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Background Many studies have evaluated the prevalence of intellectual disability (ID) by focusing on different ages during childhood and adolescence. Although the prevalence of ID is higher in older age groups, how cumulative prevalence increases, and what level it reaches before adulthood, remains unclear. Method We used Care Register for Health Care to retrieve information on individuals born in 1996-2007 with any of the inclusion diagnoses of ID (F7 group and/or aetiological diagnoses) for the period 1996 to 2013. The cumulative prevalence was calculated as percentages for every age based on Finnish population data. Results The registration of new diagnoses of ID continued steadily throughout the developmental years. The cumulative prevalence reached 1.19% by age 17.5 among those born in 1996. Later-born age groups appeared to receive their first ID diagnoses earlier in childhood. Those born in 1999 reached a cumulative prevalence of 1.21% already by age 14.5. Of all those with ID, 67% had an F7 diagnosis only, 42% had an aetiological diagnosis only and 9% had both diagnoses. Conclusions Cumulative prevalence of ID by year, until the age of 18, will provide a better estimate and understanding of the prevalence of ID than a point prevalence at any one point during the developmental years. [ABSTRACT FROM AUTHOR]

Objectives To examine whether number of remaining teeth and regular dental care affect incident functional disability in elderly Japanese adults. Design Prospective cohort study. Setting Tsurugaya district, Sendai, Japan. Participants Community-dwelling individuals aged 70 and older (N = 834). Measurements The outcome measurement was incident functional disability, defined as first certification of long-term care insurance in Japan, which is determined on the basis of a strictly established uniform nationwide standard. During a median follow-up of 7.9 years (interquartile range 4.8-7.9 years), information on long-term care insurance was obtained from the Sendai Municipal Authority. Oral health was assessed according to number of remaining teeth and presence or absence of regular dental care. Data were also collected on age, sex, body mass index, medical history, smoking, alcohol consumption, duration of education, depressive symptoms, cognitive impairment, physical functioning, and social support. Results Participants with 10 to 19 teeth (adjusted hazard ratio ( aHR) = 1.42, 95% confidence interval ( CI) = 1.03-1.94), one to nine teeth ( aHR = 1.46, 95% CI = 1.04-2.03), and no teeth ( aHR = 1.49, 95% CI = 1.03-2.14) were more likely to develop functional disability than those with 20 or more teeth. There was no significant difference in risk of functional disability between participants with 20 or more teeth and those with zero to 19 teeth who were receiving regular dental care, whereas those with zero to 19 teeth without regular dental care had a significantly greater risk of functional disability than those with 20 or more teeth ( HR = 1.46, 95% CI = 1.11-1.92). Conclusion Tooth loss was associated with greater risk of functional disability in community-dwelling elderly Japanese. Regular dental care might moderate the risk of functional disability in elderly individuals with missing teeth. [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]

This article presents qualitative data taken from in-depth interviews with 25 long-term sickness benefits recipients in the north east of England, UK. A key theme emerging from the research is the importance of listening to the narratives of long-term sick and disabled benefits recipients, particularly in relation to the formation of policy responses and in terms of practice. The findings also illustrate how stigma associated with claiming benefits can deter people from accessing the support they need, leading to under-claiming and the risk of amplified financial strain and hardship. Further, the importance of evidence that emerges from research which focuses upon the lived experiences of sickness benefits recipients to provide evidence in the framing of disability and welfare policy is crucial. Lastly, the article discusses how the narratives presented have implications for social policy and practice, alongside the potential implications for sick and disabled people themselves. [ABSTRACT FROM AUTHOR]

Putting disability studies to work in art education suggests a form of action or industry, a creative opportunity for something to be done, recognising the relationship between theory and practice. Drawing on discourse analysis, this article offers an initial theoretical discussion of some of the ways in which disability is revealed and created through discourses about art education in articles published over the last 30 years in iJADE. This article proposes that the lens of critical social pedagogies applied to work relating to gender, race and class should be extended to disability in order to promote critical engagement through art education rather than critical avoidance. Drawing on Elliot Eisner's six lessons in what can be learnt from the arts, the article concludes by recognising the importance of art education as a means of epistemic validation, where different ways of being in the world are valued. Art education and arts practice offer a means of valuing and expressing the 'dynamic difference of what it means to be human'. The article argues that the combination of disability studies and art education can, therefore, be a force to be reckoned with. [ABSTRACT FROM AUTHOR]

Objectives Human Disabled-2 ( Dab2), a putative tumor suppressor gene, is frequently down-regulated in human tumors. This study aims to explore the association between Dab2 methylation status and expression in newly diagnosed myelodysplastic syndrome ( MDS) patients and patients who received 5-aza-2′-deoxycytidine (decitabine) treatment, so as to determine the effect of Dab2 in the pathogenesis of MDS. Methods Methylation-specific polymerase chain reaction and bisulfite sequencing were used to detect the methylation status of Dab2 gene. Dab2 expression was investigated by using fluorescence quantitation RT- PCR ( FQRT- PCR) and western blot analysis. Results Hypermethylation of Dab2 gene was present in 50.6% of patients with MDS and was significantly correlated with the down-regulation of Dab2 mRNA and protein expression. There was a significant difference in methylation frequency between refractory anemia/refractory anemia with ringed sideroblasts/ MDS associated with isolated del (5q) ( RA/RARS/5q-) group (33.3%) and refractory anemia with excess blasts-1/-2 ( RAEB-1/ RAEB-2) group (73.3%). Significant difference was also observed between refractory cytopenia with multiline dysplasia group (37.8%) and RAEB-1/ RAEB-2 group. In addition, higher frequency of hypermethylation was observed in intermediate-2-/high-risk group, compared to low-risk/intermediate-1-risk group (75.0% vs. 40.0%). Demethylating agent 5-aza-2′-deoxycytidine treatment could partly reverse hypermethylation and, hence, restore the expression of Dab2 gene. Conclusions The Dab2 gene is inactivated in MDS in part by DNA methylation, and the suppression of Dab2 expression by DNA methylation may play a role in the development of MDS. [ABSTRACT FROM AUTHOR]

Objective This study sought to examine long-term health, symptom, and disability outcomes among patients with chronic fatigue syndrome (CFS) by comparing those diagnosed with CFS 25 years ago with healthy controls. Method Of the 25 participants diagnosed with CFS 25 years ago, 5 self-reported that they maintained a diagnosis of CFS, while 20 reported no longer having a diagnosis. These two groups were compared with healthy controls on outcomes related to functioning and symptom severity. Results Those who remitted from CFS showed significantly more impairment on 21 out of 23 outcomes compared with controls. On 17 outcomes, those who remitted had nonsignificant differences in impairment compared to those who maintained a CFS diagnosis. Conclusions Findings from this study suggest that over time many individuals will not maintain a CFS diagnosis but will not return to their premorbid level of functioning. [ABSTRACT FROM AUTHOR]

Medical and scientific research frequently has perpetuated the cycle of oppression by reinforcing the notion of disability as individual deviance rather than a sociopolitical issue. [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]

Campus assessment instruments can explore the campus climate for students, faculty, and staff with disabilities, contributing useful insights for services and program development. [ABSTRACT FROM AUTHOR]

Background: Previous studies have found simultaneous increases in skin conductance response and decreases in heart rate when normally fluent speakers watched and listened to stuttered speech compared with fluent speech, suggesting that stuttering induces arousal and emotional unpleasantness in listeners. However, physiological responses of persons who stutter observing stuttering and fluent speech has not been measured. Research suggests that the mechanism responsible for listeners' reactions is the mirror neuron system. The mirror neuron system activates when perceiving and producing goal-directed actions and forms the link between action perception and action production. Aims: To compare physiological responses elicited via fluent and stuttered speech in fluent and persons who stutter groups. Methods & Procedures: Participants included 15 adult persons who stutter (mean age = 29.7 years) and 21 normally fluent controls (mean age = 23.7 years). Participants watched and listened to six speech samples read by three persons who stutter speakers and three fluent speakers, while their skin conductance response and heart rate were recorded simultaneously. Participants' responses to each speech sample were defined as changes in mean heart rate and mean skin conductance response between 15 s before and 15 s during stimuli presentation. Outcomes & Results: Both groups showed similar patterns of response: skin conductance response was significantly increased and heart rate was significantly decreased in response to stuttered versus fluent speech. Similar to previous findings, the highest skin conductance response measures were induced by the first presentation of stuttered speech, with the response attenuating on subsequent presentations, while the heart rate was stable over time. Conclusions & Implications: Results confirmed past research that showed arousal and emotional unpleasantness when observing stuttering. Clinically, these results acknowledge the arousal and emotional discomfort in fluent speakers and persons who stutter. The physiological responses to stuttering and the underlying emotional aspects should be discussed in the therapeutic milieu with notions about coping strategies. [ABSTRACT FROM AUTHOR]

Background: Little is known about the way people with aphasia perceive their social participation and its influencing factors. Aims: To explore how people with aphasia perceive participation in society and to investigate influencing factors. Methods & Procedures: In this qualitative study thirteen persons with aphasia and twelve central caregivers kept a pre-structured diary over two weeks, followed by a semi-structured interview. Diaries and interviews were transcribed verbatim and analysed by two researchers independently using codes, categories and central themes inductively. Plausibility of the analyses was discussed several times with a third independent senior-researcher. In a focus group interview, the results were discussed with the participants. Outcomes & Results: The number of social activities and the character of these activities are not as important as the perceived engagement in the social activities for the participants. People with aphasia feel isolated but want to feel engaged. They feel burdensome to others and wish to function in an ordinary way. Extracting information from conversations is difficult but they want to know what is going on. Often they are not able to work and they wish to contribute to the community in other ways. Although they often feel stigmatized, they wish to be respected. Often they do not reach that goal. Perceived factors influencing engagement in social participation can be divided into personal, social and environmental factors. The following personal factors are reported: motivation, physical and psychological condition and communication skills. The social factors are: the role of the central caregiver and the characteristics of the communication partner(s), namely willingness, skills and knowledge. The environmental factors refer to quietness and familiarity of the place in which the person with aphasia live. Conclusions: Social participation is a theoretical concept that people with aphasia do not use. Instead, people speak in terms of engagement, involvement, having a feeling of belonging. People with aphasia describe the degree of engagement in activities in social life domains (i.e. the quality of activities) as more important than the quantity of performing activities. [ABSTRACT FROM AUTHOR]

Title. Reflexivity, critical qualitative research and emancipation: a Foucauldian perspective. Aim. In this paper, we consider reflexivity, not only as a concept of qualitative validity, but also as a tool used during the research process to achieve the goals of emancipation that are intrinsic to qualitative research conducted within a critical paradigm. Background. Research conducted from a critical perspective poses two challenges to researchers: validity of the research must be ensured and the emancipatory aims of the research need to be realized and communicated. The traditional view of reflexivity as a means of ensuring validity in qualitative research limits its potential to inform the research process. Data sources. The Medline and CINAHL data bases were searched (1998-2008 inclusive) using keywords such as reflexivity, validity, subjectivity, bias, emancipation, empowerment and disability. In addition, the work of Michel Foucault was examined. Discussion. Using the work of the late French philosopher Michel Foucault, we explore how Foucault's 'technologies of the self' can be employed during critical qualitative research to achieve emancipatory changes. Using research conducted with marginalized populations as an example (specifically, individuals with disabilities), we demonstrate the potential for using reflexivity, in a Foucauldian sense, during the research process. Conclusion. Shifting the traditional view of reflexivity allows researchers to focus on the subtle changes that comprise emancipation (in a Foucauldian sense). As a result, researchers are better able to see, understand and analyse this process in both the participants and themselves. [ABSTRACT FROM AUTHOR]

Background The idea that raising a child with disabilities has a negative impact on the parents’ relationship is still widely accepted despite contradictory research findings. This article addresses the impact of raising a child with disabilities on family structure in the present Norwegian context. Method Family demographics were collected at two stages during the childhood of children with physical, intellectual or multiple disabilities born 1993–1995 (1999, n = 603 and 2003, n = 489). These figures were compared with the corresponding data for all children (Statistics Norway, Children Statistics). Results The family structures of children with disabilities were fairly similar to those of the typical family. Slightly fewer children with disabilities had siblings and a higher proportion of the parents of children with disabilities were married or cohabiting. The type or degree of impairment was not found to have any impact on family structure. Conclusions The results suggest that family structure in families raising a child with a disability is similar to other families. Whether this should only be seen as positive is discussed, as is whether the disability may produce a stronger feeling of obligation to stay together. [ABSTRACT FROM AUTHOR]

Background Little is known about the mortality of individuals with Down syndrome who have lived at home with their families throughout their lives. The current study evaluates the predictors, causes and patterns of mortality among co-residing individuals in midlife with Down syndrome as compared with co-residing individuals with ID owing to other causes. Method This paper examines mortality in 169 individuals with and 292 individuals without Down syndrome from 1988 to 2007. Dates and causes of death were obtained from maternal report, the Social Security Death Index and the National Death Index. Risk factors predicting mortality, including demographic variables, transition variables, and initial and change measures of health, functional abilities and behaviour problems, were obtained from maternal report. Results Having Down syndrome is a risk factor of mortality, net of other risk factors including older age, poorer functional abilities, worsening behaviour problems, residential relocation and parental death. The causes of death among individuals with and without Down syndrome who are in midlife and co-residing with their families are similar, and are most commonly due to cardiovascular or respiratory problems. Conclusions The findings indicate that midlife adults with Down syndrome who co-reside with their families generally exhibit similar causes of mortality as do midlife adults with intellectual disability owing to other causes, but show an elevated risk of mortality in midlife net of other variables, such as age and changes in functional abilities and behaviour problems. [ABSTRACT FROM AUTHOR]

In the last few years, experimental data have been reported on differences in implicit memory processes of genetically distinct groups of individuals with Intellectual Disability (ID). These evidences are relevant for the more general debate on supposed asynchrony of cognitive maturation in children with abnormal brain development. This study, comparing implicit memory processes in individuals with Williams syndrome (WS) and Down syndrome (DS), was planned to verify the ‘etiological specificity' hypotheses pertaining to the skill learning abilities of individuals with ID. A modified version of Nissen and Bullemer's (1987) Serial Reaction Time (SRT) task was used. The performances of three group were evaluated. The first group consisted of thirty-two people with WS (18 males and 14 females). The second group was comprised of twenty-six individuals with DS (14 males and 12 females). The two groups of individuals with ID were selected so that the groups were comparable as for mental age and chronological age. The third group consisted of forty-nine typically developed children with a mental age similar to that of the groups with WS and DS. The two groups of individuals with ID demonstrated different patterns of procedural learning. WS individuals revealed poor implicit learning of the temporal sequence of events characterizing the ordered blocks in the SRT task. Indeed, differently from normal controls, WS participants showed no reaction time (RT) speeding through ordered blocks. Most importantly, the rebound effect, which so dramatically affected normal children's RTs passing from the last ordered to the last block, had only a marginal influence on WS children's RTs. Differently from the WS group, the rate of procedural learning of the participants with DS was comparable to that of their controls. Indeed, DS and typically developed individuals showed parallel RT variations in the series of ordered blocks and, more importantly, passing from the last ordered to [ABSTRACT FROM AUTHOR]

Persons with Down syndrome are frequently described as ‘clumsy’. The recent progress in the development of quantitative approaches to motor synergies has allowed researchers to move towards an understanding of ‘clumsiness’ at the level of underlying control mechanisms. This progress has also offered an opportunity to quantify changes in motor synergies that accompany improvement in the performance of motor tasks. Previous studies of our group have shown, in particular, that persons both with and without Down syndrome are able to show improvements in indices of their multi-finger synergies in tasks that require accurate production of finger forces. In particular, 3 days of practice has been shown to lead to significant improvements in indices of multi-finger synergies that stabilize the time patterns of the total force produced by the fingers of a hand. Persons with Down syndrome showed a qualitative change in their synergies that failed to stabilize the total force altogether prior to practice and became able to do so after practice. In addition, the studies have also shown that variable practice is more beneficial for the improvement of motor synergies than blocked practice. I would like to draw an optimistic conclusion that persons with Down syndrome are not inherently ‘clumsy’, but have a vast potential for an improvement of their motor performance. The current state of the area of motor control allows researchers and practitioners to tap into these reserves, and to use quantitative indices of changes in motor synergies with practice to optimize motor performance of these individuals. [ABSTRACT FROM AUTHOR]

Background This preliminary study served as a pilot for an ongoing analysis of spectral power in adults with Down syndrome (DS) using a 151 channel whole head magnetoencephalography (MEG). The present study is the first step for examining and comparing cortical responses during spontaneous and task related activity in DS. Method Cortical responses were recorded with a 151 channel whole head MEG system in three adults with DS and three age-matched adults without DS. MEG data were obtained at rest with eyes open and during observation of point-light displays of human motion and object motion. Data from both groups were evaluated by spectral analysis. Results The preliminary results showed greater alpha (8–14 Hz) power particularly in the occipital and parietal areas during the eyes open condition in the adults with DS in relation to a normal comparison group. The visual task had little effect on alpha power in the comparison group. Engaging in the visual task reduced power in alpha across all regions in the DS group to the level observed in comparisons. In the gamma band (30–50 Hz), power values were similar across both groups for the eyes open condition. In the comparison group, large reductions in gamma were observed in the occipital and bilateral temporal areas during the visual task. This change was not observed in the DS group. Conclusions The results from this pilot study suggest that MEG may be useful in characterizing task-specific changes in cortical activity in individuals with DS. Future studies with a larger group of individuals will further contribute to our understanding of the neurophysiology of Down syndrome. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders (ASDs) represent a range of behavioural phenotypes defined by impaired development in social interaction, communication, imagination, and range of interests or behaviours. The aetiology and epidemiology of these serious developmental disabilities (DDs) are poorly understood. Estimates of the population prevalence of ASDs have varied widely within the US and abroad, with increasing estimates in most of the recent studies. In an effort to improve our understanding of the prevalence, population characteristics and public health impact of these conditions, the Centers for Disease Control and Prevention has funded a multi-site surveillance network for ASDs and other DDs that consists of programmes known as the Autism and Developmental Disabilities Monitoring (ADDM) network which conducts surveillance activities and the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) which also conducts surveillance in addition to special research studies related to the ASDs. This collaboration will be referred to hereafter as the ADDM Network. The ADDM Network is implementing a multiple-source surveillance programme to determine population prevalence and characteristics of ASDs and other DDs. This paper describes the collaborative efforts and explains the methods in developing this coordinated public health surveillance network to provide an ongoing source of high-quality data on ASDs. [ABSTRACT FROM AUTHOR]

This paper outlines a recent study which, in an attempt to illuminate the processes surrounding the formation of what is increasingly being referred to as 'the disabled identity', set out to explore the effects of the onset and ongoing experience of impairment in relation to disabled people's self-perceptions. A grounded theory approach was adopted and the data derived from the stories of 92 people from four countries, through telephone dialogues and autobiographical material which sought to answer, or, in the case of unsolicited material, could be said to have answered, the question: How has [the illness or disabling condition] affected the ways in which you see yourself and how others treat you? The major areas of identity which were found to be affected by disability were those which related to independence, work and appearance/sexuality, all of which were heavily influenced by the negative attitudes of others and each of which were related to qualities which could be argued to represent the pivotal characteristics separating the 'affiliated and the marginalised' in contemporary Western society. [ABSTRACT FROM AUTHOR]

People with disabilities often are precluded from research by accessibility problems. This article explores what it really means to make research accessible, and provides suggestions for including people with 2 types of disabilities. Eight specific research activities are explored in relation to 2 disabilities (visual impairments and deafness). [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]

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

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.

The article examines effects of verbalization on discrimination reversal learning for moderately mentally retarded children under three verbal training conditions. The subjects were 45 moderately mentally retarded children who were drawn from special classes or special schools for the mentally handicapped in Chiba and Tokyo. From analysis of the reversal discrimination, the verbalization group of appropriate and inappropriate cues learned reversal discrimination more easily than the control group or the verbalization group of appropriate cues, but there was no remarkable difference between the latter groups.

This article describes the programme of mental handicap research funded by the Great Britain Department of Health (DH) to draw out some of the findings, to encourage contact with the researchers and to contribute to the dissemination of their work. One of the most pressing issues in the field of mental handicap is the provision of high-quality residential accommodation in the community with supporting care appropriate to every individual's needs and wishes. A number of studies funded by the DH document the process of setting up such schemes, and evaluate the benefits to the new residents.

The article reports the results of an evaluation of two hostels for mentally handicapped adults situated within an inner London borough, one supported by the local authority and the other by an independent charity. The study aimed to test the hypothesis that community based residences provide an environment in which mentally handicapped people can acquire the skills necessary for independent living by employing an experimental research design and a sensitive and comprehensive measure of social and personal progress.

This article presents a study on Down's syndrome and toddler temperament. The Down's syndrome children in this study were drawn from longitudinal research program of the Carolina Institute for Research on Early Education for the Handicapped. Children in the longitudinal sample were served by intervention program in a number of locations within the state of North Carolina and across the country. There was a total of 100 Down's syndrome children between 3 and 75 months of age in this population.

The article presents a study that of all mentally handicapped patients in institutions in the city and county of Dublin, Ireland and in three institutions outside this area. As a control group, specimens from normal, healthy children living in orphanages were examined. Urine specimens were collected one to two hours after a meal containing protein. One of the aims of researchers was to determine the incidence of biochemically identifiable inborn errors of metabolism in mentally handicapped population.