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This paper attempts to discuss findings from an exploratory study in respect to the situation of disability research discourse in the Republic of the Philippines. We disseminate qualitative surveys to three key informants in The Philippines that we choose purposively. The three informants consist of a person with visual impairment, a person with speech impairment, and a person with mobility impairment. Responses from our informants reveal there exists a priority gap on disability research production between different stakeholders. We also learn that disability research produces benefits both in micro and macro contexts. Informants also claim to face barriers in accessing local disability research. Concerns are also being made in regards to emancipatory impact of local disability research as well as for competency and commitment by local researchers. We conclude this paper by stressing the importance of disability studies scholarship development in Southeast Asian region and aggressive effort is needed to merge the academic, political and public spheres to empower the disabled community. [ABSTRACT FROM AUTHOR]

Objective: To assess the perceived barriers to oral health care for persons with disabilities living in Islamabad. Study Design: Cross-sectional study. Place and Duration of Study: Study was conducted at general community organizations in Islamabad providing services to Persons with Disabilities (PWDs) from Jan 2013 to Jun 2013 over a period of 6 months. Material and Methods: A total of 500 persons with disability who were dependent on someone to reach dental facilities were included in the study while those who were not dependent on someone were excluded from the study. A 12-item self-administered questionnaire was used. Patient's demographic data, type of disability and barriers to oral health care were recorded. Finally data was analyzed by using SPSS version 20. Results: Out of 400 respondents the most common disability was physical impairment (33.25%) followed by visual impairment (20.75%) and polio (14.75%). The major barriers to oral health care were transportation difficulty (48%) followed by high cost of dental treatment (39.5%) and inability to sit on dental chair /co-operate with dentist (31.25%). Conclusion: Significant barriers exist that limit the access to dental care for Person with Disabilities (PWDs). [ABSTRACT FROM AUTHOR]

Background: Little is known about depressive symptoms in podoconiosis despite the independent contribution of depression to worse health outcomes and disability in people with other chronic disorders. Method: Two-hundred and seventy-one individuals with podoconiosis and 268 healthy neighbours (individuals from the nearest household in any direction) were investigated for depressive symptoms using a validated Amharic version of the Patient Health Questionnaire (PHQ-9). The WHO Disability Assessment Schedule II (WHODAS II) tool was used to measure disability. Logistic regression and zero inflated negative binomial regression were used to identify factors associated with elevated depressive symptoms, and disability, respectively. Results: Among study participants with podoconiosis, 12.6% (34/269) had high levels of depressive symptoms (scoring 5 or more points on the PHQ-9, on two assessments two weeks apart) compared to 0.7% (2/268) of healthy neighbours (p<0.001). Having podoconiosis and being older were significantly associated with increased odds of a high PHQ-9 score (adjusted odds ratios [AOR] 11.42; 95% CI 2.44-53.44 and AOR 1.04; 95% CI 1.00- 1.08, respectively). Significant predictors of a higher disability score were having podoconiosis (WHODAS II multiplier value: 1.48; 95% CI 1.39-1.58) and having a high PHQ-9 score (1.07; 95% CI 1.06-1.08). Conclusion: We recommend integrating evidence-based treatments for depression into podoconiosis interventions. [ABSTRACT FROM AUTHOR]

AIMS Older and disabled rheumatoid arthritis (RA) patients are often not present in large numbers in clinical trials or registries. A novel, claims-based clinical effectiveness algorithm provides the potential to compare the effectiveness of different biologics among this population using large administrative databases. METHOD Using Medicare 2006-2010 data for 100% of patients with RA, we identified biologic naïve users of abatacept, adalimumab, etanercept and infliximab, defined as no biologic use during the 12months before the biologic initiation. The effectiveness was evaluated at 365 days after biologic initiation, determined using a validated claims-based algorithm. We compared the proportion meeting effectiveness criteria for each biologic using robust Poisson regression to compute risk ratios (RRs) adjusted for potential confounders. One year cost per effectively treated patient was calculated by different biologics. RESULTS The study included biologic naïve users of abatacept (n = 2129), adalimumab (n = 2944), etanercept (n = 3517) and infliximab (n = 5654). The algorithm classified the medications as 26% effective for abatacept, 24% for adalimumab, 28% for etanercept and 23% for infliximab, indicating comparable effectiveness. However, after adjustment and compared with infliximab, the RRs for effectiveness were 1.17 (95% CI 1.06, 1.30) for abatacept, 1.11 (95% CI 1.02, 1.23) for adalimumab and 1.27 (95% CI 1.17, 1.39) for etanercept. Older patients had a higher effectiveness than patients who were disabled (RR = 1.18, 95% CI 1.08, 1.28). Infliximab had highest cost per effectively treated patient. CONCLUSION Abatacept, adalimumab and etanercept are more effective than infliximab among RA patients initiating biologics. Effectiveness was significantly higher among older patients compared with disabled RA Medicare patients. [ABSTRACT FROM AUTHOR]

Background: We sought to define quality in telehealth and telecare with the aim of improving the proportion of patients who receive appropriate, acceptable and workable technologies and services to support them living with illness or disability. Methods: This was a three-phase study: (1) interviews with seven technology suppliers and 14 service providers, (2) ethnographic case studies of 40 people, 60 to 98 years old, with multi-morbidity and assisted living needs and (3) 10 co-design workshops. In phase 1, we explored barriers to uptake of telehealth and telecare. In phase 2, we used ethnographic methods to build a detailed picture of participants' lives, illness experiences and technology use. In phase 3, we brought users and their carers together with suppliers and providers to derive quality principles for assistive technology products and services. Results: Interviews identified practical, material and organisational barriers to smooth introduction and continued support of assistive technologies. The experience of multi-morbidity was characterised by multiple, mutually reinforcing and inexorably worsening impairments, producing diverse and unique care challenges. Participants and their carers managed these pragmatically, obtaining technologies and adapting the home. Installed technologies were rarely fit for purpose. Support services for technologies made high (and sometimes oppressive) demands on users. Six principles emerged from the workshops. Quality telehealth or telecare is 1) ANCHORED in a shared understanding of what matters to the user; 2) REALISTIC about the natural history of illness; 3) CO-CREATIVE, evolving and adapting solutions with users; 4) HUMAN, supported through interpersonal relationships and social networks; 5) INTEGRATED, through attention to mutual awareness and knowledge sharing; 6) EVALUATED to drive system learning. Conclusions: Technological advances are important, but must be underpinned by industry and service providers following a user-centred approach to design and delivery. For the ARCHIE principles to be realised, the sector requires: (1) a shift in focus from product ('assistive technologies') to performance ('supporting technologies-in-use'); (2) a shift in the commissioning model from standardised to personalised home care contracts; and (3) a shift in the design model from 'walled garden', branded products to inter-operable components that can be combined and used flexibly across devices and platforms. [ABSTRACT FROM AUTHOR]

Background: Disability is not just a health problem or attribute of individuals, but it reflects the problems individuals experience in their interaction with society and physical movements. Disabled persons remain neglected part of society and they also experience various barriers due to restriction of participation. Objectives: The aim was to assess the quality of life (QOL) of physically disabled persons, the impact of physical disability on activities of daily living (ADL) and to study the awareness about laws and facilities available for disabled persons. Materials and Methods: A cross-sectional community based study was conducted among 130 physical disabled persons who were selected using convenience sampling technique. The WHO BREF scale was used to assess QOL, while assessment of ADL was done using Barthel Index. Socio-demographic assessment was done using Udai Pareek scale. SPSS version 15.0 was used to analyze data. Categorical variables were expressed as frequencies and percentages. As per guidelines physical, psychological, social, and environmental domain scores for WHO BREF scale were calculated. Results: Among the study participants, 36.2% had a disability from birth that is, congenital. The second common cause of disability was found to be postpolio residual paralysis as it was found among 26.2% respondents. Other causes found were stroke/paralysis and accidents, in 19.2% and 18.5% respondents, respectively. Activities such as transfer, mobility, and stair climbing showed greater impact of physical disability. It was found that 11.5% respondents required help in one of the ADL. QOL score was found to be low under the psychological domain reflecting on negative feelings, bodily image, appearance, spirituality, and self-esteem of respondents. Conclusion: Physical disability had affected social participation as well as marriage of the respondents. However, it was found that very few of them are aware about facilities provided under persons with disability act. [ABSTRACT FROM AUTHOR]

Pressure ulcers can be a fatal complication. Many immobile wheelchair users face this threat. Current passive and active cushions do reduce the incidence of pressure ulcers and they have different merits. We proposed an active approach to combine their advantages which is based on the concept that the interface pressure can be changed with different supporting shapes. The purpose of this paper is to verify the proposed approach. With practical applications in mind, we have developed a modular system whose support surface is composed by height-adjustable support elements. Each four-element module was self-contained and composed of force sensors, position sensors, linear actuators, signal conditioners, driving circuits, and signal processors. The modules could be chained and assembled together easily to form different-sized support surfaces. Each support element took up a 3 cm x 3 cm supporting area. The displacement resolution was less than 0.1 mm and the force sensor error was less than 1% in the 2000 g range. Each support element of the system could provide 49 N pushing force (408 mmHg over the 3 cm x 3 cm area) at a speed of 2.36 mm/s. Several verification tests were performed to assess the whole system's feasibility. Further improvements and clinical applications were discussed. In conclusion, this modularized system is capable of actively managing interface pressure in real time. [ABSTRACT FROM AUTHOR]

The kitchen environment is one of the scenarios in the home where users can benefit from Ambient Assisted Living (AAL) applications. Moreover, it is the place where old people suffer from most domestic injuries. This paper presents a novel design, implementation and assessment of a Smart Kitchen which provides Ambient Assisted Living services; a smart environment that increases elderly and disabled people's autonomy in their kitchen-related activities through context and user awareness, appropriate user interaction and artificial intelligence. It is based on a modular architecture which integrates a wide variety of home technology (household appliances, sensors, user interfaces, etc.) and associated communication standards and media (power line, radio frequency, infrared and cabled). Its software architecture is based on the Open Services Gateway initiative (OSGi), which allows building a complex system composed of small modules, each one providing the specific functionalities required, and can be easily scaled to meet our needs. The system has been evaluated by a large number of real users (63) and carers (31) in two living labs in Spain and UK. Results show a large potential of system functionalities combined with good usability and physical, sensory and cognitive accessibility. [ABSTRACT FROM AUTHOR]

Autism Spectrum Disorder is a social communication disorder in someone displaying repetitive and restrictive interests. Diagnosed in early childhood, children struggle to develop social relationships required for further learning and independent living. This article discusses changes to the diagnosis, how the diagnosis is made, the prevalence, causes and interventions. Importantly, this review guides medical students towards an understanding of what to expect in individuals with autism spectrum disorder and how to interact with them. [ABSTRACT FROM AUTHOR]

Persons with chronic disabilities report the lowest subjective well-being (SWB) in many countries. The gap in SWB compared with the non-disabled population is smaller in some countries than in others. Data from the European Social Survey were analysed in order to: (1) describe the inequality in SWB in 21 European countries; and (2) identify the main determinants of this inequality in SWB. Data on a range of topics of a total of 40,605 persons, including 2,846 persons with serious chronic disabilities, were used of the European Social Survey. SWB was measured using multi-item scales for 'emotional well-being' and 'satisfying life'. Variables on disability, socio-demographics (age, gender, household composition), socio-economic status (level of education, net household income), participation (paid work, voluntary work, social contacts), and personal resources (supportive relationships, social cohesion, vitality, optimism, resilience, perceived autonomy, perceived accomplishment, perceived capacity, perceived engagement, perceived meaning and purpose) were entered stepwise in regression models of SWB. The results show that persons with disabilities are in a disadvantaged position in terms of SWB in all countries. In the Northern countries, the gaps between disabled and non-disabled persons are smaller than in Eastern European countries. In all countries inequality in SWB is explained mostly by personal resources and not by the level of disability, socio-economic status or level of participation in work. The implications of these findings for policy and practice (e.g. social cohesion and physical exercise programs) are discussed. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objectives:To examine the association of living arrangements with functional disability among older persons and explore the mediation of impact factors on the relationship. Design: Cross-sectional analysis using data from Healthy Aging study in Zhejiang Province. Participants: Analyzed sample was drawn from a representative rural population of older persons in Wuyi County, Zhejiang Province, including 1542 participants aged 60 and over in the second wave of the study. Measurements: Living arrangements, background, functional disability, self-rated health, number of diseases, along with contemporaneous circumstances including income, social support (physical assistance and emotional support). Instrument was Activities of Daily Living (ADL) scale, including Basic Activities Daily Living (BADL) and Instrumental Activities of Daily Living (IADL). Results: Living arrangements were significantly associated with BADL, IADL and ADL disability. Married persons living with or without children were more advantaged on all three dimensions of functional disability. Unmarried older adults living with children only had the worst functional status, even after controlling for background, social support, income and health status variables (compared with the unmarried living alone, ß for BADL: 21.262, ß for IADL: 22.112, ß for ADL: 23.388; compared with the married living with children only, ß for BADL: 21.166, ß for IADL: 22.723, ß for ADL: 23.902). In addition, older adults without difficulty in receiving emotional support, in excellent health and with advanced age had significantly better BADL, IADL and ADL function. However, a statistically significant association between physical assistance and functional disability was not found. Conclusion: Functional disabilities vary by living arrangements with different patterns and other factors. Our results highlight the association of unmarried elders living with children only and functioning decline comparing with other types. Our study implies policy makers should pay closer attention to unmarried elders living with children in community. Community service especially emotional support such as psychological counseling is important social support and should be improved. [ABSTRACT FROM AUTHOR]

We evaluated the effects of noncontingent reinforcement (NCR) on compliance with wearing foot orthotics and a hearing aid with 2 individuals. Results showed that NCR increased the participants' compliance with wearing prescription prostheses to 100% after just a few 5-min sessions, and the behavior change was maintained during lengthier sessions. The results are discussed in terms of the potential value-altering effects of NCR. [ABSTRACT FROM AUTHOR]

The article reports on research conducted to determine the levels of physical activity and to determine the factors related to the physical activity behavior of adults with multiple sclerosis by use of the Physical Activity for People With a Disability (PAD) model. Researchers evaluated 106 people with multiple sclerosis. They found that the the individuals that they evaluated spent an average of 30 hours per week on activities with metabolic equivalents of two on the Expanded Disability Status Scale score. They also found that people with multiple sclerosis were less active if their disease was more severe, if they received a disability pension or had children to care for. INSET: The Bottom Line.

The article presents a study which aims to examine perception-based intensity regulation's validity during handcycling exercise. Participants were people with injured spinal cord who then completed an exercise test and V̇O2peak test with the use of a hand bike. Two 20-minute exercise tests were conducted at an individualized power output (PO) at vigorous and moderate intensities. Participants were also instructed to produce a workload equal to the average RPE for the 20-minute imposed condition. The result showed that PO slightly increased on the moderate-intensity RPE-regulated trial but remained constant during the vigorous RPE-regulated trial. It says that the PO also tends to be slightly higher during the vigorous RPE-regulated trial.

The article discusses a study which seeks to correlate knee isometric strength and aerobic capacity with functional tasks of daily life performed by persons with Down Syndrome. It notes that 35 adult individuals with Down Syndrome were the main subjects of the study and that every participant has undergone tests to define knee extensor and flexor strength with the use of a Biodex System 3 dynamometer followed by exercises that determined peak aerobic capacities of each. It states that the subjects were asked to perform three basic tasks which include chair rise, gait speed and stair ascent and descent. Moreover, it says that knee flexor and extensor strength together with peak aerobic capacity limit the capacities of adults with Down Syndrome in performing tasks of daily living.

In this article, we examine changes in life expectancy free of disability using longitudinal data collected from 1984 through 2000 from two cohorts who composed the Longitudinal Studies of Aging I and II. Life expectancies with and without ADL and/or IADL disability are calculated using a Markov-based multistate life table approach. At age 70, disability-free life expectancy increased over a 10-year period by 0.6 of a year in the later cohort, which was the same as the increase in total life expectancy, both increases marginally statistically significant. The average length of expected life with IADL and ADL disability did not change. Changes in disability-free life expectancy resulted from decreases in disability incidence and increases in the incidence of recovery from disability across the two survey cohorts. Age-specific mortality among the ADL disabled declined significantly in the later cohort after age 80. Mortality for the IADL disabled and the nondisabled did not change significantly. Those with ADL disability at age 70 experienced substantial increases in both total life expectancy and disability-free life expectancy. These results indicate the importance of efforts both to prevent and delay disability and to promote recovery from disability for increasing life expectancy without disability. Results also indicate that while reductions in incidence and increases in recovery work to decrease population prevalence of disability, declining mortality among the disabled has been a force toward increasing disability prevalence. [ABSTRACT FROM AUTHOR]

The article discusses the use of Internet resources in disability studies. Teachers can improve a student's understanding of disability studies by incorporating Internet resources into their curriculum. Some students can be intimidated by areas of a library where disability studies resources are kept and many libraries are not open at night whereas the Internet can be used at any time and is both a familiar and friendly atmosphere for students. The American Folklife Center of the Library of Congress hosts the Veterans History Project which is a collection of veterans' histories.

The article discusses a study that determines the role of confidence and emotion to the people with disabilities who played wheelchair basketball. The researcher examined seventy-nine adult male and female Caucasian wheelchair basketball players and uses performance self-efficacy (PSE), training self-efficacy (TSE), thought control self-efficacy (TCSE), resilient self-efficacy (RSE), positive and negative affect (PANA) as research instruments. The study revealed that players were efficacious about their sports, in managing their thoughts in times of difficulty and have positive feelings towards the game.

Objectives. We sought to identify the income-disability prevalence relationship among older Brazilians. Methods. Data were from 63985 individuals 60 years and older from the 1998 and 2003 Brazilian National Household Surveys. Generalized additive logistic models with cubic regression splines were used to estimate the disability-income relationships. Results. There was a strong linear relationship between increased income and reduced disability prevalence for most of the income distribution. Benefits were still present above the 90th percentile of income but were more modest. Because incomes among the wealthiest few are disproportionately large, odds ratios of disability nevertheless showed marked improvements, even across the very highest income groups. Conclusions. Among older Brazilians, reduced disability is associated with higher income, and these associations are present even above the 90th percentile of income. In addition to understanding mechanisms of disability reduction among impoverished individuals, work is needed to understand these mechanisms in middle-and high-income groups. (Am J Public Health. 2009;99:81-86. doi:10.2105/AJPH.2007.130708) [ABSTRACT FROM AUTHOR]

Background and Purpose Although a criterion reference of 10,000 steps per day is recommended for health benefits, a literature search yielded no normative standard for daily steps. Therefore, a meta-analysis was used in estimate the number of pedometer-documented steps that adults take daily. Methods Studies were retrieved using electronic databases and cross-referencing from retrieved studies. A random-effects model and 95% confidence intervals (CIs) were used tor all analyses of daily step data. Results Seventy-one outcomes, representing 6,199 subjects from 42 studies, met the inclusion criteria. Excluding Amish subjects, the daily step count averaged 9,448 (95% CI=8,899-9,996) and was greater in subjects younger than 65 years of age (mean=9,797, 95% CI=9,216-10,377) compared with subjects 65 years of age or older (mean=6,565, 95% CI=4,897-8,233). Discussion and Conclusion This study provides an estimate of the number of daily steps taken by adults. The number is less than the recommended 10,000 steps per day and is especially low in adults 65 years of age or older. [ABSTRACT FROM AUTHOR]

Medical advances and the growth of the elderly population have focused interest on trends in the health of the elderly. Three theories have been advanced to describe these trends: compression of morbidity, expansion of morbidity, and dynamic equilibrium. We applied multistate life table methods to the Medicare Current Beneficiary Survey to estimate active and disabled life expectancy from 1992 to 2003, defining disability as having difficulty with instrumental activities of daily living or activities of daily living. We found increases in active life expectancy past age 65 and decreases in life expectancy with severe disability. These trends are consistent with elements of both the theory of compression of morbidity and the theory of dynamic equilibrium. [ABSTRACT FROM AUTHOR]

The article focuses on two surveys which were conducted in Latvia to obtain the perceptions of disabled students and their families to including students with disabilities in general education classes, and to determine the perceptions of general physical educators' perceptions of including students with physical disabilities in general physical education classes. The surveys revealed that there was frustration and dissatisfaction with both students and teachers with the manner in which students with disabilities were included in general physical education classes, and that more research needed to be done before inclusion could be properly managed.

Objective:The objective of this paper is to outline the proposed development process for the ICF Core Sets for Spinal Cord Injury (SCI) and to invite clinical and consumer experts to actively participate in this process. ICF Core Sets are selections of categories of the International Classification of Functioning, Disability and Health (ICF) that are relevant to persons with a specific condition or in a specific setting.Method:The project is a cooperation between the ICF Research Branch of the World Health Organization (WHO) Collaboration Centre of the Family of International Classifications (DIMDI, Germany), the Classification, Assessment and Terminology (CAT) team and the Disability and Rehabilitation (DAR) team at WHO, the International Spinal Cord Society (ISCoS) and International Society for Physical and Rehabilitation Medicine (ISPRM) and partner institutions across the world. The project will consist of four worldwide studies to be conducted from 2006 to 2007 with a proposed ICF Core Set Consensus Conference to be held in 2007. ICF categories relevant for SCI are to be identified by means of (I) an empirical study, (II) a systematic review of outcomes and measures used in SCI research (III) an expert survey and (IV) focus groups and semistructured interviews with persons with SCI. Consensus about items that have to be part of a Comprehensive and of a Brief ICF Core Set for SCI will be reached in a final ICF Core Set Consensus Conference. Subsequent field testing will be necessary to validate this first version of ICF Core Sets for SCI.Invitation for participation:The development of ICF Core Sets is an inclusive and open process. Anyone who wishes to actively participate in this process is invited to contact the project coordinator (Monika.Scheuringer@med.uni-muenchen.de or http://www.icf-research-branch.org/research/spinalcord-injuries.htm). Individuals, institutions and associations can be formally associated as partners of the project.Spinal Cord (2006) 44, 541–546. doi:10.1038/sj.sc.3101918 [ABSTRACT FROM AUTHOR]

Research on the positive and negative events experienced by parents with acquired physical disabilities is limited, and research on their children's experiences is even rarer. Thus, with this project the author merged stress-and-coping research with the social model of disability to develop two specifically tailored profiles of life events specific to the experiences of these family members. Fifty knowledgeable informants (parents with acquired disabilities, their spouses, their adolescent children, and professionals) were interviewed about the positive and negative aspects of being or living with a parent with a physical disability. From these discussions, the author identified samples of meaningful positive and negative events so that future researchers can examine the associations among the experiences of these events and adolescents' and parents' coping and adjustment as well as evaluate social policy to reduce barriers and create supports for parents with physical disabilities and their families. [ABSTRACT FROM AUTHOR]

Outcomes and effectiveness research is a category of health services research that gauges how well the health care needs of persons with disabilities are being met. Using Patrick’s Model of Health Promotion for people with disabilities as a framework for analysis, this article examines outcomes and effectiveness research related to the health care needs of persons with disabilities. The three most pressing research priorities are clear theoretical conceptualizations and qualitative research on health outcomes relevant to the needs of persons with disabilities; a systemic analysis of existing assessment instruments’ utility for disability outcomes research; and the development and testing of new outcome instruments. [ABSTRACT FROM AUTHOR]

Compares the relevance of the feminist accounts of human embodiment for disability studies by Judith Butler and Maxine Sheets-Johnstone. Butler's notion that bodies are materialized via performances resignifying disability; Bipedal locomotion as an ingredient of our pan-hominid speciation, according to Sheets-Johnstone; Axiological aspirations of the feminists' views.

Reviews the major definitions of disability and reports the results of a national study assessing disability in both family and paid work roles. Disability and rheumatoid arthritis; Work and family work disability; Program definitions of disability in the US; National health surveys; Definitions of disability; Methods and results of the study; Discussion.

Presents information on a study researching the happiness of people with profound multiple disabilities. How happiness indices were defined; Number of participants; Observations; Results.