient healthcare record; in which predefined criteria are used to categorize and classify imaging and clinical data in accordance with anatomy, technology, pathology, and time. The population of this referenceable database can be performed through a combination of manual and automated methods, with an additional step of data verification introduced for data quality control. Once created, these referenceable databases can be filtered at the point of care to provide context and user-specific data specific to the task being performed and individual end-user requirements.
Butterly, Felicity; Percy, Carol; Ward, Gillian
The aim of this study was to identify the outcomes expected and assessed by those providing service dogs to children with developmental disabilities. Seventeen registered service dog providers were invited to complete a mixed methods online survey. Five providers, who prepared dogs to work with a wide range of conditions and behaviours, mainly Asperger's syndrome, autism and communication disorders, completed the survey. All five participants reported that they expected to see positive changes as a consequence of the service dog placement, in both the recipient child and their family, including improvements in attention span and language skills, as well as increased familial cohesion. Survey responses indicated that not all desired outcomes were routinely assessed. The range of assessments used were interviews, intake conversations, pre-placement questionnaires, child social diaries filled in by parents, follow up surveys after placement, and child observation by parents. No specifically named valid and reliable clinical or research measures were referred to, showing an emphasis on assessments from parents and service dog providers. It is not clear whether pre-intervention assessments are repeated systematically at follow-up, which could show robust intervention effects. There is scope for professionals in developmental disability to work with service dog providers to improve the evidence base in this field.
Agustín Huete García
Full Text Available At present, there are several alternatives to support daily life of people with disabilities, which require different resources: human, institutional, technical, material, financial, etc. In addition, these alternatives involve different impacts on both the life of people with disabilites and their immediate environment. This paper presents a case study that compares an user of personal assistance services of the Program for Independent Living (PAVI with an user of a residential service. The study method used is based on the approach of Social Return on Investment (SROI. It also specifies the selection of cases, the partners consulted to gather concepts and values, data collection, variables and formulas for calculating and monetization. Despite its limited scope, it is possible to draw conclusions about the social return on investment in a “standard profile” receiving personal assistance services compared with a “standard profile” in a residential service.
Kishore, M Thomas
Understanding the disability impact on parenting and caregiving is important for intervention. The present study was designed to understand the differences in perceived disability impact and related coping in mothers having children with intellectual disabilities alone compared to those having children with intellectual disabilities and additional disabilities. Accordingly, 30 mothers of children with intellectual disabilities and 30 mothers of children with intellectual and additional disabilities were assessed for disability impact and coping. Group differences for disability impact were present in specific domains but not overall. Despite variations in coping pattern, both positive and negative coping strategies were observed in both groups. The results may imply that the impact of intellectual disability is so pervasive that except in certain domains mothers may not perceive the further impact of additional disabilities. Positive coping does not rule out negative coping strategies. These findings have specific relevance to service delivery in a cultural context.
Full Text Available Objective: In 2013, the Democratic People’s Republic of Korea (DPRK signed the United Nations Convention on the Rights of Persons with Disabilities (UN-CRPD. Since the concept of rehabilitation services in the DPRK did not meet international standards, the government, through the Korean Federation for Protection of the Disabled (KFPD and Munsu Rehabilitation Hospital (MRH, set up a technical consultation with external experts. Methods: Two rounds of consultations were performed, in August 2016 and March 2017, with available methodology, as used in previous consultation processes, but excluding site visits. The consultations started by collecting available data and holding workshops with representatives from the KFPD and the MRH. The results are listed as recommendations for the improvement of health-related rehabilitation services in the DPRK. The results were further developed by KFPD into a draft National Strategy and Action Plan on Comprehensive Rehabilitation (NSAPCR 2017–2020. The draft was discussed with external experts for further improvement prior to discussion with the government. Results and discussion: Overall, the consultation processes was successful, despite the limitation of not making site visits. Recent developments in the DPRK include ratification of the UN-CRPD in December 2016. The authors hope that the NSAPCR can be implemented successfully, leading to improved quality of life for people with disabilities in the DPRK.
WHAT IS KNOWN ON THE SUBJECT?: People with mental health problems and learning disabilities often do not receive the care they require. The Care Programme Approach (CPA) is meant to help with this. However, there have been many problems in the past with the introduction of the CPA into mental health services. There is no literature which explores what factors help or hinder the introduction of the CPA for service users with a mental health and learning disability, especially from the perspective of those responsible for overseeing this process. WHAT DOES THIS ARTICLE ADD TO EXISTING KNOWLEDGE?: The implementation of the CPA for this service user group is fragmented, and services are not working together in partnership. The CPA is being effectively implemented for people who are deemed to present with a risk to themselves or others. If a service user does not present with a high risk, they are not provided care through the CPA. Service users were not involved in the development or introduction of the policy in practice. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Services need to work better at engaging service users when they are developing and introducing new policies. Rather than applying the CPA for all service users, across all services, it should only be considered for those deemed to present with a high risk. It is effectively implemented for these people. For those not deemed to present with a high risk, services should consider using alternative service user led care planning frameworks. Introduction The Care Programme Approach was introduced in England to ensure services met the needs of people with mental health problems and a concurrent learning disability (dual diagnosis). The CPA implementation was patchy and services failed to work in partnership. Aim This study aimed to explore the factors shaping the recent implementation of the CPA for service users with a dual diagnosis. Method A single case study approach was undertaken. Data were collected through
Cegep Graduates with Disabilities: College Exit (CRC) Scores of Graduates Registered for Disability Related Services Compared to Non-Registered Graduates and Graduates without Disabilities. Final Report Presented to PAREA, Spring 2007
Jorgensen, Shirley; Fichten, Catherine; Havel, Alice
The goal of the study was to determine the relative competitiveness in gaining access to university of graduates with and without disabilities, and to determine whether the ease with which graduates experienced aspects of their college environment was related to their college exit scores. We found that graduates who responded to surveys, whether…
Tuffrey-Wijne, I; Rose, T
Most staff working in intellectual disability services will be confronted with people with intellectual disabilities who need support around death, dying and bereavement. Previous studies suggest that intellectual disability staff tend to protect clients from knowing about death and avoid communication about death. The aims of this study were to gain further insight into the individual, organisational and contextual factors that affect the communication of death-related bad news to people with intellectual disabilities by intellectual disability staff and to develop guidelines for services to enable appropriate communication with clients about death and dying. Semi-structured interviews were held with 20 social care staff working in intellectual disability residential or supported living services in London, who had supported a client affected by death-related bad news in the past 6 months. Staff found supporting people with intellectual disabilities around death and dying extremely difficult and tended to avoid communication about death. The following factors had a particularly strong influence on staff practice around communicating death-related bad news: fear and distress around death; life and work experience; and organisational culture. Staff attitudes to death communication had a stronger influence than their client's level of cognitive or communicative abilities. Managers were important role models. Service managers should ensure not only that all their staff receive training in death, loss and communication but also that staff are enabled to reflect on their practice, through emotional support, supervision and team discussions. Future work should focus on the development and testing of strategies to enable intellectual disability staff to support their clients in the areas of dying, death and bereavement. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Nichols, Emily M; Bonomi, Amy; Kammes, Rebecca; Miller, Elizabeth
To examine mental health service experiences following sexual violence (SV) and intimate partner violence (IPV) victimization among college women with a disability. College women (n = 27, ages 19 to 24) with a disability who experienced at least one SV/IPV occurrence; interviewed July/August 2016. Qualitative study using in-depth interviews, with thematic analysis. Women tended to wait several months (or did not seek care at all) following SV/IPV, because they downplayed their experience (e.g., not wanting to label an experience as "rape"). Those seeking services primarily did so because of escalating mental health concerns. Among service seekers, women were satisfied when professionals validated their experiences/concerns; and were dissatisfied when faced with extended wait time for care and/or professionals unskilled with SV/IPV and mental health. However, women still sought care following negative experiences. Improved access to integrated care for SV/IPV and mental health, along with skilled professionals, is essential.
Bradbury-Jones, Caroline; Breckenridge, Jenna P; Devaney, John; Duncan, Fiona; Kroll, Thilo; Lazenbatt, Anne; Taylor, Julie
Domestic abuse is a significant public health issue. It occurs more frequently among disabled women than those without a disability and evidence suggests that a great deal of domestic abuse begins or worsens during pregnancy. All women and their infants are entitled to equal access to high quality maternity care. However, research has shown that disabled women who experience domestic abuse face numerous barriers to accessing care. The aim of the study was to identify the priority areas for improving access to maternity services for this group of women; develop strategies for improved access and utilisation; and explore the feasibility of implementing the identified strategies. This multi-method study was the third and final part of a larger study conducted in the UK between 2012 and 2014. The study used a modified concept mapping approach and was theoretically underpinned by Andersen's model of healthcare use. Seven focus group interviews were conducted with a range of maternity care professionals (n = 45), incorporating quantitative and qualitative components. Participants ranked perceived barriers to women's access and utilisation of maternity services in order of priority using a 5-point Likert scale. Quantitative data exploration used descriptive and non-parametric analyses. In the qualitative component of each focus group, participants discussed the barriers and identified potential improvement strategies (and feasibility of implementing these). Qualitative data were analysed inductively using a framework analysis approach. The three most highly ranked barriers to women's access and utilisation of maternity services identified in the quantitative component were: 1) staff being unaware and not asking about domestic abuse and disability; 2) the impact of domestic abuse on women; 3) women's fear of disclosure. The top two priority strategies were: providing information about domestic abuse to all women and promoting non-judgemental staff attitude. These were
Azar, Sandra T.; Robinson, Lara R.; Proctor, Stephon N.
Child neglect has negative effects throughout the life span. Although an argument for a link between intellectual disabilities and neglectful parenting can be made, this article argues for a more fine-grained view of the cognitive problems that underlie child neglect perpetration and provides evidence for a social information processing model of…
Full Text Available The aim of this study is to develop and validate a scale on the Quality of Life (QoL of people with intellectual disabilities as assessed by family members (external perspective. The instrument measures improvement in QoL due to actions by organizations delivering services to individuals with intellectual disabilities (organization-oriented measure. In order to design the items for the scale, focus groups were set up with professionals dedicated to attending to individuals with intellectual disabilities. An initial scale of 20 items was constructed by consensus. A total of 1195 family members answered the questionnaire. In order to assess the structure of the scale, EFA recommended deleting 3 overlapping items. The final scale consisted of 17 items (α=95 and was composed of four main dimensions: self-determination (SD, social inclusion (SI, rights (RI and overall improvement (OI, which explained 74.83% of the variance. Finally, the consistency and validity were assessed. Convergent validity and discriminant validity were satisfactory. Moreover, CFA confirmed the structure of the scale. Main conclusions, limitations and practical implications are discussed.
Hyassat, Mizyed A.
Since the literature in the field of special education supports the argument that involving parents in the educational process is more likely to positively influence children's educational outcomes, this research aims at exploring the position of Jordanian parents of young children with disabilities in terms of their involvement. A qualitative…
Hatton, Chris; Emerson, Eric
Questionnaire data were collected from 64 direct-care staff members in a residential facility for people with multiple disabilities. Path analyses identified factors predicting levels of perceived stress, overall job satisfaction, overall life satisfaction, and perceived likelihood of leaving the organization. Factors included staff support, job…
Campbell, Edward M.; Fortune, Jon; Severance, Donald; Holderegger, John; Fortune, Barbara
A database was assembled from data collected on all people served by the Developmental Disabilities divisions of Nebraska, South Dakota, and Wyoming, including state institutions and state-funded programs (n=5,928). Information included provider expenditures associated with each individual, allocations made by individual reimbursement rates,…
Leser, Kendall A.; Pirie, Phyllis L.; Ferketich, Amy K.; Havercamp, Susan M.; Wewers, Mary Ellen
Direct support professionals (DSPs) play a large social role in the lives of people with developmental disabilities (DD) and have the potential to influence their health behaviors. Six qualitative focus groups (n = 48) were conducted with DD community agency administrators, DSPs, family members and adults with DD to better understand the perceived…
What and whom we choose to celebrate says a lot about us. As I thought about celebrating systemic practice, I wondered about how and when those with whom I most often practice, men and women with intellectual disabilities, have been celebrated?
Spruin, Elizabeth; Abbott, Nicola; Holt, Nicole
Globally, families who care for a child or adolescent with disabilities have been found to experience high levels of maternal ill health, stress, depression and family breakdown. In extreme cases, children and adolescents may have to move away from their family to a permanent residential placement. A potentially more appropriate and cost-effective…
Jang, Yuh; Wang, Yun-Tung; Lin, Meng-Hsiu; Shih, Kevin J.
Introduction: We investigated the employment status and identified factors that may affect the employment outcomes of people with visual impairments in Taiwan. Methods: A retrospective, ex post facto design study was conducted. The sample included 313 visually impaired clients who commenced and "closed" (completed) disability employment…
Wells, M. B.; Turner, S.; Martin, D. M.; Roy, A.
A study of 120 British adults with intellectual disability found they had higher risk factors of developing coronary heart disease and stroke than the general population. There was a greater incidence of obesity and considerably lower physical activity levels than the general population. Several also had abnormal cholesterol readings. (CR)
Tuffrey-Wijne, Irene; Rose, Tracey; Grant, Robert; Wijne, Astrid
Background: Many people with intellectual disabilities are affected by death, yet conversations about death are often avoided by staff working with them. This study aimed to assess staff training needs and to develop, trial and evaluate a training course on communicating about death and dying. Method:(i) Semi-structured interviews with 20 staff in…
Ernst, Jeremy V.; Li, Songze; Williams, Thomas O.
The ever-changing student population of engineering design graphics students necessitates broader sets of instructor adeptness. Specifically, preparedness to educate and provide adequate educational access to content for students with identified categorical disabilities and Limited English Proficiency (LEP) is now an essential readiness skill for…
Williamson, Heather J.; Perkins, Elizabeth A.
Individuals with intellectual and developmental disabilities (IDD) in the U.S. predominantly live with their family caregivers. As care delivery and support systems vary widely globally, consideration of caregiver outcomes specifically in the U.S. context is needed. A systematic literature review was conducted to identify U.S. family caregiver…
Venville, Annie; Sawyer, Anne-Maree; Long, Maureen; Edwards, Niki; Hair, Sara
This article reports on the findings of a scoping review of peer-reviewed research that investigates the formal support experiences of adults with an intellectual disability and mental health problems. Seven databases and 21 sources of grey literature were searched and 17 articles were retained for review, demonstrating the dearth of literature in…
Head Start Program Performance Standards on Services for Children with Disabilities (45-CFR 1308) [and] Normas de Ejecucion del Programa Head Start Sobre Servicios para Ninos con Discapacidades (45-CFR 1308).
Administration for Children, Youth, and Families (DHHS), Washington, DC. Head Start Bureau.
This document consolidates, clarifies, and updates federal regulations on Head Start services for children with disabilities. The regulations are designed to complement the Head Start Program Performance Standards governing services to all enrolled children. Specifically, these regulations require Head Start programs to: (1) design comprehensive…
"Everyone Thought I Was a Very Very Bad Person… No One Want to Know You Like the Nurses and Doctors": Using Focus Groups to Elicit the Views of Adults with Learning Disability Who Use Challenging Behaviour Services
Haydon-Laurelut, Mark; Edmonds, Jane; Daynes, Shona; Clare, Amy; Byles, Rosalind; Barber, Victoria
Background: Following scandals such as Winterbourne view, Department of Health, (A national response to Winterbourne View Hospital, 2012) seeks changes in challenging behaviour services. A key part of this change is ensuring people with learning disabilities who use challenging behaviour services have more personalised support and their voices are…
Zhou, Huaqiong; Roberts, Pamela; Dhaliwal, Satvinder; Della, Phillip
This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. A search was carried out using the EBSCOhost, Embase, MEDLINE, PsycINFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be
Shilling, V; Bailey, S; Logan, S; Morris, C
Parents of disabled children often seek support from their peers. The shared experience between parents appears to be a crucial mediating factor. Understanding how a sense of shared experience is fostered can help to design and evaluate services that seek to provide peer support. We carried out a qualitative study involving semi-structured interviews and focus groups. Participants were 12 parents and 23 befrienders who had contact with the Face2Face one-to-one befriending service in Devon and Cornwall during a 12-month period, and 10 professionals from health, social care and education. Formal structures and processes in place such as training and ongoing supervision and support were highly valued as was the highly personalized, confidential, flexible, one-to-one at-home nature of the service. Crucial to establishing rapport was putting the right people together and ensuring a good match between befrienders and parents. Clearly, the befriending parent has to be emotionally prepared to provide help. However, if the parent being offered support was not ready to accept help at the time it was offered or the type of support was not right for them, they are less likely to engage with the service. Organizational and process factors as well as characteristics of the parents offering and receiving support contribute to the sense of shared experience in one-to-one peer support. These factors interact to influence whether peer support is effective and should be explicitly considered when designing and evaluating services. © 2015 John Wiley & Sons Ltd.
Blatter, L A; Cloetta, B
The incidence and prevalence of patients with musculoskeletal disorders benefiting from the Swiss invalidity insurance system in the Canton of Berne, Switzerland, are studied. During a 5-year period 1252 such patients (393 women) first received either payments or were supported by rehabilitation measures (incidence). The correlation of this incidence with sociodemographic factors such as sex, age, disease pattern, place of residence and occupation, as well as the type of service delivered, are analyzed and discussed. At a given date (March 1982) 2754 patients with musculoskeletal disorders were receiving insurance pension (prevalence). By relating these figures to census data (total population), a 1.37% 5-year benefit incidence and a 3.02% pension prevalence can be calculated.
Kilcommons, Aoiffe M.; Withers, Paul; Moreno-Lopez, Agueda
Background: Involving ID service users in risk decision making necessitates consideration of an individual's ability to assess the implications and associated risks and thus make an informed choice. This calls for research on service users' awareness and understanding of risk management (RM). Method: Thirteen people in a residential ID service who…
Murdoch, Maureen; Polusny, Melissa A; Hodges, James; Cowper, Diane
The goal was to describe the association between post-traumatic stress disorder (PTSD) and in-service sexual harassment in a nationally representative sample of Department of Veterans Affairs PTSD disability applicants. The study was a cross-sectional survey. Of 4,918 eligible veterans, 3,337 (68%) returned surveys. Nonresponse bias appeared to be minimal. After adjustment for other reported traumas, women's reported in-service sexual harassment severity was significantly associated with PTSD symptom severity (p men and for in-service sexual assault among the women. Men showed no association between in-service sexual harassment and PTSD (p = 0.33), although power was low for this test. Sexual harassment significantly contributed to female veterans' PTSD symptoms; its contribution to men's symptoms was unclear. We discuss mechanisms through which sexual harassment might affect PTSD symptom severity, including the possibility that sexual harassment sometimes meets the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, definition of a criterion A stressor.
Furlan, Andréa D; Irvin, Emma; Munhall, Claire; Giraldo-Prieto, Mario; Fullerton, Laura; McMaster, Robert; Danak, Shivang; Costante, Alicia; Pitzul, Kristen B; Bhide, Rohit P; Marchenko, Stanislav; Mahood, Quenby; David, Judy A; Flannery, John F; Bayley, Mark
To compare models of rehabilitation services for people with mental and/or physical disability in order to determine optimal models for therapy and interventions in low- to middle-income countries. CINAHL, EMBASE, MEDLINE, CENTRAL, PsycINFO, Business Source Premier, HINARI, CEBHA and PubMed. Systematic reviews, randomized control trials and observational studies comparing >2 models of rehabilitation care in any language. Date extraction: Standardized forms were used. Methodological quality was assessed using AMSTAR and quality of evidence was assessed using GRADE. Twenty-four systematic reviews which included 578 studies and 202,307 participants were selected. In addition, four primary studies were included to complement the gaps in the systematic reviews. The studies were all done at various countries. Moderate- to high-quality evidence supports the following models of rehabilitation services: psychological intervention in primary care settings for people with major depression, admission into an inpatient, multidisciplinary, specialized rehabilitation unit for those with recent onset of a severe disabling condition; outpatient rehabilitation with multidisciplinary care in the community, hospital or home is recommended for less severe conditions; However, a model of rehabilitation service that includes early discharge is not recommended for elderly patients with severe stroke, chronic obstructive pulmonary disease, hip fracture and total joints. Models of rehabilitation care in inpatient, multidisciplinary and specialized rehabilitation units are recommended for the treatment of severe conditions with recent onset, as they reduce mortality and the need for institutionalized care, especially among elderly patients, stroke patients, or those with chronic back pain. Results are expected to be generalizable for brain/spinal cord injury and complex fractures.
Tadic, Valerie; Hamblion, Esther Louise; Keeley, Sarah; Cumberland, Phillippa; Lewando Hundt, Gillian; Rahi, Jugnoo Sangeeta
Purpose. To investigate patterns of participation of visually impaired (VI) children and their families in health services research. Methods. The authors compared clinical and sociodemographic characteristics of children and their families who participated with those who did not participate in two studies of quality of life (QoL) of VI children. In Study 1, the authors interviewed VI children and adolescents, aged 10 to 15 years, about their vision-related quality of life (VRQoL) as the first phase of a program to develop a VRQoL instrument for this population. One hundred seven children with visual impairment (visual acuity in the better eye LogMar worse than 0.51) were invited to participate in the interviews. Study 2 investigated health-related quality of life (HRQoL) of VI children using an existing generic instrument, administered in a postal survey. 151 VI children and adolescents, aged 2 to 16 years, with hereditary retinal disorders were invited to participate in the survey. Results. The overall participation level was below 50%. In both studies, participants from white ethnic and more affluent socioeconomic backgrounds were overrepresented. Participation did not vary by age, sex, or clinical characteristics. Conclusions. The authors suggest that there are barriers to participation in child- and family-centered research on childhood visual disability for children from socioeconomically deprived or ethnic minority groups. They urge assessment and reporting of participation patterns in further health services research on childhood visual disability. Failure to recognize that there are "silent voices" is likely to have important implications for equitable and appropriate service planning and provision for VI children.
Full Text Available Abstract Background Patient reported outcome measures (PROMs are self-report measures of health status increasingly promoted for use in healthcare quality improvement. However people with low literacy skills or learning disabilities may find PROMs hard to complete. Our study investigated stakeholder views on the accessibility and use of PROMs to develop suggestions for more inclusive practice. Methods Taking PROMs recommended for chronic obstructive pulmonary disease (COPD as an example, we conducted 8 interviews with people with low literacy skills and/or learning disabilities, and 4 focus groups with 20 health professionals and people with COPD. Discussions covered the format and delivery of PROMs using the EQ-5D and St George Respiratory Questionnaire as prompts. Thematic framework analysis focused on three main themes: Accessibility, Ease of Use, and Contextual factors. Results Accessibility included issues concerning the questionnaire format, and suggestions for improvement included larger font sizes and more white space. Ease of Use included discussion about PROMs’ administration. While health professionals suggested PROMs could be completed in waiting rooms, patients preferred settings with more privacy and where they could access help from people they know. Contextual Factors included other challenges and wider issues associated with completing PROMs. While health professionals highlighted difficulties created by the system in managing patients with low literacy/learning disabilities, patient participants stressed that understanding the purpose of PROMs was important to reduce intimidation. Conclusions Adjusting PROMs’ format, giving an explicit choice of where patients can complete them, and clearly conveying PROMs’ purpose and benefit to patients may help to prevent inequality when using PROMs in health services.
Tallentire, Liz; Smith, Matthew; David, Lee; Roberts, Adam; Bruce; Morrow, Sarah; Withers, Paul; Smith, Ian
This research is about people who have intellectual disabilities and live in a secure hospital. It is about a group of people who meet at a support group. The support group is for people who are lesbian, gay, bisexual or transgender. These people with intellectual disabilities helped with planning, doing, and telling other people about the research. They told their stories about going to the support group. Their stories were joined together into a group story. The story said that the group helped people in lots of different ways. For some people going to the group was difficult at first because it was ?coming out'. This means telling other people you are lesbian, gay, bisexual, or transgender. Then it got easier and people started to feel better about themselves. Then they wanted to help others and this was important in their lives. This group seemed to help people get better. We have given some ideas for setting up other groups and doing more research. © 2016 John Wiley & Sons Ltd.
Naruse, Takashi; Matsumoto, Hiroshige; Fujisaki-Sakai, Mahiro; Nagata, Satoko
Home care service demands are increasing in Japan; this necessitates improved service allocation. This study examined the relationship between home visit nursing (HVN) service use and the proportion of elderly people living within 10 min' travel of HVN agencies. The population of elderly people living within reach of HVN agencies for each of 17 municipalities in one low-density prefecture was calculated using public data and geographic information systems. Multilevel logistic analysis for 2641 elderly people was conducted using medical and long-term care insurance claims data from October 2010 to examine the association between the proportion of elderly people reachable by HVNs and service usage in 13 municipalities. Municipality variables included HVN agency allocation appropriateness. Individual variables included HVN usage and demographic variables. The reachable proportion of the elderly population ranged from 0.0 to 90.2% in the examined municipalities. The reachable proportion of the elderly population was significantly positively correlated with HVN use (odds ratio: 1.938; confidence interval: 1.265-2.967). Residents living in municipalities with a lower reachable proportion of the elderly population are less likely to use HVN services. Public health interventions should increase the reachable proportion of the elderly population in order to improve HVN service use.
Reliability and Utility of the Behaviour Support Plan Quality Evaluation Tool (BSP-QEII) for Auditing and Quality Development in Services for Adults with Intellectual Disability and Challenging Behaviour
McVilly, K.; Webber, L.; Paris, M.; Sharp, G.
Background: Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II…
Jukes, Mark; Aspinall, Susan-Louise
Leadership is seen as critical for the transformation of learning disability services and has been further emphasised since the publication of Transforming Care, the Department of Health's response to the review of events at Winterbourne View. What is clear within learning disability nursing and services is the demand for leadership in the quest for improving the quality and effectiveness of services across health and social care. This article discusses the challenges for the undergraduate learning disability nurse with the recommendation to pursue a framework that promotes and focuses on integrating knowledge transfer into services for people with a learning disability. It explores practice change using the Promoting Action on Research Implementation in Health Services (PARiHS) framework, and the example of the involvement of service users in practitioner training on the Mental Capacity Act 2005 and consent and capacity to consent for treatment.
Veitch, Craig; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Dew, Angela; Bulkeley, Kim; Brentnall, Jennie; Griffiths, Scott
Policy that supports rural allied health service delivery is important given the shortage of services outside of Australian metropolitan centres. The shortage of allied health professionals means that rural clinicians work long hours and have little peer or service support. Service delivery to rural and remote communities is further complicated because relatively small numbers of clients are dispersed over large geographic areas. The aim of this five-year multi-stage project is to generate evidence to confirm and develop evidence-based policies and to evaluate their implementation in procedures that allow a regional allied health workforce to more expeditiously respond to disability service need in regional New South Wales, Australia. The project consists of four inter-related stages that together constitute a full policy cycle. It uses mixed quantitative and qualitative methods, guided by key policy concerns such as: access, complexity, cost, distribution of benefits, timeliness, effectiveness, equity, policy consistency, and community and political acceptability. Stage 1 adopts a policy analysis approach in which existing relevant policies and related documentation will be collected and reviewed. Policy-makers and senior managers within the region and in central offices will be interviewed about issues that influence policy development and implementation. Stage 2 uses a mixed methods approach to collecting information from allied health professionals, clients, and carers. Focus groups and interviews will explore issues related to providing and receiving allied health services. Discrete Choice Experiments will elicit staff and client/carer preferences. Stage 3 synthesises Stage 1 and 2 findings with reference to the key policy issues to develop and implement policies and procedures to establish several innovative regional workforce and service provision projects. Stage 4 uses mixed methods to monitor and evaluate the implementation and impact of new or adapted
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Berryman, Doris L.
The suggested standards and evaluative criteria are designed to assist hospitals and other residential institutions in evaluating recreation services provided to residents, primarily children and youth. Described are the development of the standards and the rating instrument, guidelines for using the standards, evaluation and scoring procedures,…
Hallam, Rena A.; Rous, Beth; Grove, Jaime; LoBianco, Tony
Data from a statewide billing and information system for early intervention are used to examine the influence of multiple factors on the level and intensity of services provided in a state early intervention system. Results indicate that child and family factors including entry age, gestational age, Medicaid eligibility, access to third party…
Moran, Galia Sharon; Russinova, Zlatka; Yim, Jung Yeon; Sprague, Catherine
Individuals with psychiatric disabilities have low rates of employment and occupational rehabilitation success. Mental health peer services are a new occupational modality that opened a promising occupational path: persons with serious mental illnesses employed to provide support to others with psychiatric conditions. However challenges to successful peer work exist. Work motivation is central to understanding and supporting peer workers, yet little is known about sources of motivation to work as mental health peer providers. The aim of this study was to identify what drives individuals to mental health peer work using self determination theory (SDT). Motivations of 31 mental health peer workers were explored as part of a larger study. A theory driven approach was employed to emerging qualitative data using SDT concepts: external motivation and internally regulated motivations derived from basic needs (autonomy, competence, relatedness). External motivations included generic occupational goals and getting away from negative work experiences. Internal motivations corresponded with SDT basic needs: autonomy met-needs was reflected in having freedom to disclose and finding that work accords with personal values; competence met-needs was reflected in using personal experience as a resource to help others; and relatedness met-needs were reflected in having opportunity to connect intimately and reciprocate with consumers. This study identified external and internal motivations of persons with psychiatric disabilities to work as peer providers-a novel occupation in mental health. Employing personal experience and enabling peer contact emerge as major motivational tenets of mental health peer work. According to SDT instrumental occupational goals are considered more external than satisfaction of basic psychological needs. The study demonstrates the applicability of SDT in the design of autonomy supported environments to promote work engagement and sustenance of mental
This Article argues that the practice of holding so many adjudicative proceedings related to disability in private settings (e.g., guardianship, special education due process, civil commitment, and social security) relative to our strong normative presumption of public access to adjudication may cultivate and perpetuate stigma in contravention of the goals of inclusion and enhanced agency set forth in antidiscrimination laws. Descriptively, the law has a complicated history with disability--initially rendering disability invisible; later, underwriting particular narratives of disability synonymous with incapacity; and, in recent history, promoting the full socio-economic visibility of people with disabilities. The Americans with Disabilities Act (ADA), the marquee civil rights legislation for people with disabilities (about to enter its twenty-fifth year), expresses a national approach to disability that recognizes the role of society in its construction, maintenance, and potential remedy. However, the ADA’s mission is incomplete. It has not generated the types of interactions between people with disabilities and nondisabled people empirically shown to deconstruct deeply entrenched social stigma. Prescriptively, procedural design can act as an "ntistigma agent"to resist and mitigate disability stigma. This Article focuses on one element of institutional design--public access to adjudication--as a potential tool to construct and disseminate counter-narratives of disability. The unique substantive focus in disability adjudication on questions of agency provides a potential public space for the negotiation of nuanced definitions of disability and capacity more reflective of the human condition.
Full Text Available We welcome Andrew Haig's critique of our paper, "Disability & Health: A research agenda" in Social Inclusion. Our paper sought to identify research priorities to better understand, provide enhanced services and a better quality of life for people with disabilities, particularly in relation to their health and wellbeing. Haig's critique makes several important points that deserve serious consideration. His comments reflect a view of the relationship between disability and health which is different from the one we have espoused. Specifically, Haig argues that (a disability is a health problem, (b medical rehabilitation should be separated from Community Based Rehabilitation (CBR, and (c the evidence base for medical rehabilitation is much stronger than for CBR. We address each of these points below arguing that while some types of disability clearly result from health problems; often disability is not experienced as a health problem; and sometimes, disability in interaction with restricted access is the cause of health problems.
Ptomey, Lauren T; Wittenbrook, Wendy
It is the position of the Academy of Nutrition and Dietetics that nutrition services provided by registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs), who work under RDN supervision, are essential components of comprehensive care for adults with intellectual and developmental disabilities (IDD) and children and youth with special health care needs (CYSHCN). Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community based, and culturally competent. Individuals with IDD and CYSHCN have many risk factors requiring nutrition interventions, including growth alterations (eg, failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, drug-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Furthermore, these individuals are also more likely to develop comorbid conditions, such as obesity or endocrine disorders that require nutrition interventions. Poor nutrition-related health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Timely and cost-effective nutrition interventions can promote health maintenance and reduce risk and cost of comorbidities and complications. Public policy for individuals with IDD and CYSHCN has evolved, resulting in a transition from institutional facilities and programs to community and independent living. The expansion of public access to technology and health information on the Internet challenges RDNs and NDTRs to provide accurate scientific information to this rapidly growing and evolving population. RDNs and NDTRs with expertise in this area are best prepared to provide appropriate nutrition information to promote wellness and improve quality of life. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Ling, Bin; Allison, Colin; Nicholl, J. Ross; Moodley, Luke; Roberts, Dave
The Disabilities Information Flow (DIF) project at the University of St Andrews has sought to provide a means of efficiently managing all student disabilities information within the institution and provide appropriate role-based service interfaces for all staff who need to routinely interact with this information. This paper describes the software…
Full Text Available Locating occupational therapy within gendered and racialized systems of power, the authors consider the intersectional nature of critical disability studies discourse and the need for occupational therapy to incorporate such values into practice. This article discusses ways in which occupational therapy as a profession and individual therapists can align with or resist the economic determination which has come to dominate medical systems. It considers some of the political background to the history of the profession and its relationship with power. This positioning of the profession is explored against the impact of neoliberal economic policy on health, rights, service delivery and disability, and against some key issues, the pressure of ageing populations and the positon of occupational therapists as women professionals. Current policies present a critical challenge to central occupational therapy tenets. Occupational therapists may find themselves working both in alliance with disabled people and disability activists, and against them.
Johnsson, Genevieve; Kerslake, Rachel; Crook, Sarah; Cribb, Corinne
there are difficulties in recruiting and retaining practitioners in rural and remote communities and that access to support and professional development can be key in breaking this cycle, which may be triggered by geographical isolation. Technology-delivered intervention and support, also known as eHealth or Telehealth, has been used successfully in the disability sector for medical rehabilitation, direct intervention, employment support and support groups, but there is little evidence as to how technology is received by and implemented with disability and mainstream service providers supporting children with autism living in remote regions. What does this paper add? This paper provides an insight into the current skills and confidence of a broad range of service providers, including educators, allied health therapists and therapy and community support workers, in working with children with autism. This paper also investigates the experience, feasibility and potential uptake of a technology-driven program of support and professional development in rural and remote Australia. Finally, this paper provides an insight into the desired frequency of training and support, as well as identified learning support needs. What are the implications for practitioners? These findings have and will continue to guide practitioners in the development of an evidence-based, technology-driven model of supporting rural and remote staff working with children with autism. Technology has the potential to provide practitioners in geographically isolated areas with access to more responsive, collaborative and individualised professional support and training. Such practice may improve the skills of practitioners and the level of support they can provide their clients with autism, with the added potential of increasing staff retention in rural and remote areas of Australia.
Full Text Available Disability is a complex phenomenon. It reflects an interaction between features of a person’s body and features of the society in which he or she lives. International Classification of Functioning, Disability and Health (ICF, lays stress on the functional as well as the structural problem of a person. All the definitions of disability also include the disorders of the reproductive and endocrine system. So infertility and impotency should also be included in the category of disability. It affects the participation in areas of life and can have a disabling affect on an individual. Like any other disability the couple has to adapt and integrate infertility in their sense of self thus infertility comes as a major life crisis. Medically, infertility, in most cases, is considered to be the result of a physical impairment or a genetic abnormality. Socially, couples are incapable of their reproductive or parental roles. On social level, infertility in most cultures remains associated with social stigma and taboo just like the social model of disability. Couples who are unable to reproduce may be looked down upon due to social stigmatisation. Infertility can lead to divorces and separation leading to a broken family life. Without labelling infertility as a disability, it is difficult for the people to access services and welfare benefits offered by the government. Infertility treatments are highly sophisticated so they are very expensive and are even not covered by insurance and government aid.In the light of all this it becomes imperative to categorise infertility as disability.
Fleming-Castaldy, Rita P
To examine the relationships between satisfaction with and self-management of personal assistance services (PAS) and the quality of life (QoL) of persons with disabilities. To test the postulate that consumer-directed PAS can fulfil the human need for control and contribute to a satisfactory life. A survey compared the perspectives of persons using consumer-directed PAS versus those using agency-directed. A Personal Data Form obtained demographics and PAS characteristics. The Quality of Life Inventory measured life satisfaction. A PAS questionnaire measured perceptions about the management of, desire for control of, and satisfaction with PAS. Data were analysed using SPSS®- 14. Significant relationships were found between QoL and satisfaction with PAS (p perceived control of PAS and satisfaction with PAS (p satisfaction with their PAS (p satisfaction, and QoL support the value of consumer-directed programmes. Rehabilitation professionals can use this knowledge to develop, implement and research practises that enable self-management.
Flynn, Samantha; Hastings, Richard P; Gillespie, David; McNamara, Rachel; Randell, Elizabeth
Previous research has demonstrated an association between aggressive challenging behaviour (CB) and reductions in work-related well-being for intellectual disability (ID) support staff. Much of this research has used subjective measures of CB. To examine whether exposure to aggressive CB is associated with reduced work-related well-being in staff working in ID residential settings across the UK. A cross-sectional analysis was undertaken as part of a randomised trial; 186 staff from 100 settings completed questionnaires on their CB self-efficacy, empathy, positive work motivation, and burnout. Objective measures of aggressive CB in the preceding 16 weeks were collected from each setting. There was little association between staff exposure to aggressive CB and work-related well-being. Clustering effects were found for emotional exhaustion and positive work motivation, suggesting these variables are more likely to be influenced by the environment in which staff work. The level of clustering may be key to understanding how to support staff working in ID residential settings, and should be explored further. Longitudinal data, and studies including a comparison of staff working in ID services without aggressive CB exposure are needed to fully understand any association between aggressive CB and staff well-being. Copyright © 2018 Elsevier Ltd. All rights reserved.
... provides the most current information on research, practice, theory, issues, and trends to broaden understanding and improve ... These services make LDA the leading resource for information on learning disabilities. Learn more about: Auditory Processing ... Processing Disorder ...
Walker, Michael J.
The Disabled Veterans Outreach Program (DVOP) administered by the Department of Labor's Employment and Training Administration arranges training and placement for disabled veterans in local job service offices. These employees then assist in placing other disabled veterans on jobs. Some typical DVOP success stories are described. (MF)
Clapper, Ann T.; Bremer, Christine D.; Kachgal, Mera M.
This research brief discusses two reading instruction models for teaching secondary school students with disabilities. The first, Collaborative Strategic Reading (CSR), is designed specifically for students with learning disabilities and students who are at risk of reading failure. This strategy adapts reciprocal reading and incorporates…
Grindrod, Andrea; Rumbold, Bruce
Background: There is broad consensus within the disability field that the end-of-life care offered to people with intellectual disabilities should be of a quality consistent with that advocated by contemporary palliative care. In practice, however, various barriers are encountered when applying palliative care strategies to the end-of-life care of…
Yan, Lijing L; Chen, Shu; Zhou, Bo; Zhang, Jing; Xie, Bin; Luo, Rong; Wang, Ninghua; Lindley, Richard; Zhang, Yuhong; Zhao, Yi; Li, Xian; Liu, Xiao; Peoples, Nicholas; Bettger, Janet Prvu; Anderson, Craig; Lamb, Sarah E; Wu, Yangfeng; Shi, Jingpu
Stroke is the leading cause of death and disability in rural China. For stroke patients residing in resource-limited rural areas, secondary prevention and rehabilitation are largely unavailable, and where present, are far below evidence-based standards. This study aims to develop and implement a simplified stroke rehabilitation program that utilizes nurses and family caregivers for service delivery, and evaluate its feasibility and effectiveness in rural China. This 2-year randomized controlled trial is being conducted in 2-3 county hospitals located in northwest, northeast, and southwest China. Eligible and consenting stroke inpatients (200 in total) have been recruited and randomized into either a control or intervention group. Nurses in the county hospital are trained by rehabilitation specialists and in turn train the family caregivers in the intervention group. They also provide telephone follow-up care three times post discharge. The recruitment, baseline, intervention, follow-up care, and evaluation are guided by the RECOVER mobile phone app specifically designed for this study. The primary outcome is patients' Barthel Index (activities of daily living: mobility, self-care, and toileting) at 6 months. Process and economic evaluation will also be conducted. The results of our study will generate initial high-quality evidence to improve stroke care in resource-scarce settings. If proven effective, this innovative care delivery model has the potential to improve the health and function of stroke patients, relieve caregiver burden, guide policy-making, and advance translational research in the field of stroke care. © 2016 World Stroke Organization.
Full Text Available Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. This approach gives little information regarding a child's capacity to maintain oral health or regarding the social determinants of oral health. The biopsychosocial approach, embodied in the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY (WHO, provides a wider picture of a child's real-life experience, but practical tools for the application of this model are lacking. This article describes the preliminary empirical study necessary for development of such a tool - an ICF-CY Core Set for Oral Health. An ICF-CY questionnaire was used to identify the medical, functional, social and environmental context of 218 children and adolescents referred to special care or paediatric dental services in France, Sweden, Argentina and Ireland (mean age 8 years ± 3.6 yrs. International Classification of Disease (ICD-10 diagnoses included disorders of the nervous system (26.1%, Down syndrome (22.0%, mental retardation (17.0%, autistic disorders (16.1%, and dental anxiety alone (11.0%. The most frequently impaired items in the ICF Body functions domain were 'Intellectual functions', 'High-level cognitive functions', and 'Attention functions'. In the Activities and Participation domain, participation restriction was frequently reported for 25 items including 'Handling stress', 'Caring for body parts', 'Looking after one's health' and 'Speaking'. In the Environment domain, facilitating items included 'Support of friends', 'Attitude of friends' and 'Support of immediate family'. One item was reported as an environmental barrier - 'Societal attitudes'. The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts. The results of this empirical
Transicion de la Escuela a la Vida Adulta Manual de Informacion para la Provision de Servicios de Transicion a los Jovenes con Impedimentos (Transition from School to Adult Life. Manual of Information for the Provision of Transitional Services for Youth with Disabilities).
Puerto Rico State Dept. of Education, Hato Rey. Office of Special Education.
This manual has been prepared to orient school personnel in the development of programs for the transition of students with disabilities from school to adult life so that they can fulfill their responsibilities in planning and providing services. The laws under which such services are required are reviewed, and the services and planning are…
Brameld, Kate; Spilsbury, Katrina; Rosenwax, Lorna; Leonard, Helen; Semmens, James
To describe the cause of death together with emergency department presentations and hospital admissions in the last year of life of people with intellectual disability. A retrospective matched cohort study using de-identified linked data of people aged 20 years or over, with and without intellectual disability who died during 2009 to 2013 in Western Australia. Emergency department presentations and hospital admissions in the last year of life of people with intellectual disability are described along with cause of death. Of the 63 508 deaths in Western Australia from 2009 to 2013, there were 591 (0.93%) decedents with a history of intellectual disability. Decedents with intellectual disability tended to be younger, lived in areas of more social disadvantage, did not have a partner and were Australian born compared with all other decedents. A matched comparison cohort of decedents without intellectual disability (n=29 713) was identified from the general population to improve covariate balance.Decedents with intellectual disability attended emergency departments more frequently than the matched cohort (mean visits 3.2 vs 2.5) and on average were admitted to hospital less frequently (mean admissions 4.1 vs 6.1), but once admitted stayed longer (average length of stay 5.2 days vs 4.3 days). People with intellectual disability had increased odds of presentation, admission or death from conditions that have been defined as ambulatory care sensitive and are potentially preventable. These included vaccine-preventable respiratory disease, asthma, cellulitis and convulsions and epilepsy. People with intellectual disability were more likely to experience potentially preventable conditions at the end of their lives. This indicates a need for further improvements in access, quality and coordination of healthcare to provide optimal health for this group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved
The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described
Lindstrom, Jennifer H.; Lindstrom, Will
In order to gain access to accommodations and services at colleges and universities, students with learning disabilities must provide documentation of their disabilities, and as students with learning disabilities access higher education at increasing rates, the need for documentation of their disabilities and its impact becomes even more…
Lloyd, Jennifer L.; Coulson, Neil S.
Research suggests that the uptake of cervical screening by women with intellectual disabilities (commonly known as learning disabilities within UK policy frameworks, practice areas and health services) is poor compared to women without intellectual disabilities. The present study explored learning disability nurses' experiences of supporting women…
Bachani, Abdulgafoor M; Bentley, Jacob A; Zia, Nukhba; Galiwango, Edward; Lum, Jeremiah; Tuli, Gulnar; Ho, Shuen-En
Disability is highly prevalent in low-and-middle-income countries (LMICs), but there is a relative dearth of disability and caregiving research from LMICs. To examine type and severity of disability experienced by individuals 60 years and older, caregivers and type of caregiving assistance, and the interrelationships between sociodemographic factors involved in Uganda. Data was collected from two Eastern Ugandan districts using the WHO Disability Assessment Schedule 2.0. Data on availability of caregiver was analyzed for 816 participants with disability. Group comparisons and regression analyses examined differences based on caregiver availability. Approximately 66% of individuals with disability had a caregiver. The mean age of those with a caregiver (74.7 ± 8.9 years) was statistically significantly (p = .0004) higher than that of individuals without caregiver (72.4 ± 8.2 years). Significant differences based on caregiver availability were found relative to sex (p = .009), age (p≤.001), education level (p≤.001), occupation (p≤.001) and head of household status (p≤.001). The most frequent types of disability were related to vision (78.4%) and ambulation (71.7%). Caregiving most often fell to family members. Logistic regression results showed that individuals over the age of 80 years were 2.51 times more likely to have a caregiver compared to those 60-69 years (p≤.001). Those in the highest wealth quintile were 1.77 times more likely to have a caregiver. Findings demonstrate gaps in caring for aging individuals with disabilities in LMICs and highlight the importance of understanding caregiver access in generating effective healthy aging initiatives and long-term care systems. Copyright © 2018 Elsevier Inc. All rights reserved.
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Total disability-speech... SERVICE LIFE INSURANCE Premium Waivers and Total Disability § 8.18 Total disability—speech. The organic loss of speech shall be deemed to be total disability under National Service Life Insurance. [67 FR...
PEB Exchange, 2000
Examines how France's University of Grenoble provides for its disabled students in its residence halls, including a description of the university's service for disabled service. A hospital/education center where disabled students can receive care and physiotherapy while attending school is highlighted. (GR)
... below average Development way below that of peers Intelligence quotient (IQ) score below 70 on a standardized ... Social. Nutrition programs can reduce disability associated with malnutrition. Early intervention in situations involving abuse and poverty ...
... NICHD) See all related organizations Publications Problemas de aprendizaje Order NINDS Publications Patient Organizations CHADD - Children and ... NICHD) See all related organizations Publications Problemas de aprendizaje Order NINDS Publications Definition Learning disabilities are disorders ...
... books. While his friends were meeting for pickup soccer games after school, he was back home in ... sometimes thought to contribute to learning disabilities. Poor nutrition early in life also may lead to learning ...
Reproductive health barriers facing men and women with disabilities in Durban, South Africa. ... Gender and Behaviour ... reproductive health services is often overshadowed by negative stereotypes that are held about persons with disabilities ...
Anger management for people with mild to moderate learning disabilities: Study protocol for a multi-centre cluster randomized controlled trial of a manualized intervention delivered by day-service staff
Full Text Available Abstract Background Cognitive behaviour therapy (CBT is the treatment of choice for common mental health problems, but this approach has only recently been adapted for people with learning disabilities, and there is a limited evidence base for the use of CBT with this client group. Anger treatment is the one area where there exists a reasonable number of small controlled trials. This study will evaluate the effectiveness of a manualized 12-week CBT intervention for anger. The intervention will be delivered by staff working in the day services that the participants attend, following training to act as 'lay therapists' by a Clinical Psychologist, who will also provide supervision. Methods/Design This is a multi-centre cluster randomized controlled trial of a group intervention versus a 'support as usual' waiting-list control group, with randomization at the level of the group. Outcomes will be assessed at the end of the intervention and again 6-months later. After completion of the 6-month follow-up assessments, the intervention will also be delivered to the waiting-list groups. The study will include a range of anger/aggression and mental health measures, some of which will be completed by service users and also by their day service key-workers and by home carers. Qualitative data will be collected to assess the impact of the intervention on participants, lay therapists, and services, and the study will also include a service-utilization cost and consequences analysis. Discussion This will be the first trial to investigate formally how effectively staff working in services providing day activities for people with learning disabilities are able to use a therapy manual to deliver a CBT based anger management intervention, following brief training by a Clinical Psychologist. The demonstration that service staff can successfully deliver anger management to people with learning disabilities, by widening the pool of potential therapists, would have
Christine O'Rourke - Lang
Full Text Available This issue of Global Education Review examines the global context of disability and how in different geographic locations, socioeconomic factors, domestic policy, and disability perspectives impact access to special education services, and the types of resources and interventions available to individuals with diverse learning needs. Practices in countries including India, Singapore, South Korea, Hong Kong, El Salvador, Ethiopia, Liberia, and Kenya were studied and implications for meeting the special education needs for children and adults with disabilities and their families are discussed
Utilization of medical and health-related services among school-age children and adolescents with special health care needs (1994 National Health Interview Survey on Disability [NHIS-D] Baseline Data).
Weller, Wendy E; Minkovitz, Cynthia S; Anderson, Gerard F
To determine how sociodemographic factors and type of insurance influence use of medical and health-related services by children with special health care needs (CSHCN), after controlling for need. A cross-sectional analysis of 1994 National Health Interview Disability Survey was conducted. Children between 5 and 17 years were identified as chronically ill according to the Questionnaire for Identifying Children with Chronic Conditions (n = 3061). Independent variables included child and family characteristics categorized as predisposing, enabling, and need. Dependent variables included use of 4 medical or 7 health-related services. Most children (88.7%) had seen a physician; 23.9% had an emergency department visit, 11.4% had a mental health outpatient visit, and 6.4% were hospitalized. Health-related service use ranged from <5.0% (transportation and social work) to 65.1% (medical care coordination); 20% to 30% of children used the remaining services (therapeutic, assistive devices, nonmedical care coordination, housing modifications). In fully adjusted logistic models, children with public insurance were significantly more likely than privately insured children to use 2 of the 4 medical services and 5 of the 7 health-related services. Non-Hispanic black children and children from less educated families were significantly less likely to use many of the services examined. In 1994, factors in addition to need influenced medical and health-related service use by CSHCN. Differences in the scope of benefits covered by public insurance compared with private insurance may influence utilization of medical and especially health-related services. Attention is needed to ensure that CSHCN who are racial/ethnic minorities or are from less educated families have access to needed services. Future studies should determine whether these patterns have changed over time.
Harbour, Wendy S.; Greenberg, Daniel
This research brief summarizes issues related to campus climate issues and disability, to improve social and educational outcomes for students with disabilities, support faculty and staff with disabilities, and increase understanding of disability among nondisabled members of the campus community. Instead of relying on disability services offices…
Hussein, S; Manthorpe, J
The life expectancy of people with learning disabilities has increased substantially. Services for older people with learning disabilities are provided by various sectors and practitioners (generic health and social care, or specialist learning disability or old age). The literature suggests that practitioners do not feel well-equipped to support people with learning disabilities as they grow older, and older people's services do not always have the opportunity to share experiences and skills...
... 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 ...
Giorgadze, Gvantsa; Mania, Maka; Kukava, Maka; Dzagnidze, Ana; Mirvelashvili, Ekaterine; Steiner, Timothy J; Katsarava, Zaza
Background Headache disorders are widespread and disabling. They are common in Georgia, especially headache on ≥15 days/month (HA ≥ 15), but there are no headache services. Objective We established headache services meeting local needs, investigating feasibility, consumer uptake and satisfaction, and cost, with an exit strategy bequeathing effective, self-sustaining services that could be rolled out nationwide. Methods We created headache centres in Tbilisi and Gori offering free expert care for three visits over three months, and affordable medication thereafter. The primary outcome measure was the percentage of patients using the service beyond the free period - a measure of both satisfaction and sustainability. Results Of 1,445 patients (age 43.7 ± 12.4 years; 10.5% male), 49.8% had episodic migraine, 22.5% episodic tension-type headache, 25.7% HA ≥ 15 (24.5% overusing medication) and 2.0% trigeminal autonomic cephalalgias. Only 454 (31.4%) and 51 (3.5%) returned for second and third visits; in these, headache improved and treatment costs decreased. As information about the service spread, five other headache clinics opened in Tbilisi and Kutaisi (western Georgia). Pharmaceutical companies reduced prices (sumatriptan 100 mg from US$7 to US$1). Conclusion The study failed to achieve its primary outcome, but sustainable headache services operating to international standards were successfully implemented nonetheless, with demand increasing.
Mallik, Kalisankar; Shaver, Elaine M.
The final report of a 3 year project to improve the quality of life of mentally retarded, cerebral palsied, and epileptic persons in Region III is presented. The first section details the efforts of the project staff in providing competitive employment opportunities or sheltered employment for 40 severely disabled persons. Equipment modification…
Jahagirdar, D.; Kroll, T.; Ritchie, K.; Wyke, S.
ABSTRACT: BACKGROUND: Patient reported outcome measures (PROMs) are self-report measures of health status increasingly promoted for use in healthcare quality improvement. However people with low literacy skills or learning disabilities may find PROMs hard to complete. Our study investigated
Foti, Calogero; Albensi, Caterina; Giordani, Laura; Azeufack Ngueko, Yannick; Sanou Sobze, Martin; Colizzi, Vittorio
Rehabilitation services for disabled persons are lacking in countries with limited economic resources. Reliable and objective data are needed to plan for their implementation and to determine the burden of disability in these countries. A descriptive cross-sectional study conducted in June 2013 among people living in Dschang Health District, in the West region of Cameroon, to collect information about socio-demographic aspects of physically disabled subjects and health determinants of disabilities. Data was collected using a standard questionnaire in French. In total, 159 physically disabled subjects were enrolled in the study. Mean age was 36 years [± SD 17.26], 55.9% of subjects were female, and 33.8% had a low educational-level. The most frequently reported disabilities were orthopaedic problems (mainly fractures) [45.8%], infectious diseases [29.1%]), and neurological disabilities (mainly hemiplegia [33.3%], hemiparesis [23.8%], and monoplegia [23.8%]). The main causes of disability were trauma due to traffic accidents (17.8%) and inappropriate medical interventions (14.5%). Disability was related to age and 50% of participants experienced social discrimination. Disabled subjects with low-incomes (from 50.000 to 200.000 XAF) were required to pay for rehabilitative care (XAF 10.000 to 100.000), and up to 83% had appealed for improved quality of Rehabilitation Medicine. Although Law n. 83/013 for the protection of persons with disabilities in Cameroon dates back to 1983, the results of this study show that disabled people, and children in particular, are still marginalized, vulnerable and have little chance of recovery. Therefore, there is a clear need to improve the quality and availability of rehabilitative care services , with programmatic interventions that ensure implementation of existing laws, improve access to rehabilitative services, provide disabled persons with the necessary specialty medical products, and eliminate barriers to their social
People with learning disabilities have poorer health than the general population and experience health inequalities - partly as a result of problems with accessing health services. Health services have a duty to address health inequalities, by making reasonable adjustments to their services so they are more accessible to people with learning disabilities, but this does not always happen. Failure to make reasonable adjustments can have significant adverse effects for people with learning disabilities and their families. Nurses are well placed to implement reasonable adjustments, many of which are simple to do and can save lives.
Implementing a routine outcome assessment procedure to evaluate the quality of assistive technology service delivery for children with physical or multiple disabilities: Perceived effectiveness, social cost, and user satisfaction.
Desideri, Lorenzo; Bizzarri, Martina; Bitelli, Claudio; Roentgen, Uta; Gelderblom, Gert-Jan; de Witte, Luc
There is a lack of evidence on the effects and quality of assistive technology service delivery (ATSD). This study presents a quasi-experimental 3-months follow-up using a pre-test/post-test design aimed at evaluating outcomes of assistive technology (AT) interventions targeting children with physical and multiple disabilities. A secondary aim was to evaluate the feasibility of the follow-up assessment adopted in this study with a view to implement the procedure in routine clinical practice. Forty-five children aged 3-17 years were included. Parents were asked to complete the Individual Prioritised Problem Assessment (IPPA) for AT effectiveness; KWAZO (Kwaliteit van Zorg [Quality of Care]) and Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2.0 for satisfaction with ATSD; Siva Cost Analysis Instrument (SCAI) for estimating the social cost of AT interventions. At follow-up, 25 children used the AT recommended. IPPA effect sizes ranged from 1.4 to 0.7, showing a large effect of AT interventions. Overall, parents were satisfied with ATSD, but Maintenance, Professional Services, and AT Delivery were rated not satisfactory. SCAI showed more resources spent for AT intervention compared to human assistance without technological supports. AT may be an effective intervention for children with disabilities. Issues concerning responsiveness and feasibility of the IPPA and the SCAI instruments are discussed with a view to inform routine clinical practice.
Mac Giolla Phadraig, Caoimhin
This study aimed to generate prioritised goals for oral health services for people with disabilities as a first step in meeting the need for evidence based oral health services for people with disabilities in Ireland.
V. A. Lipatov
Full Text Available The distance education contributes to the solution of educational problems of disabled persons. The study of foreign experience is extremely important. North American universities saved up a wide experience in this sphere. Unlike self-made software products created by many Russian universities, Blackboard is the leading educational software package that professionally helps to solve educational problems of disabled persons. The international University of the Arctic has a growing interest in the use of information communication technologies and open educational resources and networks. In 2008 the subject network of University of the Arctic on distance education and e-learning began to function. The Internet and distance learning creates a new opportunity for disabled persons. Main goal: Whether distance education on Alaska and in Northern and Siberian regions of the Russian Federation promotes the solution of educational problems of the North for disabled persons. Main research problems: to reveal modern educational Arctic problems for disabled persons; to analyse specifics of remote education; to analyse a question of distance training of the circumpolar North; to carry out the comparative analysis of distance training on Alaska and in Russian northern and the Siberian regions; to analyse a contribution of distance training to wider problems of the Arctic policy and management. Relevance of work: The Arctic Human Development Report I specifi es that there are very few circumpolar researches in the fi eld of education, including for disabled persons. This article can begin initial discussion of a subject which can be in addition studied in future works. An emerging trend for Arctic education is its increasing accessibility. Accessibility is about students being able to take classes and fulfi ll their potential, that is, it concerns their possibilities for attending school, both physically and culturally. Even though this
This booklet uses hypothetical case examples to illustrate the definition, causal theories, and specific types of learning disabilities (LD). The cognitive and language performance of students with LD is compared to standard developmental milestones, and common approaches to the identification and education of children with LD are outlined.…
Manual de Orientacion para la Organizacion de Servicios de Vida Independiente a Jovenes con Impedimentos (Orientation Manual for the Organization of Independent Living Services for Youth with Disabilities).
Puerto Rico State Dept. of Education, Hato Rey. Office of Special Education.
The Secretary of Special Education of Puerto Rico has been searching for ways to offer appropriate special education services for young people between 13 and 21 years of age whose educational level does not allow them to benefit from current prevocational or vocational services. At present groups are being organized to offer services for…
benefits occurs when a service member is found unfit for duty , but the condition is determined to have occurred as a result of misconduct, negligence ...service members evaluated for disability Hospitalization records received by AMSARA include data on direct care inpatient visits among active duty ...hospitalization among active duty service members evaluated for disability .......... 58 Database Limitations
... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Technology and Media Services for Individuals With Disabilities Program AGENCY: Department of Education. ACTION..., authorized under the Individuals with Disabilities Education Act. Through this notice, we are adding a...
Berliss, Jane; And Others
Eight articles review the progress achieved in making library computing technologies and library services accessible to people with disabilities. Adaptive technologies, automated conversion into Braille, and successful programs that demonstrate compliance with the American with Disabilities Act are described. A resource list is included. (EA)
Thomsen, Frej Klem
Criminalisation of prostitution, and minority rights for disabled persons, are important contemporary political issues. The article examines their intersection by analysing the conditions and arguments for making a legal exception for disabled persons to a general prohibition against purchasing...... sexual services. It explores the badness of prostitution, focusing on and discussing the argument that prostitution harms prostitutes, considers forms of regulation and the arguments for and against with emphasis on a liberty-based objection to prohibition, and finally presents and analyses three...... arguments for a legal exception, based on sexual rights, beneficence, and luck egalitarianism, respectively. It concludes that although the general case for and against criminalisation is complicated there is a good case for a legal exception....
Thomsen, Frej Klem
Criminalisation of prostitution, and minority rights for disabled persons, are important contemporary political issues. The article examines their intersection by analysing the conditions and arguments for making a legal exception for disabled persons to a general prohibition against purchasing sexual services. It explores the badness of prostitution, focusing on and discussing the argument that prostitution harms prostitutes, considers forms of regulation and the arguments for and against with emphasis on a liberty-based objection to prohibition, and finally presents and analyses three arguments for a legal exception, based on sexual rights, beneficence, and luck egalitarianism, respectively. It concludes that although the general case for and against criminalisation is complicated there is a good case for a legal exception. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Whinnery, Keith W.
A college preparation curriculum relevant to the needs of students with learning disabilities is presented, focusing on early planning, instructional modifications, strategy instruction, and support services. (JDD)
Emong, Paul; Eron, Lawrence
Uganda has embraced inclusive education and evidently committed itself to bringing about disability inclusion at every level of education. Both legal and non-legal frameworks have been adopted and arguably are in line with the intent of the Convention on the Rights of Persons with Disabilities (CRPD) on education. The CRPD, in Article 24, requires states to attain a right to education for persons with disabilities without discrimination and on the basis of equal opportunities at all levels of education. Despite Uganda's robust disability legal and policy framework on education, there is evidence of exclusion and discrimination of students with disabilities in the higher education institutions. The main objective of this article is to explore the status of disability inclusion in higher education and strategies for its realisation, using evidence from Emong's study, workshop proceedings where the authors facilitated and additional individual interviews with four students with disabilities by the authors. The results show that there are discrimination and exclusion tendencies in matters related to admissions, access to lectures, assessment and examinations, access to library services, halls of residence and other disability support services. The article recommends that institutional policies and guidelines on support services for students with disabilities and special needs in higher education be developed, data on students with disabilities collected to help planning, collaboration between Disabled Peoples Organisations (DPO's) strengthened to ensure disability inclusion and the establishment of disability support centres.
U.S. Department of Health & Human Services — According to findings reported in, The Medicaid Medically Improved Group, Losing Disability Status and Growing Earnings, published in Volume 4, Issue 1 of the...
Ying Li, Eria Ping
The aim of this study was to examine the experience of the first generation of sibling advocates in Hong Kong. A qualitative approach was adopted and six sibling advocates of people with intellectual disabilities from one non-government organization were interviewed. Data were analyzed using a constant comparative method and content analysis. Findings revealed that the six participants were reactive in the process of taking up the caregiver responsibility and they performed three functions: to advocate for more service provision, to improve service quality, and to facilitate communication between individual service units and family members of people with intellectual disabilities. All of the participants expressed that they needed support from service providers when they tried to function as the sibling advocates. Strategies to promote the involvement of siblings of people with intellectual disabilities as advocates are discussed and it is expected that more siblings of people with intellectual disabilities will be supported to have a higher level of involvement in advocacy.
Mondejar-Jimenez, Jose; Vargas-Vargas, Manuel; Meseguer-Santamaria, Maria-Leticia; Mondejar-Jimenez, Juan-Antonio
Disabled women suffer from a double labour discrimination due to their gender and their disability. In rural areas, in addition, they also suffer from a lack of specific services, the isolation of the disabled associations, problems with public transport, the dispersion of population centres, and a limited access to information that could improve…
Wilton, Robert D.
This paper explores the implications of emotional labour for workers with disabilities, drawing on qualitative data from interviews with 59 respondents who had disabilities and who worked in service sector occupations. The analysis illustrates that employer demands for emotional labour may prove difficult for workers with a range of disabilities,…
... type. (d) OPM also considers a disability retirement application to be withdrawn when the agency... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Withdrawal of disability retirement...) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Disability Retirement § 831.1207 Withdrawal of...
Army and Air Force had higher percentages of reserve component disability evaluations, likely due to the inclusion of National Guard service members...Annual Report 2015 Disability Evaluation Systems Analysis and Research Prepared by Accession Medical Standards Analysis and Research Activity...Preventive Medicine Branch Walter Reed Army Institute of Research Silver Spring, Maryland Disability Evaluation Systems Analysis and Research
Mohamed, Ahmed Hassan Hemdan
Extensive efforts have been made to maximize the potential of children with disabilities in Oman. The establishment of Al-Wafaa centers of disabilities served as a channel to help families secure a variety of services provided to children with different disabling conditions. The purpose of this study was to explore the burnout of staff working in…
Pingry O'Neill, Laura N.; Markward, Martha J.; French, Joshua P.
This exploratory study determined which set of student characteristics and disability-related services explained graduation success among college students with disabilities. The archived records of 1,289 unidentified students with disabilities in three public universities were examined ex-post-facto to collect demographic data on the students, the…
Drake, Robert E.; Skinner, Jonathan S.; Bond, Gary R.; Goldman, Howard H.
Social Security Administration disability programs are expensive, growing, and headed toward bankruptcy. People with psychiatric disabilities now constitute the largest and most rapidly expanding subgroup of program beneficiaries. Evidence-based supported employment is a well-defined, rigorously tested service model that helps people with psychiatric disabilities obtain and succeed in competitive employment. Providing evidence-based supported employment and mental health services to this population could reduce the growing rates of disability and enable those already disabled to contribute positively to the workforce and to their own welfare, at little or no cost (and, depending on assumptions, a possible savings) to the government. PMID:19414885
Prodinger, Birgit; Scheel-Sailer, Anke; Escorpizo, Reuben; Stucki, Gerold
Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care. The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services. UEMS PRM Workshop in Nottwil, Switzerland, January 2016. PRM physicians representatives from 12 European countries, as well as Israel and Japan, mostly delegates of UEMS PRM Section and Board, and experts with other rehabilitation professional backgrounds. Participants were divided into 6 working groups and asked to specify what functioning aspects would be essential to document using the available ICF sets for the identified rehabilitation services contained in the newly developed service classification (ICSO-R): acute, post-acute and long-term rehabilitation services. The 7 ICF Generic and 23 Rehabilitation Set categories were confirmed as well as specific health condition categories for acute rehabilitation services (mobile team), for postacute rehabilitation services (general outpatient rehabilitation, musculoskeletal and neurological rehabilitation, as well as specialized SCI rehabilitation), and for long-term rehabilitation services (day clinic and rehabilitation provided in the community). While general principles of the CLAS were defined, the need to align the CLAS for a specific service, as well as across services along the continuum of care was highlighted. All groups deliberated on this topic; however, no conclusive statement was presented yet. The groups recognized a need for a systematic effort to identify data collection tools currently used. CLASs will serve in the future to ensure that functioning information is systematically and consistently collected across services, and thus respond also to various global reports and initiatives which stress the need for
Mudrick, Nancy R
Every examination of disability among children must first grapple with definition of disability. The challenges to identifying disability among children involve not only determining the appropriate paradigm for defining disability, but also applying that paradigm to children in a meaningful way. This discussion of the prevalence of disability among children starts by examining the various paradigms utilized to identify disability and how they are interpreted when applied to children. Estimates of the prevalence of childhood disability, under different definitions of disability are presented. The goal of the discussion is to illustrate the sensitivity of the estimates of disability prevalence to the particular definition and data set used. Finally, the potential influence of the choice of paradigm on further measurement and service delivery is outlined.
Werner, Shirli; Araten-Bergman, Tal
Introduction: People with disabilities often identify professionals' stigmatic views as significant barriers to accessing mainstream services. This study aimed to examine differences in stigmatic attitudes held by social workers toward individuals with intellectual disabilities (ID), mental illness (MI), or dual diagnosis (DD) of ID and MI.…
Full Text Available This paper aims to question the living conditions of disabled people in the 21st century from the framework of social justice. The concept of “social justice” has a long history, influenced by the works of numerous writers including Rawls (1971, Miller (1999, Reeves (2005, Fainstein (2009, Marcuse (2009 and Harvey (1992, 2009 and by the recent debates on inequality, diversity, segregation, exclusion, and discrimination. The debates on segregation, exclusion and discrimination are generally focused on inequalities in terms of economic, ethnic and gender dimensions; however, in these debates, there is very little reference to unequal opportunities of disabled people. On the other hand, the diversity issue is generally discussed with respect to ethnic and cultural elements, again with very little concern for the rights of disabled people. In many developing countries, including Turkey, a legal framework for addressing disability issues has started to be put in place. Awareness among governments and society of the needs and rights of people with disabilities is growing. In the last decade in Turkey, the difficulties faced by disabled people have started to be taken into consideration seriously. Before that, the only information about the disabled population could be obtained from General Population Census in Turkey. In 2002 “Turkey Disability Survey” was carried out collectively by the State Institute of Statistics and the Presidency of Administration on Disabled People. In this survey, it has been targeted to estimate the number of disabled people and comprehend their socio-economic characteristics, their problems in social life, expectations, types and causes of disability, regional differences and also the proportion of population having chronic illnesses. After this survey, many projects have started to be realized in order to propose strategies for eliminating discrimination in Turkey. In this paper, we will
This article covers current trends in disability rights and raises questions about how society's views of disability influence the music education of students in need of special education services. Brief overviews of the disability-rights movement in the United States and of federal laws pertaining to disabilities and education are included. Next,…
Gelbar, Nicholas W.; Madaus, Joseph W.; Lombardi, Allison; Faggella-Luby, Michael; Dukes, Lyman
College students with physical disabilities were among the first students to receive disability supports in higher education in the United States, and the earliest journal articles in disability services focused almost exclusively on this cohort. As more students with a range of disability types have accessed higher education over the past 25…
Somme, D; Trouvé, H; Couturier, Y; Carrier, S; Gagnon, D; Lavallart, B; Hébert, R; Cretin, C; Saint-Jean, O
The French health and services system to maintain at home is characterized by its fragmentation, whereas the need of the people for intervention is generally total. This fragmentation have consequences: delay in services delivery, inadequate transmission of information, redundant evaluation, service conditioned by the entrance point solicited rather than by the need of the person and inappropriate use of expensive resources by ignorance or difficulty of access to the less expensive resources. The purpose of integration is to improve continuity of interventions for people in loss of autonomy. It consists in setting up a whole of organisational, managerial and clinical common tools. Organisational model "Projet et Recherches sur l'Intégration des Services pour le Maintien de l'Autonomie" (Prisma) tested in Quebec showed a strong impact on the prevention of the loss of autonomy in term of public health on a population level. This model rests on six principal elements: partnership, single entry point, case-management, a multidimensional standardized tool for evaluation, an individualized services plan and a system for information transmission. Thus, it was decided to try to implement in France this organisational model. The project is entitled Prisma France and is presented here. The analysis of the context of implementation of the innovation which represents integration in the field of health and services for frail older reveals obstacles (in particular because of diversity of professional concerned and a presentiment of complexity of the implementation of the model) and favourable conditions (in particular the great tension towards change in this field). The current conditions in France appear mainly favourable to the implementation of integration. The establishment of Prisma model in France requires a partnership work of definition of a common language as well on the diagnoses as on the solutions. The strategic and operational dialogue is thus a key element of the
Interagency partnership to deliver Veteran-Directed Home and Community-Based Services: Interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.
Thomas, Kali S; Allen, Susan M
Veteran-Directed Home and Community-Based Services (VD-HCBS) is a consumer-directed program that began in 2009 and is jointly administered in a partnership between the Veterans Health Administration and the Administration for Community Living. The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Qualitative interviews with 26 ADNA VD-HCBS personnel across the country were transcribed, coded, and analyzed. Results suggest that the majority of ADNA personnel interviewed perceive the collaboration experience to be positive. Interviewees reported several key mechanisms for facilitating a successful partnership, including frequent communication, training in VAMC billing procedures, having a designated VAMC staff person for the program, and active involvement of the VAMC from the onset of VD-HCBS program development. Findings have implications for other interagency partnerships formed to deliver services to vulnerable Veterans.
Shamyr Sulyvan Castro
ciudad de Sao Paulo, Sureste de Brasil, de junio a agosto de 2007, que respondieron preguntas relacionadas con el desplazamiento e el acceso a los servicios de salud. La metodología utilizada para análisis fue el discurso del sujeto colectivo y los análisis fueron conducidos con recurso al programa Qualiquantisoft. ANÁLISIS DE RESULTADOS: El análisis de los discursos sobre el desplazamiento al servicio de salud mostró diversidad con relación al usuario ir al servicio sólo o acompañado, utilizar carro particular, transporte colectivo, ir a pie o de ambulancia y demandar tiempo variado para llegar al servicio. Con relación a las dificultades ofrecidas de acceso por los servicios de salud, hubo relatos de demora en la atención, problemas con estacionamiento, falta de rampas, elevadores, sillas de rueda, sanitarios adaptados y de médicos. CONCLUSIONES: Las personas con algún tipo de discapacidad hicieron uso de medios de transporte diversificados, necesitando de compañía en algunos casos. Problemas con el acceso a los servicios de salud fueron relatados por los sujetos con discapacidades, contrariando el principio de la equidad, precepto del Sistema Único de Salud.OBJECTIVE: To analyze the difficulties in accessibility to health services experienced by persons with disabilities. METHODOLOGICAL PROCEDURES: A qualitative study was performed with individuals who reported having a certain type of disability (paralysis or amputation of limbs; low vision, unilateral or total blindness; low hearing, unilateral or total deafness. A total of 25 individuals (14 women were interviewed in the city of São Paulo, Southeastern Brazil, between June and August 2007, responding to questions about transportation and accessibility to health services. Collective Subject Discourse was the methodology used to analyze results and analyses were performed with the Qualiquantisoft software. ANALYSIS OF RESULTS: The analysis of discourses on transportation to health services revealed a
Gubata, Marlene E; Packnett, Elizabeth R; Cowan, David N
Surveillance of trends in disability is necessary to determine the burden of disability on the U.S. military, the most common types of disability conditions, and the prevalence of combat exposures in the disability population. Previous studies of disability in the U.S. military have focused on a particular service or condition rather than examining the epidemiology of disability in the military overall. This study's objective is to describe rates of disability evaluation and retirement in U.S. Army, Navy, and Marine Corps. A cross-sectional study of 126,170 service members evaluated for disability discharge from the U.S. military in fiscal years 2005-2011 was conducted. Crude and standardized rates of disability evaluation and retirement were calculated per 10,000 service members by year of disability, demographic characteristics, and type of disability evaluation or retirement. Temporal trends in the prevalence of combat-related disability in the disability evaluated and retired population were also examined. Rates of disability evaluation and retirement were highest among female, enlisted, and active duty service members. Overall rates of disability evaluation significantly decreased, while rates of disability retirement increased. Rates of psychiatric disability evaluation and retirement significantly increased in all services during the same time period from 2005 to 2011. Combat-related disability evaluations and retirements have substantially increased in all services particularly among psychiatric disability cases. Psychiatric disability, combat-related disability, and disability retirement continue to increase in the military, despite observed decreases in the rates of disability the Department of Defense since 2005. Published by Elsevier Inc.
Dell, Thomas Francis
The purpose of this study was to describe and analyze how the characteristics of age, major and type of disabilities for students who received services through Disability Support Services at Montana State University-Billings have changed from 1999 to 2011. Furthermore, this analysis contrasted local trends for types of disabilities with national…
Tsai, Wen-Chen; Kung, Pei-Tseng; Wang, Jong-Yi
Children with disabilities face more barriers accessing preventive health services. Prior research has documented disparities in the receipt of these services. However, most are limited to specific types of disability or care. This study investigates disparities in the use of preventive health care among children with disabilities in Taiwan. Three…
Family-centredness of professionals who support people with profound intellectual and multiple disabilities: validation of the Dutch 'Measure of Processes of Care for Service Providers' (MPOC-SP-PIMD).
Jansen, Suzanne L G; van der Putten, Annette A J; Post, Wendy J; Vlaskamp, Carla
A Dutch version of the 'Measure of Processes of Care for Service Providers' (MPOC-SP) was developed to determine the extent to which professionals apply the principles of family-centred care in the rehabilitation of children with physical disabilities. However, no data were available on the reliability and construct validity of this instrument when it comes to supporting people with profound intellectual and multiple disabilities (PIMD). This study aimed to validate an adapted version of the Dutch MPOC-SP for assessing the family-centred behaviours of professionals who support this group (MPOC-SP-PIMD). A total of 105 professionals took part in the study. A Mokken scale analysis was conducted to determine whether the instrument satisfied the assumptions of both monotone homogeneity and double monotonicity. Loevinger's scalability coefficient (H) was used for the scalability of the entire scale and of each item separately. Rho was calculated as a measure of the internal consistency of the scales. The analyses resulted in two scales: a nine-item scale interpreted as 'Showing Interpersonal Sensitivity', with H=.39 and rho=.76, and a seven-item scale interpreted as 'Treating People Respectfully', with H=.49 and rho=.78. A validated version of the MPOC-SP-PIMD, suitable for supporting people with PIMD, consists of a subset of two scales from the original Dutch MPOC-SP. This instrument can be used to compare the family-centredness of professionals with parent's expectations and views. This information can be used in practice to match the support to the needs of the parents and family of the child with PIMD. Copyright © 2014 Elsevier Ltd. All rights reserved.
Home care is care that allows a person with special needs stay in their home. It might be for people who are getting ... are chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help ...
Goverman, Jeremy; Mathews, Katie; Holavanahalli, Radha K; Vardanian, Andrew; Herndon, David N; Meyer, Walter J; Kowalske, Karen; Fauerbach, Jim; Gibran, Nicole S; Carrougher, Gretchen J; Amtmann, Dagmar; Schneider, Jeffrey C; Ryan, Colleen M
The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) established the Burn Model System (BMS) in 1993 to improve the lives of burn survivors. The BMS program includes 1) a multicenter longitudinal database describing the functional and psychosocial recovery of burn survivors; 2) site-specific burn-related research; and 3) a knowledge dissemination component directed toward patients and providers. Output from each BMS component was analyzed. Database structure, content, and access procedures are described. Publications using the database were identified and categorized to illustrate the content area of the work. Unused areas of the database were identified for future study. Publications related to site-specific projects were cataloged. The most frequently cited articles are summarized to illustrate the scope of these projects. The effectiveness of dissemination activities was measured by quantifying website hits and information downloads. There were 25 NIDILRR-supported publications that utilized the database. These articles covered topics related to psychological outcomes, functional outcomes, community reintegration, and burn demographics. There were 172 site-specific publications; highly cited articles demonstrate a wide scope of study. For information dissemination, visits to the BMS website quadrupled between 2013 and 2014, with 124,063 downloads of educational material in 2014. The NIDILRR BMS program has played a major role in defining the course of burn recovery, and making that information accessible to the general public. The accumulating information in the database serves as a rich resource to the burn community for future study. The BMS is a model for collaborative research that is multidisciplinary and outcome focused.
Fitzcharles, Mary-Ann; Ste-Marie, Peter A; Rampakakis, Emmanouil; Sampalis, John S; Shir, Yoram
It is intuitive that disability caused by illness should be reflected in illness severity. Because disability rates for fibromyalgia (FM) are high in the developed world, we have examined disease and work characteristics for patients with FM who were working, unemployed, or receiving disability payments for disability as a result of FM. Of the 248 participants in a tertiary care cohort study of patients with FM, 90 were employed, 81 were not employed and not receiving disability payments, and 77 were not working and currently receiving disability payments awarded for disability caused by FM. Demographic, occupation, and disease characteristics were compared among the groups. The prevalence of disability caused by FM was 30.8%. There were no demographic differences among the working, unemployed, or disabled patients. With the exception of measures for anxiety and depression, all measurements for disease severity differed significantly among the groups, with greater severity reported for the disabled group, which used more medications and participated less in physical activity. Disabled patients were more likely previously employed in manual professions or the service industry, whereas employed patients were more commonly working in non-manual jobs that included clerical, managerial, or professional occupations (p = 0.005). The one-third rate of disability for this Canadian cohort of patients with FM is in line with other reports from the western world. Associations of disability compensation were observed for subjective report of symptom severity, increased use of medications, and previous employment in more physically demanding jobs.
Ways of thinking about and responding to disability have radically changed in recent decades. Traditionally, disability was regarded in terms of sin, karma, or divine punishment. More recently, disability was made a medical issue and defined in terms of shortcomings of body or mind, which had to be prevented or cured at all costs. In the late 20th century, people with disabilities worldwide became more organised and created national and international disabled people’s organisations. They succ...
Consumer Guide Speech to Speech Relay Service Speech-to-Speech (STS) is one form of Telecommunications Relay Service (TRS). TRS is a service that allows persons with hearing and speech disabilities ...
Wallace, Robyn A
Preventable poor health outcomes for adults with intellectual disability in health settings have been known about for years. Subsequent analysis and the sorts of reasonable adjustments required in health and disability support settings to address these health gaps are well described, but have not really been embedded in practice in any significant way in either setting. As far as health is concerned, implementation of the National Disability Insurance Scheme (NDIS, the Scheme) affords an opportunity to recognise individual needs of people with intellectual disability to provide reasonable and necessary functional support for access to mainstream health services, to build capacity of mainstream health providers to supply services and to increase individual capacity to access services. Together these strands have potential to transform health outcomes. Success of the Scheme, however, rests on as yet incompletely defined operational interaction between NDIS and mainstream health services and inherently involves the disability sector. This interaction is especially relevant for adults with intellectual disability, known high users of hospitals and for whom hospital outcomes are particularly poor and preventable. Keys to better hospital outcomes are first, the receiving of quality person-centred healthcare from physicians and hospitals taking into account significance of intellectual disability and second, formulation of organised quality functional supports during hospitalisation. Achieving these require sophisticated engagement between consumers, the National Disability Insurance Agency, Commonwealth, State and Territory government leaders, senior hospital and disability administrators, NDIS service providers and clinicians and involves cross fertilisation of values, sharing of operational policies and procedures, determination of boundaries of fiscal responsibility for functional supports in hospital. © 2018 Royal Australasian College of Physicians.
Joaquín Gairín Sallán; José Luís Muñoz Moreno
This article places an emphasis on the importance of tutorials for students with a disability in universities. It presented the most significant results of the study of tutorials carried out in help services, units or offices for students with a disability inmore than 45 Spanish universities, in relation to promotion, reception, completion and graduation. The contributions highlight the importance of organising a response through a Tutorial Action Plan made up of the stages of motivation and ...
Mercier, C; Picard, S
The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a team dedicated to homeless persons. (1) To describe the characteristics, history and current situation of these persons; and (2) to report within-group differences as a function of gender and current residential status. The data were collected from files using an anonymous chart summary. Descriptive statistics on the whole sample (n = 68) and inferential statistics on cross-tabulations by gender and residential status were performed. Persons with ID exhibited several related problems. Some of these persons, primarily women, experienced relatively short periods of homelessness and their situations stabilised once they were identified and followed up. Other persons with ID experienced chronic homelessness that appeared to parallel the number and severity of their other problems. When compared with a previous epidemiological study of the homeless in Montreal, the population of homeless persons with ID differed from the overall homeless population in a number of respects. The results suggest prevention and intervention targets. The need for epidemiological research appears particularly clear in light of the fact that below-average intellectual functioning has been identified as a risk factor for homelessness and a predisposing factor for vulnerability among street people. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.
Wolfe, C V
These cases represent individuals who feel they have a severe impairment and are "disabled." They have been labeled with fibromyalgia. They are truly distressed. Their symptoms, their courses, are more chronic and refractory than those of medically ill patients, and they are high users of medical services, laboratory investigations, and surgical procedures. These patients see multiple providers simultaneously and frequently switch physicians. They are difficult to care for, and they reject psychosocial factors as an influence on their symptoms. Such persons "see themselves as victims worthy of a star appearance on the Oprah Winfrey show. A sense of bitterness emerges...." Shorter, a historian, believes that fibromyalgia is "heaven-sent to doctors as a diagnostic label for pain patients who display an important neurotic component in their illness. Our culture increasingly encourages patients to conceive vague and nonspecific symptoms as evidence of real disease and to seek specialist help for them; and the rising ascendancy of the media and the breakdown of the family encourage patients to acquire the fixed belief that they have a given illness...." Regarding the finding of "disability," this is a social construct, and many authors believe it is society and the judicial system who must decide who can work. To remain objective, the physician should report the objective clinical information. Physicians need not and should not sit in judgment of the veracity of another human being.
Hatice Yildirim Sari
Full Text Available Mentally disabled individuals are at risk of health problems. In fact, health problems are more frequent in mentally disabled individuals than in the general population and mentally disabled individuals less frequently use health care facilities. It has been shown that mentally disabled individuals frequently have nutritional problems. They may suffer from low weight, malnutrition, high weight, pica, iron and zinc deficiencies and absorption and eating disorders. Activities can be limited due to motor disability and restricted movements. Depending on insufficient liquid intake and dietary fiber, constipation can be frequent. Another problem is sleep disorders such as irregular sleep hours, short sleep, waking up at night and daytime sleepiness. Visual-hearing losses, epilepsy, motor disability, hepatitis A infection and poor oral hygiene are more frequent in mentally disabled children than in the general population. The mentally disabled have limited health care facilities, poorer health status than the general population and difficulties in demanding for health care and expressing health problems. Therefore, they should be provided with more health promotion services. [TAF Prev Med Bull 2010; 9(2.000: 145-150
Hiranandani, Vanmala Sunder
Medicaid, America's largest government-funded health insurance program, plays a pivotal role in providing health services to eight million adults with disabilities. Since the mid-1990s, many Medicaid programs have aggressively introduced managed care, which reconfigures service delivery using...... business principles. Most states have insufficient experience in developing managed care plans for Medicaid beneficiaries with disabilities. Middle-aged adults with physical disabilities present their own constellation of health care issues that is not readily appreciated in health and social services....... The purpose of the study was to understand their experiences in accessing physical health care services and to ascertain the effects of managed care on their health and well-being. This study found beneficiaries encounter numerous barriers in accessing preventative, treatment, and acute care services. Overall...
Full Text Available Neurological disorders with a prolonged course, either remediable or otherwise are being seen increasingly in clinical practice and many such patients are young and are part of some organization or other wherein their services are needed if they were healthy and fit. The neurologists who are on the panel of these organizations are asked to certify whether these subjects are fit to work or how long they should be given leave. These certificates may be produced in the court of law and may be subjected to verification by another neurologist or a medical board. At present there are no standard guidelines in our country to effect such certification unlike in orthopedic specialty or in ophthalmology. The following is a beginning, based on which the neurologist can certify the neurological disability of such subjects and convey the same meaning to all neurologists across the country.
Harniss, Mark; Samant Raja, Deepti; Matter, Rebecca
This special issue addresses access to and service delivery of assistive technology (AT) in resource-limited environments (RLEs). Access to AT is complicated not simply by limited funds to purchase AT, but by larger ecosystem weaknesses in RLEs related to legislation and policy, supply, distribution, human resources, consumer demand and accessible design. We present eight diverse articles that address various aspects of the AT ecosystem. These articles represent a wide range of AT, many different countries and different research methods. Our goal is to highlight a topic that has received scant research investigation and limited investment in international development efforts, and offer an insight into how different countries and programs are promoting access to AT. We encourage researchers, funders and non-profit organizations to invest additional effort and resources in this area.
Bhardwaj, S.; Ozcelebi, T.; Ozunlu, O.; Lukkien, J.J.
Smart spaces are physical spaces where services provided by Consumer Electronics (CE) devices with varying resource availabilities work together to realize user-specific automated scenarios. These scenarios may be interrupted in case one of the services making up the scenario stops, e.g. due to lack
Bhardwaj, S.; Ozcelebi, T.; Syed, Aly; Ozunlu, O.; Lukkien, J.J.
Smart spaces are physical spaces where services provided by Consumer Electronics (CE) devices with varying resource availabilities work together to realize user-specific automated scenarios. These scenarios may be interrupted in case one of the services making up the scenario stops working, e.g. due
Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities.
Furuta, Michiko; Komiya-Nonaka, Manae; Akifusa, Sumio; Shimazaki, Yoshihiro; Adachi, Munehisa; Kinoshita, Toshinori; Kikutani, Takeshi; Yamashita, Yoshihisa
Malnutrition and cognitive impairment lead to declines in activities of daily living (ADL). Nutritional status and cognitive ability have been shown to correlate with oral health status and swallowing function. However, the complex relationship among the factors that affect decline in ADL is not understood. We examined direct and indirect relationships among oral health status, swallowing function, nutritional status, cognitive ability, and ADL in Japanese elderly people living at home and receiving home care services because of physical disabilities. Participants were 286 subjects aged 60 years and older (mean age, 84.5±7.9 years) living at home and receiving home care services. Oral health status (the number of teeth and wearing dentures) was assessed, and swallowing function was examined using cervical auscultation. Additionally, ADL, cognitive ability, and nutritional status were assessed using the Barthel Index, the Clinical Dementia Rating Scale, and the Mini Nutritional Assessment-Short Form, respectively. Path analysis was used to test pathways from these factors to ADL. The mean number of teeth present in the participants was 8.6±9.9 (edentates, 40.6%). Dysphagia, malnutrition, and severe cognitive impairment were found in 31.1%, 14.0%, and 21.3% of the participants, respectively. Path analysis indicated that poor oral health status and cognitive impairment had a direct effect on denture wearing, and the consequent dysphagia, in addition to cognitive impairment, was positively associated with malnutrition. Malnutrition as well as dysphagia and cognitive impairment directly limited ADL. A lower number of teeth are positively related to swallowing dysfunction, whereas denture wearing contributes to recovery of swallowing function. Dysphagia, cognitive impairment, and malnutrition directly and indirectly decreased ADL in elderly people living at home and receiving home nursing care. The findings suggest that preventing tooth loss and encouraging denture
... are the requirements to qualify for the service? Cost: The fees for transportation services will vary and may include a reduced rate or no-cost service for older adults and people with disabilities. ...
Reschly, D J
Students with disabilities or suspected disabilities are evaluated by schools to determine whether they are eligible for special education services and, if eligible, to determine what services will be provided. In many states, the results of this evaluation also affect how much funding assistance the school will receive to meet the students' special needs. Special education classification is not uniform across states or regions. Students with identical characteristics can be diagnosed as disabled in one state but not in another and may be reclassified when they move across state or school district lines. Most disabilities with a clear medical basis are recognized by the child's physician or parents soon after birth or during the preschool years. In contrast, the majority of students with disabilities are initially referred for evaluation by their classroom teacher (or parents) because of severe and chronic achievement or behavioral problems. There is evidence that the prevalence of some disabilities varies by age, the high-incidence disabilities such as learning disabilities and speech-language disabilities occur primarily at the mild level, the mild disabilities exist on broad continua in which there are no clear demarcations between those who have and those who do not have the disability, and even "mild" disabilities may constitute formidable barriers to academic progress and significantly limit career opportunities. Problems with the current classification system include stigma to the child, low reliability, poor correlation between categorization and treatment, obsolete assumptions still in use in treatment, and disproportionate representation of minority students. Both African-American and Hispanic students are disproportionately represented in special education but in opposite directions. The disproportionately high number of African Americans in special education reflects the fact that more African-American students than white students are diagnosed with
Social Security Administration — The dataset includes fiscal year data for initial claims for SSA disability benefits that were referred to a state agency for a disability determination. Specific...
Hayhoe, Celia Ray; Smith, Mike, CPF
The purpose of disability income insurance is to partially replace your income if you are unable to work because of sickness or an accident. This guide reviews the types of disability insurance, important terms and concepts and employer provided benefits.
... Over a billion people, about 15% of the world's population, have some form of disability. Between 110 million ... disability. This corresponds to about 15% of the world's population. Between 110 million (2.2%) and 190 million ( ...
Bjorvatn, Kjetil; Tungodden, Bertil
We report from the first randomized controlled trial of a development program targeting people with disabilities: a village savings‐ and loans program in rural Uganda. We find that it has had a strong, positive impact on the lives of the disabled participants, through providing access to financial services and strengthening locus of control. Our results suggest that such programs may represent a promising tool to empowering people living with disabilities in developing countries, but al...
Jordan, L; Bryan, K
The potential value of a framework enabling practitioners to conceptualise speech and language therapy from a range of perspectives engendered by different theories about disability is explored. Four disability research paradigms are used to categorise professional activities, whilst the 'individual' and 'social' models of disability are considered as alternative value systems. Challenges facing speech and language therapists in developing roles and services to embrace different perspectives are outlined.
Pay More Attention: a national mixed methods study to identify the barriers and facilitators to ensuring equal access to high-quality hospital care and services for children and young people with and without learning disabilities and their families.
Oulton, Kate; Wray, Jo; Carr, Lucinda; Hassiotis, Angela; Jewitt, Carey; Kerry, Sam; Tuffrey-Wijne, Irene; Gibson, Faith
Despite evidence of health inequalities for adults with intellectual disability (ID) there has yet to be a comprehensive review of how well hospital services are meeting the needs of children and young people (CYP) with ID and their families. We do not know how relevant existing recommendations and guidelines are to CYP, whether these are being applied in the paediatric setting or what difference they are making. Evidence of parental dissatisfaction with the quality, safety and accessibility of hospital care for CYP with ID exists. However, the extent to which their experience differs from parents of CYP without ID is not known and the views and experiences of CYP with ID have not been investigated. We will compare how services are delivered to, and experienced by CYP aged 5-15 years with and without ID and their families to see what inequalities exist, for whom, why and under what circumstances. We will use a transformative, mixed methods case study design to collect data over four consecutive phases. We will involve CYP, parents and hospital staff using a range of methods; interviews, parental electronic diary, hospital and community staff questionnaire, patient and parent satisfaction questionnaire, content analysis of hospital documents and a retrospective mapping of patient hospital activity. Qualitative data will be managed and analysed using NVivo and quantitative data will be analysed using parametric and non-parametric descriptive statistics. The study will run from December 2015 to November 2018. We have Health Authority Approval (IRAS project ID: 193932) for phase 1 involving staff only and ethical and Health Authority Approval for phases 2-4 (IRAS project ID: 178525). We will disseminate widely to relevant stakeholders, using a range of accessible formats, including social media. We will publish in international peer-reviewed journals and present to professional, academic and lay audiences through national and international conferences. Published by
Full Text Available Objective: To provide an update on disability and rehabilitation in Mongolia, and to identify potential barriers and facilitators for implementation of the World Health Organization (WHO Global Disability Action Plan (GDAP. Methods: A 4-member rehabilitation team from the Royal Melbourne Hospital conducted an intensive 6-day workshop at the Mongolian National University of Medical Sciences, for local healthcare professionals (n = 77 from medical rehabilitation facilities (urban/rural, public/private and non-governmental organizations. A modified Delphi method (interactive sessions, consensus agreement identified challenges for rehabilitation service provision and disability education and attitudes, using GDAP objectives. Results: The GDAP summary actions were considered useful for clinicians, policy-makers, government and persons with disabilities. The main challenges identified were: limited knowledge of disability services and rehabilitation within healthcare sectors; lack of coordination between sectors; geo-topographical issues; limited skilled workforces; lack of disability data, guidelines and accreditation standards; poor legislation and political commitment. The facilitators were: strong leadership; advocacy of disability-inclusive development; investment in local infrastructure/human resources; opportunities for coordination and partnerships between the healthcare sector and other stakeholders; research opportunities; and dissemination of information. Conclusion: Disability and rehabilitation is an emerging priority in Mongolia to address the rights and needs of persons with disabilities. The GDAP provides guidance to facilitate access and strengthen rehabilitation services.
Aron, Laudan; Loprest, Pamela
Education is important for all children, but even more so for children with disabilities, whose social and economic opportunities may be limited. In this article, Laudan Aron and Pamela Loprest assess how well the nation's education system is serving students with disabilities. Aron and Loprest trace the evolution of the special education system in the United States from its origins in the civil rights movement of the mid-twentieth century. They note the dual character of federal legislation, which both guarantees eligible children with disabilities the right to a "free, appropriate public education in the least restrictive setting" and establishes a federal funding program to help meet this goal. They then review the types of services and accommodations these children receive from infancy through young adulthood. The special education system has given children with disabilities much greater access to public education, established an infrastructure for educating them, helped with the earlier identification of disabilities, and promoted greater inclusion of these children alongside their nondisabled peers. Despite these advances, many problems remain, including the over- and underidentification of certain subgroups of students, delays in identifying and serving students, and bureaucratic, regulatory, and financial barriers that complicate the program for everyone involved. More important, the authors show that special education students still lag behind their nondisabled peers in educational achievements, are often held to lower expectations, are less likely to take the full academic curriculum in high school, and are more likely to drop out of school. Only limited evidence is available on the effectiveness of specific special education services or on how to improve student achievement for this important subgroup of students. Improving the system will require better ways of understanding and measuring both ends of the special education continuum, namely, what
Levey, Janet A; Chappy, Sharon L
Service dogs are critical for the independence of individuals with disabilities because they assist with daily living activities and help these individuals navigate society. Perioperative nurses need a working knowledge of disability laws pertaining to service dogs to provide patient-centered care for individuals using service dogs. This article provides information on the Americans With Disabilities Act regulations regarding service dogs, makes recommendations for the care of patients with service dogs across the perioperative continuum, and offers policy directives to ensure that safe, high-quality care is delivered to patients using service dogs. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Groce, N; Challenger, E; Berman-Bieler, R; Farkas, A; Yilmaz, N; Schultink, W; Clark, D; Kaplan, C; Kerac, M
There is increasing international interest in the links between malnutrition and disability: both are major global public health problems, both are key human rights concerns, and both are currently prominent within the global health agenda. In this review, interactions between the two fields are explored and it is argued that strengthening links would lead to important mutual benefits and synergies. At numerous points throughout the life-cycle, malnutrition can cause or contribute to an individual’s physical, sensory, intellectual or mental health disability. By working more closely together, these problems can be transformed into opportunities: nutrition services and programmes for children and adults can act as entry points to address and, in some cases, avoid or mitigate disability; disability programmes can improve nutrition for the children and adults they serve. For this to happen, however, political commitment and resources are needed, as are better data. PMID:25309998
There has been little research attention in the South African context on volunteer motivation for special events for people with disabilities. This study explored the key factors that motivated volunteers to volunteer their services at three major sport events for people with disabilities in South Africa. A 28-item questionnaire was ...
Dench, S.; And Others
A British survey of employers examined the recruitment and retention of people with disabilities (PWDs). Telephone interviews were conducted with two samples of employers: a random sample of 1,250 and a sample of 250 registered users of the Employment Service's "Disability Symbol," which sets a good practice standard for the employment…
... 34 Education 2 2010-07-01 2010-07-01 false Child with a disability. 300.8 Section 300.8 Education... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH... education, the child is not a child with a disability under this part. (ii) If, consistent with § 300.39(a...
Holdheide, Lynn R.; Reschly, Daniel J.
Teacher preparation to deliver inclusive services to students with disabilities is increasingly important because of changes in law and policy emphasizing student access to, and achievement in, the general education curriculum. This innovation configuration identifies the components of inclusive services that should be incorporated in teacher…
Full Text Available Parenthood in persons with intellectual disability (ID is an issue of concern for the family, guardians, and professionals as there are many sentiments and problems involved: financial, technical, medical, legal, and above all moral. People with intellectual, developmental, or other disabilities have feelings, want relationships, and are able to have children also. The attitude of society has changed through time from the early eugenic concern with heredity and fertility, to a focus on the risk to the children due to parental neglect or abuse, to acceptance and a search for solutions to parental training and support. This change can be seen as a result of a shift from institutional care to community care and normalization. This paper reviews available research, prevalence, service issues, experience from around the world, and relates to the situation in Israel. Jewish Law has been very progressive regarding the possibility of marriage between persons with ID (in contrast to American Law where historically this right has been denied, until recently. Recent research has shown that, in the case of such a union resulting in children, although they require some supervision, family, friends, and social welfare agencies have scrutinized these families so much they are in constant fear of their child being taken away. There is little information on the number of such cases and an overall dearth of information on the effects on the children, although one recent study from the U.K. has shown a varied picture of resilience and a close, warm relationship later on with the family and especially the mother.
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.
Full Text Available Ways of thinking about and responding to disability have radically changed in recent decades. Traditionally, disability was regarded in terms of sin, karma, or divine punishment. More recently, disability was made a medical issue and defined in terms of shortcomings of body or mind, which had to be prevented or cured at all costs. In the late 20th century, people with disabilities worldwide became more organised and created national and international disabled people’s organisations. They successfully demanded that disability be seen as a matter of equal opportunities and human rights, a shift which has now been described in the United Nations Convention on the Rights of Persons with Disabilities. This is a global treaty which has so far been signed by 155 states and passed into law by 127.
Emam, Mahmoud Mohamed; Kazem, Ali Mahdi
Research has documented overlapping and coexisting characteristics of learning disabilities (LD) and emotional and behavioural difficulties (EBD). Such concomitance may impact teacher referrals of children at risk for LD which in turn may influence service delivery. Using the Learning Disabilities Diagnostic Inventory (LDDI) and the Strengths and…
Platt, Jennifer M.; Janeczko, Donna
This article presents adaptations for teaching art to students with disabilities. Various techniques, methods, and materials are described by category of disability, including students with mental disabilities, visual impairments, hearing impairments, learning disabilities, emotional disabilities, and physical disabilities. (JDD)
Francisco Javier Leturia Arrazola
Full Text Available Although the majority of disabled people aren’t or don’t feel ill, and despite that they should be taken care of by the general medical services as many other citizens, most of them need a more intense and frequent health care. This is explained by a higher prevalence of some medical conditions as well as a higher risk of comorbidity among the people with disabilities (in comparison to the general population. At the moment there are many problems concerning accessibility, underdiagnose and overtreatment. National health systems should be able to offer all their services adapted to disabled people in order to obtain results for this group that are similar to those of the rest of the population. To achieve this objective it is necessary to improve professional competencies and skills and develop some specific health programmes.
... Adaptive Sports Coaching Communication with Deaf Athletes The Importance of Appropriate Sport Wheelchair Configuration Sports for Children and Youth with Disabilities Customer Service Chat Featured Videos DocTalk: Prescribe Exercise by NCHPAD How To: Talk To Your Doctor ...
Marriott, Anna; Turner, Sue; Giraud-Saunders, Alison
People with learning disabilities have poorer health than their non-disabled peers, and are less likely to access screening services than the general population. The National Development Team for Inclusion and the Norah Fry Research Centre developed a toolkit and guidance to improve uptake of five national (English) screening programmes (one of which is delivered through local programmes), based on work to improve access by people with learning disabilities in the south west peninsula of the UK. This article describes the findings in relation to the five English screening programmes and suggests ways to improve uptake of cancer screening by people with learning disabilities.
Corbett, Katherine; And Others
This article tackles the broad issue of the intersection of sexuality, disability, and sex education. Myths and stereotypes about the nonsexual disabled woman are examined, as are issues of identity, dating and other loving relationships, sexual abuse, sex education, sexuality related services, and inclusion of disabled students in curriculum and…
Bouck, Emily C.; Joshi, Gauri S.
Students with intellectual disability historically struggle with post-school outcomes. However, much of the research on students with intellectual disability relative to post-school outcomes and transition services is aggregated for students with mild, moderate, and severe intellectual disability. This secondary analysis of the National…
Mullins, Laura; Preyde, Michele
University institutions are required by law to make their services accessible to students with disabilities. Canadian universities have gone a long way to eliminate the physical obstacles that present barriers for students. Many students with disabilities have invisible disabilities that require different types of adjustments. Although some…
... and Technical Assistance and Disability Inclusion Programming AGENCY: Corporation for National and... Disability Inclusion Programming; correction. SUMMARY: The Corporation for National and Community Service... Disability Inclusion Programming that appeared in the Federal Register of June 11, 2012 (75 FR 34354). That...
Lunsky, Yona; Bradley, Elspeth A.; Gracey, Carolyn D.; Durbin, Janet; Koegl, Chris
There are few published studies on the relationship between gender and psychiatric disorders in individuals with intellectual disabilities. Adults (N = 1,971) with and without intellectual disabilities who received inpatient services for psychiatric diagnosis and clinical issues were examined. Among individuals with intellectual disabilities,…
females, other race, enlisted and active duty service members for all services and time periods. • Rates increase as age increases in the Army. For the...Annual Report 2017 Disability Evaluation Systems Analysis and Research Prepared by Accession Medical Standards Analysis and Research Activity ...50 History of hospitalization among active duty service
Purpose. To establish whether interactive drama has any effect on the responses of people with complex neurological disabilities resident in a long term care facility. Method. This was a service evaluation using interviews with a group of 31 independently consenting long term care residents, and 27
Lucas-Carrasco, Ramona; Salvador-Carulla, Luis
We appraised life satisfaction using the Satisfaction with Life Scale (SWLS), and analysed its psychometric properties in persons with intellectual disability (ID). Ninety-nine persons with ID from four services in Spain participated. A battery of subjective assessments was used, including the SWLS, a Quality of Life measure (WHOQOL-BREF), and…
In East Asia, Taiwan is one of only a few countries that has a clear definition of learning disabilities (LD) as well as operational criteria for the identification of LD. In Taiwan, special education services for students with LD are mandated in the Special Education Act of 1984. According to the official statistics from the Taiwanese Special…
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Disability benefits. 29.322 Section 29.322 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER CERTAIN DISTRICT OF COLUMBIA RETIREMENT PROGRAMS Split Benefits Service Performed After June 30...
... scientific merit of the research and development activities, whatever the method employed, and the... research methods, policy, services and supports, including individuals with disabilities or, as appropriate... disabilities, personal characteristics, and social circumstances. Expand field-initiated research and...
Kjeldsen, Lena; Amby, Finn
Danish governments have continuously proclaimed goals of raising the employment rate for people with disabilities, most recently in the publication “10 goal for social mobility” (Government 2016). In spite of this, the employment rate for people with disabilities has been more than 30 percent less...... than that of people without disabilities for more than a decade (Larsen & Høgelund 2015). An explanation of this difference could be the limited connection between these general goals, the employment laws and the actual implementation of the goals in the job centers (Amby 2015). Earlier Danish studies...... have by large focused on employment and disability at the stage where the client already has been categorized as having a disability (e.g. Møller & Stone 2013). This study offers new insight to the field in a Danish context by exploring the process in which people with disabilities are categorized...
Cremer, Helmuth; Lozachmeur, Jean-Marie; Pestieau, Pierre
This Paper studies the design of retirement and disability policies. It illustrates the often observed exit from the labour force of healthy workers through disability insurance schemes. Two types of individuals, disabled and leisure-prone ones, have the same disutility for labour and cannot be distinguished. They are not, however, counted in the same way in social welfare. Benefits depend on retirement age and on the (reported) health status. We determine first- and second-best optimal benef...
For the theoretical part of this master's thesis foreign literature and finished foreign researches were studied. In this part of the thesis the characteristics of mothers with intellectual disabilities; factors, which influence the success of carrying out their mother role; and the rights of people with intellectual disabilities as parents, all based on Slovene legislation are included. We listed reasons for limiting reproduction for women with intellectual disabilities and issues concerning...
Department of Veterans Affairs — This service is used to create, read, delete and update additional information captured during the EVSS Disability Compensation interview in an effort to align with...
I propose an "Interaction Model of Mental Disability (IMMD)". Several models based on ICIDH are being proposed and tested around the world focusing on different aspects of disability. Though ICIDH is an inclusive model in health services, social security, insurance, education, and so on, the remarkable point of IMMD is to visualize the mutual relation of mental disability (impairment, disability and handicap) and other factors (environmental factors, personal factors). IMMD is a practical reh...
Stevens, Alissa C.; Courtney-Long, Elizabeth A.; Okoro, Catherine A.; Carroll, Dianna D.
Introduction Beginning in 2013, in addition to the 2-item disability question set asked since 2001, Behavioral Risk Factor Surveillance System (BRFSS) began using 5 of the 6 items from the US Department of Health and Human Services?recommended disability question set. We assess and compare disability prevalence using the 2-question and 5-question sets and describe characteristics of respondents who identified as having a disability using each question set. Methods We used data from the 2013 B...
Nochajski, Susan M.
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...
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Military service. 831.301 Section 831.301...) RETIREMENT Credit for Service § 831.301 Military service. (a) Service of an individual who first became an... is not receiving military retired pay awarded for reasons other than (i) service-connected disability...
O'Brien, Kelly K; Bayoumi, Ahmed M; Stratford, Paul; Solomon, Patricia
To assess the dimensions of disability measured by the HIV Disability Questionnaire (HDQ), a newly developed 72-item self-administered questionnaire that describes the presence, severity and episodic nature of disability experienced by people living with HIV. We recruited adults living with HIV from hospital clinics, AIDS service organizations and a specialty hospital and administered the HDQ followed by a demographic questionnaire. We conducted an exploratory factor analysis using disability severity scores to determine the domains of disability in the HDQ. We used the following steps: (a) ensured correlations between items were >0.30 and 1.5 to determine the number of factors to retain; and d) used oblique rotation to simplify the factor loading matrix. We assigned items to factors based on factor loadings of >0.30. Of the 361 participants, 80% were men and 77% reported living with at least two concurrent health conditions in addition to HIV. The exploratory factor analysis suggested retaining six factors. Items related to symptoms and impairments loaded on three factors (physical [20 items], cognitive [3 items], and mental and emotional health [11 items]) and items related to worrying about the future, daily activities, and personal relationships loaded on three additional factors (uncertainty [14 items], difficulties with day-to-day activities [9 items], social inclusion [12 items]). The HDQ has six domains: physical symptoms and impairments; cognitive symptoms and impairments; mental and emotional health symptoms and impairments; uncertainty; difficulties with day-to-day activities and challenges to social inclusion. These domains establish the scoring structure for the dimensions of disability measured by the HDQ. Implications for Rehabilitation As individuals live longer and age with HIV, they may be living with the health-related consequences of HIV and concurrent health conditions, a concept that may be termed disability. Measuring disability is important
Krause, N; Lynch, J; Kaplan, G A; Cohen, R D; Goldberg, D E; Salonen, J T
Disability retirement may increase as the work force ages, but there is little information on factors associated with retirement because of disability. This is the first prospective population-based study of predictors of disability retirement including information on workplace, socioeconomic, behavioral, and health-related factors. The subjects were 1038 Finnish men who were enrolled in the Kuopio Ischemic Heart Disease Risk Factor Study, who were 42, 48, 54, or 60 years of age at the beginning of the study, and who participated in a 4-year follow-up medical examination. Various job characteristics predicted disability retirement. Heavy work, work in uncomfortable positions, long workhours, noise at work, physical job strain, musculoskeletal strain, repetitive or continuous muscle strain, mental job strain, and job dissatisfaction were all significantly associated with the incidence of disability retirement. The ability to communicate with fellow workers and social support from supervisors tended to reduce the risk of disability retirement. The relationships persisted after control for socioeconomic factors, prevalent disease, and health behavior, which were also associated with disability retirement. The strong associations found between workplace factors and the incidence of disability retirement link the problem of disability retirement to the problem of poor work conditions.
Durocher, Joan; Lord, Janet; Defranco, Allison
The United States invests billions of taxpayer dollars each year into foreign assistance programs that foster international diplomacy and development directed toward improving the quality of life for people around the world. These programs develop economies and combat poverty, promote democracy and governance, build new infrastructure, advance and protect human rights, among other development goals. The United States cannot effectively accomplish the goals of foreign assistance programs unless it undertakes measures to ensure that the programs are accessible to and inclusive of people with disabilities. The United States has been a leader in advancing the rights of people with disabilities and must continue to promote disability rights through its international development work. Overseas economic development will not be successful unless people with disabilities are included. Because of the significant number of people with disabilities in developing countries, if they are not included, the very economic growth the United States is trying to foster will be hindered. The goals of democracy and governance programs cannot be achieved without the inclusion of people with disabilities. In many countries, domestic law contains blatant discriminatory provisions for people with disabilities that undermine access to justice and full participation in society. The provisions that discriminate against people with disabilities include arbitrary exclusions in electoral codes, sweeping plenary guardianship laws with no due-process protections, discriminatory banking practices, and inaccessible court proceedings. National disability legal frameworks remain underdeveloped throughout the world. Copyright © 2012. Published by Elsevier Inc.
... outdated, and that ``intellectual disability'' is the appropriate way to discuss this type of disability..., and that ``intellectual disability'' is the appropriate way to discuss this type of disability, the... the benefit, and may not limit or target any service based on age, nature or type of disability...
Lykke Hindhede, Anette
Using disability theory as a framework and social science theories of identity to strengthen the arguments, this paper explores empirically how working-age adults confront the medical diagnosis of hearing impairment. For most participants hearing impairment threatens the stability of social...... interaction and the construction of hearing disabled identities is seen as shaped in the interaction with the hearing impaired person‟s surroundings. In order to overcome the potential stigmatisation the „passing‟ as normal becomes predominant. For many the diagnosis provokes radical redefinitions of the self....... The discursively produced categorisation and subjectivity of senescence mean that rehabilitation technologies such as hearing aids identify a particular life-style (disabled) which determines their social significance. Thus wearing a hearing aid works against the contemporary attempt to create socially ideal...
US Department of Education, 2007
Business is about productivity and maintaining a competitive advantage. To do this, business needs qualified workers. Hiring people with disabilities adds value to a business and will attract new customers. Disability is not inability. Employers can make sound business decisions and gain a competitive advantage by using this guide to increase the…
Salter, Erica K
From growth attenuation therapy for severely developmentally disabled children to the post-natal management of infants with trisomy 13 and 18, pediatric treatment decisions regularly involve assessments of the probability and severity of a child's disability. Because these decisions are almost always made by surrogate decision-makers (parents and caregivers) and because these decision-makers must often make decisions based on both prognostic guesses and potentially biased quality of life judgments, they are among the most ethically complex in pediatric care. As the introduction to HEC Forum's special thematic issue on Childhood and Disability, this article orients the reader to the history of bioethics' relationship to both pediatric ethics and disability studies and introduces the issue's five manuscripts. As clinicians, disability scholars, philosophers and clinical ethicists writing on various aspects of pediatric disability, the articles' authors all invite readers to dig beneath an overly-simplified version of what disability might mean to children and families and instead embrace a posture of genuine humility, recognizing both the limits and harms of traditional medical and bioethical responses (or indifferences) to the disabled child.
Dwyer, Kevin P.
This report discusses disciplining children with disabilities in schools, in the context of the legal requirements of the Individuals with Disabilities Education Act. Practical concepts are explained in terms of the school's responsibility to: (1) maintain a safe environment; (2) teach a code of discipline to all students; (3) use the…
Bogdan, Robert; And Others
From the early nineteenth century to the present, horror, gangster, and adventure films, television, the comics, and newspapers have shown physical and mental disabilities to connote murder, violence, and danger. Such false portrayals have promoted negative public attitudes toward people with disabilities. (Author/MJL)
Brown, S E
People with disabilities have, for the most part, failed to identify with each other as a group. This has been detrimental because it has built a sense of isolation when a camaraderie based upon existing commonalities could have been developed. During the past ten to twenty years, there has been a great deal of discussion about appropriate language to use when discussing disability issues. This discussion has been a part of a larger debate concerning the existence of a disability culture. I believe that there is indeed a disability culture and I am a proponent of identifying and passing on stories which contribute to that culture. I have chosen to use mythology to convey this message and have begun with a focus on heroes - people who do something out of the ordinary. It is contended that almost all people with disabilities have performed heroic activities because of the pervasive discrimination encountered by each individual with a disability. Creating a disability mythology is an attempt to recognize and promote heroes within the disabled community and to advocate the importance of telling other people how positive change has occurred through instances of individual heroism.
Anderson, David W.
People often hold stereotypical notions about disability, assuming people with significant disabilities offer little in terms of friendship or contribution. Some are even repulsed by that person's physical appearance. Such responses, evident within the Christian community as well, fail to acknowledge the inherent worth of the person as created in…
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.
Neely-Barnes, Susan; Graff, J. Carolyn; Marcenko, Maureen; Weber, Lisa
Family involvement in planning and choosing services has become a key intervention concept in developmental disability services. This study (N = 547) modeled patterns of family decision making and assessed benefits to persons with developmental disabilities (DDs) and their family members. A latent profile analysis identified 4 classes that were…
Stevens, Alissa C; Courtney-Long, Elizabeth A; Okoro, Catherine A; Carroll, Dianna D
Beginning in 2013, in addition to the 2-item disability question set asked since 2001, Behavioral Risk Factor Surveillance System (BRFSS) began using 5 of the 6 items from the US Department of Health and Human Services-recommended disability question set. We assess and compare disability prevalence using the 2-question and 5-question sets and describe characteristics of respondents who identified as having a disability using each question set. We used data from the 2013 BRFSS to estimate the prevalence of disability for each question set and the 5 specific types of disability. Among respondents identified by each disability question set, we calculated the prevalence of selected demographic characteristics, health conditions, health behaviors, and health status. With the 2-question set, 21.6% of adults had a disability and with the 5-question set, 22.7% of adults had disability. A total of 51.2% of adults who identified as having a disability with either the 2-question or 5-question set reported having disabilities with both sets. Adults with different disability types differed by demographic and health characteristics. The inclusion of the 5 new disability questions in BRFSS provides a level of detail that can help develop targeted interventions and programs and can guide the adaptation of existing health promotion programs to be more inclusive of adults who experience specific types of disabilities.
García Iriarte, Edurne; O'Brien, Patricia; McConkey, Roy; Wolfe, Marie; O'Doherty, Siobhain
Internationally, people with intellectual disability are socially marginalized, and their rights under the United Nations Convention for the Rights of Persons with Disabilities (CRPD) are often ignored. This paper aims to define the key concerns of adults with an intellectual disability in relation to their participation in society using an inclusive research strategy for both data gathering and data analysis. A national study involving 23 focus groups and 168 persons was conducted on the island of Ireland with people with intellectual disability as co-facilitators. A thematic content analysis was undertaken of the verbatim transcripts initially by university co-researchers, and 19 themes were identified. Co-researchers with intellectual disability joined in identifying the eight core themes. These were as follows: living options, employment, relationships, citizenship, leisure time, money management, self-advocacy, and communication. The concerns are discussed within the framework of the CRPD, and implications for transforming service policy are drawn. Why we did the research In many countries, people with intellectual disability have difficulties doing things other people without disabilities do, for example to study, to get a job or to live independently. They also find that their rights are not respected under the Convention on the Rights of Persons with Disabilities (the Convention). We did this study to Learn what are the main issues for adults with intellectual disability in Ireland. Do research with people with intellectual disability. How we did the research People with intellectual disability and their supporters worked with university researchers to plan and do the research. We met with people in groups and 168 people told us about things important to them. What we found out We found that there were very important things that people talked about in the groups. We chose the most important: living options, employment, relationships, rights, leisure, money
... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Technology and Media Services for Individuals With Disabilities Program AGENCY: Department of Education. ACTION... published by the Department. Dated: July 6, 2011. Alexa Posny, Assistant Secretary for Special Education and...
Joaquín Gairín Sallán
Full Text Available This article places an emphasis on the importance of tutorials for students with a disability in universities. It presented the most significant results of the study of tutorials carried out in help services, units or offices for students with a disability inmore than 45 Spanish universities, in relation to promotion, reception, completion and graduation. The contributions highlight the importance of organising a response through a Tutorial Action Plan made up of the stages of motivation and awareness-raisin, planning, execution, evaluation and institutionalisation. Among the principle conclusions, the importance of moving towards a truly inclusive university through tutorial activity is highlighted, thereby providing a guide for providing assistance to university students with a disability.
Martin, Anne-Marie; Connor-Fenelon, Maureen O'; Lyons, Rosemary
This is the first of two articles presenting the findings of a qualitative study which explored the experiences of Registered Nurses Intellectual Disability (RNIDs) of communicating with people with an intellectual disability who communicate non-verbally. The article reports and critically discusses the findings in the context of the policy and service delivery discourses of person-centredness, inclusion, choice and independence. Arguably, RNIDs are the profession who most frequently encounter people with an intellectual disability and communication impairment. The results suggest that the communication studied is both complicated and multifaceted. An overarching category of 'familiarity/knowing the person' encompasses discrete but related themes and subthemes that explain the process: the RNID knowing the service-user; the RNID/service-user relationship; and the value of experience. People with an intellectual disability, their families and disability services are facing a time of great change, and RNIDs will have a crucial role in supporting this transition.
Lloyd, Jennifer L; Coulson, Neil S
Research suggests that the uptake of cervical screening by women with intellectual disabilities (commonly known as learning disabilities within UK policy frameworks, practice areas and health services) is poor compared to women without intellectual disabilities. The present study explored learning disability nurses' experiences of supporting women with intellectual disabilities to access cervical screening in order to examine their role in promoting attendance and elucidate potential barriers and facilitators to uptake. Ten participants recruited from a specialist learning disability service completed a semi-structured interview and data were analysed using experiential thematic analysis. Identified individual barriers included limited health literacy, negative attitudes and beliefs and competing demands; barriers attributed to primary care professionals included time pressures, limited exposure to people with intellectual disabilities and lack of appropriate knowledge, attitudes and skills. Attendance at cervical screening was facilitated by prolonged preparation work undertaken by learning disability nurses, helpful clinical behaviours in the primary care context and effective joint working. © The Author(s) 2014.
Siblings, Parents and Professionals Working Together to Advance Knowledge and Service. Proceedings of the Annual National Seminar Dealing with Siblings of Mentally Retarded and Developmentally Disabled Persons. (2nd, New York, New York, June 11-12, 1984).
Schreiber, Meyer S., Ed.
Eleven papers from a June, 1984, seminar on siblings of mentally retarded and developmentally disabled persons are presented. The following papers are included: "An Adult Sibling Network: A Sharing of Experiences" (B. Cohen); "Siblings as Change Agents for Their Brothers and Sisters: Opportunity or Problem?" (G. Wolpert); "Adult Siblings: The…
Different disabilities are associated with differing risk of child maltreatment and child protection involvement. Groups that are considered at higher risk require services to identify and address the support needs of this group and determine how prevention and early intervention can lower the risk for child abuse and neglect in this vulnerable group.
Mohsen Adib Hajbagheri
Full Text Available Objectives: Reports are indicating of increasing trend of aging and disability in the developing countries while such disabilities are decreasing within the developed countries. This study designed to evaluate the disability and some of its related factors among the elderly population (65 and older in Kashan, Iran. Methods & Materials: A cross-sectional analytical study was conducted on a multi-stage random sample of 350 elderly people (65 year and older in Kashan. The WHO-DAS-II was used as the generic disability measure. The questionnair had 48 questions. The range of score could be between 0-144. Chi-square, t-test analysis and ANOVA were utilized to check significant differences between subgroups. Results: 61% were men and 12% were living lonely. One fourth had some type of addiction, the majority were ilitrate and two thired had not regular phisycal activity.Twenty percent of the old people had a modereate disability and 4.3% were extremely disabled. A significant relationship was found between the disability and variables such as sex, age, living style, needing help, marriage status, living location, addiction, job, level of physical activity, education, and having multiple diseases. Conclusion: In conclusion, geriatric population in Iran, has a lower levels of disability in compare to those of other developed countries. Need of geriatric cares must be be increasing, since the populationpattern of elderly people is increasing in Iran. Female and ilitrate elders were sufering of more disability. These findings indicated the nessesity to more attention to these voulnarable subgroups of population.