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Impacts of the 2010 VA PTSD Rule Change on Participation in SSA Disability Programs 2010年退伍军人事务部创伤后应激障碍规则变更对SSA残疾项目参与的影响
IF 1.6 4区 医学 Q3 REHABILITATION Pub Date : 2022-05-16 DOI: 10.1177/10442073221094812
Kara Contreary, J. Tennant, Yonatan Ben-Shalom
U.S. veterans who could qualify for disability benefits from both the Department of Veterans Affairs (VA) and the Social Security Administration (SSA) might view them as complementary or as substitutes for each other. For example, people who earn above a certain income lose their Social Security Disability Insurance (SSDI) benefits, whereas VA Disability Compensation (DC) benefits do not change based on income. Veterans with disabilities who wish to work may therefore prefer to receive DC over SSDI, in effect treating the two programs as substitutes. We examined how an eligibility rule change in DC affected participation in DC, SSDI, and Supplemental Security Income to understand whether veterans with disabilities increase or reduce their take-up of SSA disability benefits when access to DC increases. Using Current Population Survey data from 2009 to 2016, we studied a 2010 DC rule change that made it easier for veterans with posttraumatic stress disorder to demonstrate eligibility. After the rule change, veterans with self-reported cognitive difficulties reported increased receipt of DC, reduced receipt of SSDI, and reduced rates of work-limiting disability, seeming to treat the two benefit programs as substitutes.
有资格从退伍军人事务部(VA)和社会保障管理局(SSA)获得残疾福利的美国退伍军人可能会将其视为相互补充或替代。例如,收入超过一定收入的人将失去社会保障残疾保险(SSDI)福利,而退伍军人事务部残疾补偿(DC)福利不会因收入而变化。因此,希望工作的残疾退伍军人可能更喜欢接受DC而不是SSDI,实际上将这两个项目视为替代方案。我们研究了DC的资格规则变化如何影响DC、SSDI和补充保障收入的参与,以了解当获得DC的机会增加时,残疾退伍军人是否会增加或减少他们对SSA残疾福利的接受。利用2009年至2016年的当前人口调查数据,我们研究了2010年DC规则的变化,该规则使患有创伤后应激障碍的退伍军人更容易证明其符合资格。规则改变后,自我报告有认知困难的退伍军人报告说,DC的接收量增加,SSDI的接收量减少,工作限制残疾率降低,似乎将这两项福利计划视为替代品。
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引用次数: 0
United Kingdom’s Income Support Program for People With Disabilities: Redesign, Reform, and Policy Lessons for the United States 英国残疾人收入支持计划:对美国的重新设计、改革和政策教训
IF 1.6 4区 医学 Q3 REHABILITATION Pub Date : 2022-05-14 DOI: 10.1177/10442073221094804
H. Inanc, David R. Mann
We reviewed the operational aspects of Employment and Support Allowance (ESA)—the income support program for people with disabilities in the United Kingdom—and its potential policy lessons for the United States’ Social Security Disability Insurance (SSDI) program. ESA has a five-step eligibility determination process, and eligible beneficiaries receive either an unconditional cash benefit or payments conditional on participating in return-to-work activities. The United Kingdom has reformed ESA to better meet policy objectives. Both ESA and SSDI collect medical documentation, but ESA also requires face-to-face eligibility assessments for almost all claimants. ESA eligibility is based on functional limitations exclusively, whereas SSDI assesses the ability to perform substantial work. With its focus on helping some beneficiaries return to work, ESA differs from SSDI, which requires no return-to-work efforts to receive benefits. ESA might offer policy lessons for SSDI with regard to pilot testing, program reform, and accurate decision making.
我们审查了就业和支持津贴(ESA)——英国残疾人收入支持计划——的运作方面,以及它对美国社会保障残疾保险(SSDI)计划的潜在政策教训。欧空局有一个五步资格确定程序,符合条件的受益人要么获得无条件现金福利,要么以参加重返工作活动为条件获得付款。联合王国对欧空局进行了改革,以更好地满足政策目标。ESA和SSDI都收集医疗文件,但ESA还要求对几乎所有索赔人进行面对面的资格评估。ESA资格完全基于功能限制,而SSDI评估执行实质性工作的能力。ESA侧重于帮助一些受益人重返工作岗位,与SSDI不同,后者不需要重返工作岗位就能获得福利。ESA可以为SSDI提供有关试点测试、项目改革和准确决策的政策教训。
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引用次数: 0
Law Enforcement Officers: A Call for Training and Awareness of Disabilities 执法人员:呼吁对残疾人进行培训和提高认识
IF 1.6 4区 医学 Q3 REHABILITATION Pub Date : 2022-05-13 DOI: 10.1177/10442073221094803
L. Diamond, Lindsey B. Hogue
Law enforcement officers (LEOs) are likely to encounter people with disabilities (PWD) during calls for service. These interactions sometimes escalate situations involving PWD and may result in arrest or death due to a lack of disability awareness among LEOs. The purpose of this study was to explore the current perspectives of LEOs regarding PWD and to identify the current training needs of LEOs regarding disability awareness and interactions with PWD. This study utilized two focus groups consisting of participants representing seven law enforcement agencies across a large, Western state. Results indicate that the perceptions and needs of the LEOs regarding PWD are shaped by four themes: (a) personal connections, (b) job experience, (c) training opportunities, and (d) training needs. Implications for policy and practice to enhance the rigor of disability awareness training for LEOs are described.
执法人员在执行公务时,很可能会遇到残疾人士。这些互动有时会使涉及残疾人士的情况升级,并可能由于基层工作人员缺乏残疾意识而导致逮捕或死亡。本研究的目的是探讨当前弱势群体对残疾的看法,并确定当前弱势群体在残疾意识和与残疾人士互动方面的培训需求。这项研究利用了两个焦点小组,由代表七个执法机构的参与者组成,横跨一个大的西部州。调查结果显示,长者对残疾人士的看法和需求主要受以下四个主题影响:(a)个人关系、(b)工作经验、(c)培训机会和(d)培训需求。本文描述了对政策和实践的影响,以加强对leo的残疾意识培训的严谨性。
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引用次数: 1
Boards of Disability Service Provider Organizations for Adults With Intellectual Disability and Their Role in the Delivery of Quality Service 智障成人残疾服务机构委员会及其在提供优质服务中的作用
IF 1.6 4区 医学 Q3 REHABILITATION Pub Date : 2022-05-11 DOI: 10.1177/10442073221094809
R. Wallace, J. Rimes, V. Bitsika
Provision of quality service by disability service providers for adults with intellectual disability is a core responsibility. It is central to access and participation in social, community goods, and services so that individuals are effectively supported in achieving their goals and aspirations and live a long life. Dimensions of quality service encompass how well the individual receives what they want, disability-related regulatory and legislative standards, kindness and professionalism, quality-of-life, and the extent of any breaches. Boards of disability service providers have ultimate responsibility for their organization’s service to ensure quality. They must appreciate and understand quality service dimensions in the context of the disability sector, collect and measure quality service data, hone their skills in weighing up and processing data, respond to user views, and enact improvement measures by way of directions to management. This article reviews board roles, membership, quality service dimensions, and mechanisms by which to obtain input data, process, and deliver outcomes contextualized to the requirements of boards of disability service providers for adults with intellectual disability. Furthermore, this article discusses a novel six-step implementation guide referred to as the SQUARE. That guide describes the functionary and cognitive elements required by boards to conduct effective quality service reviews.
残疾服务提供者为智障成人提供优质服务是一项核心责任。它是获取和参与社会、社区产品和服务的核心,使个人在实现其目标和愿望并长寿方面得到有效支持。优质服务的维度包括个人得到他们想要的东西的程度,与残疾有关的法规和立法标准,善良和专业,生活质量,以及任何违规的程度。残疾人服务提供者委员会对其组织的服务质量负有最终责任。他们必须在残疾部门的背景下欣赏和理解优质服务的各个方面,收集和衡量优质服务数据,磨练衡量和处理数据的技能,回应用户的意见,并通过向管理层指示的方式制定改进措施。本文回顾了委员会的角色、成员、质量服务维度以及获取输入数据、处理和交付结果的机制,这些机制与成人智障残疾人服务提供者委员会的要求相结合。此外,本文还讨论了一种新的六步实现指南,称为SQUARE。该指南描述了董事会进行有效的质量服务审查所需的功能和认知要素。
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引用次数: 0
Effects of Medicaid Expansions 2001–2015 on Supplemental Security Income Program Participation Among Childless Adults 2001-2015年医疗补助扩大对无子女成年人补充保障收入计划参与的影响
IF 1.6 4区 医学 Q3 REHABILITATION Pub Date : 2022-05-10 DOI: 10.1177/10442073221094807
M. Burns, Laura Dague, E. Wood, J. Kennedy
Growing research indicates that Medicaid expansions reduce Supplemental Security Income (SSI) participation, although the magnitude of effects may vary with the presence of other health policy reforms. We examine how a series of Medicaid expansions for childless adults before and after implementation of the Patient Protection and Affordable Care Act (ACA) impact SSI participation among childless adults. We use the Medical Expenditure Panel Survey to compare the change in SSI participation in states that expanded Medicaid coverage relative to those that did not during two time periods: 2001–2013 and 2001–2015. On average, SSI participation declined by a nonstatistically significant 0.10 percentage points (95% confidence interval [CI] = [−0.54, 0.32]) from a baseline SSI participation rate of 2.2% following Medicaid expansions implemented between 2001 and 2015. When restricted to the pre-ACA era, SSI participation declined by a nonstatistically significant 0.30 percentage points (95% CI = [−0.77, 0.16]). Although the direction of the point estimates suggests that Medicaid expansions before and after implementation of the ACA may be associated with reduced SSI participation, the imprecision of the estimates due in part to the sample size precludes this conclusion. To guide states in decision-making, it is essential to understand how increased Medicaid availability impacts SSI participation under different policy environments.
越来越多的研究表明,医疗补助计划的扩大减少了补充保障收入(SSI)的参与,尽管其影响程度可能因其他卫生政策改革的存在而有所不同。我们研究了在《患者保护和平价医疗法案》(ACA)实施前后,针对无子女成年人的一系列医疗补助扩展如何影响无子女成年人对SSI的参与。我们使用医疗支出小组调查来比较2001-2003年和2001-2005年两个时期内,扩大医疗补助覆盖范围的州与未扩大医疗补贴覆盖范围的各州的SSI参与度的变化。在2001年至2015年实施医疗补助扩展后,SSI参与率从2.2%的基线下降了0.10个百分点(95%置信区间[CI]=[-0.54,0.32]),这是一个非统计显著的下降。当限制在ACA之前的时代时,SSI参与度下降了0.30个百分点(95%CI=[-0.77,0.16])。尽管点估计的方向表明,ACA实施前后的医疗补助扩展可能与SSI参与率下降有关,部分由于样本量的原因,估计的不精确性排除了这一结论。为了指导各州的决策,了解在不同的政策环境下,医疗补助的增加如何影响SSI的参与至关重要。
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引用次数: 0
MAD2B promotes podocyte injury through regulating Numb-dependent Notch 1 pathway in diabetic nephropathy. MAD2B 通过调节糖尿病肾病中 Numb 依赖性 Notch 1 通路促进荚膜细胞损伤
IF 9.2 4区 医学 Q3 REHABILITATION Pub Date : 2022-02-21 eCollection Date: 2022-01-01 DOI: 10.7150/ijbs.68977
Meng-Ran Li, Chun-Tao Lei, Hui Tang, Xing-Jie Yin, Zhe Hao, Yang Qiu, Ya-Ru Xie, Jie-Yu Zeng, Hua Su, Chun Zhang

Rationale: Recent studies have demonstrated that the loss of podocyte is a critical event in diabetic nephropathy (DN). Previously, our group have found that the mitotic arrest deficient protein MAD2B was involved in high glucose (HG)-induced podocyte injury by regulating APC/C activity. However, the exact mechanism of MAD2B implicated in podocyte injury is still lacking. Methods: The experiments were conducted by using kidney tissues from streptozotocin (STZ) induced diabetic mice with or without podocyte-specific deletion of MAD2B and the cultured podocytes exposed to different treatments. Glomerular pathological injury was evaluated by periodic acid-Schiff staining and transmission electron microscopy. The endogenous interaction between MAD2B and Numb was discovered by yeast two-hybrid analysis and co-immunoprecipitation assay. The expressions of MAD2B, Numb and related pathway were detected by western blot, immunochemistry and immunofluorescence. Results: The present study revealed that MAD2B was upregulated in diabetic glomeruli and cultured podocytes under hyperglycemic conditions. Podocyte-specific deletion of MAD2B alleviated podocyte injury and renal function deterioration in mice of diabetic nephropathy. Afterwards, MAD2B was found to interact with Numb, which was downregulated in diabetic glomeruli and HG-stimulated cultured podocytes. Interestingly, MAD2B genetic deletion could partly reverse the decline of Numb in podocytes exposed to HG and in diabetic mice, and the expressions of Numb downstream molecules such as NICD and Hes-1 were decreased accordingly. In addition, overexpression of Numb ameliorated HG-induced podocyte injury. Conclusions: The present findings suggest that upregulated MAD2B expression contributes to Numb depletion and activation of Notch 1 signaling pathway, which ultimately leads to podocyte injury during DN progression.

理由最近的研究表明,荚膜丧失是糖尿病肾病(DN)的一个关键事件。此前,我们的研究小组发现,有丝分裂停滞缺陷蛋白 MAD2B 通过调节 APC/C 的活性参与了高糖(HG)诱导的荚膜细胞损伤。然而,MAD2B 参与荚膜损伤的确切机制仍然缺乏研究。研究方法实验使用链脲佐菌素(STZ)诱导的糖尿病小鼠的肾脏组织,这些组织含有或不含荚膜特异性缺失的 MAD2B,培养的荚膜细胞暴露于不同的处理。肾小球病理损伤通过周期性酸-Schiff染色和透射电子显微镜进行评估。通过酵母双杂交分析和共免疫沉淀实验发现了MAD2B和Numb之间的内源性相互作用。通过Western印迹、免疫化学和免疫荧光检测了MAD2B、Numb及相关通路的表达。结果本研究发现,在高血糖条件下,MAD2B在糖尿病肾小球和培养的荚膜细胞中上调。荚膜特异性缺失 MAD2B 可减轻糖尿病肾病小鼠的荚膜损伤和肾功能恶化。随后,研究发现 MAD2B 与 Numb 相互作用,后者在糖尿病肾小球和 HG 刺激培养的荚膜细胞中下调。有趣的是,MAD2B 基因缺失可部分逆转暴露于 HG 和糖尿病小鼠荚膜细胞中 Numb 的下降,Numb 下游分子如 NICD 和 Hes-1 的表达也相应减少。此外,过表达 Numb 可改善 HG 诱导的荚膜细胞损伤。结论:本研究结果表明,MAD2B表达上调导致Numb耗竭和Notch 1信号通路激活,最终导致DN进展过程中的荚膜细胞损伤。
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引用次数: 6
Using Implementation Science Active Implementation Frameworks to Implement an Instructional Framework to Increase Teacher Capacity for Instructional Access for Students With Disabilities 运用实施科学主动实施框架实施教学框架以提高教师为残疾学生提供教学机会的能力
IF 1.6 4区 医学 Q3 REHABILITATION Pub Date : 2022-01-05 DOI: 10.1177/10442073211066785
H. Murphy, Sandi M. Cole, Lucy Fischman
This article discusses the use of the Active Implementation Frameworks (AIF; Fixsen et al., 2005; Fixsen & Blasé, 2011) in a grant-funded project to implement the use of Universal Design for Learning as an instructional intervention to improve the access to quality instruction for students with disabilities. The discussion is based upon data specific to the AIF Implementation Drivers that facilitate and ensure the success of initiatives. The data illustrate the extent that characteristics of the respective schools and districts participating in the project impacted the fidelity of implementation processes and their associated outcomes.
本文讨论了在一个由赠款资助的项目中使用主动实施框架(AIF;Fixsen等人,2005年;Fixsen和Blasé,2011年),该项目旨在将通用学习设计作为一种教学干预措施,以改善残疾学生获得高质量教学的机会。讨论基于AIF实施驱动因素的具体数据,这些驱动因素有助于确保举措的成功。这些数据说明了参与该项目的各个学校和地区的特征对实施过程及其相关结果的保真度的影响程度。
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引用次数: 1
Schaffer v. Weast’s Effects on California Special Education Hearing Decisions 谢弗诉韦斯特案对加州特殊教育听证决定的影响
IF 1.6 4区 医学 Q3 REHABILITATION Pub Date : 2022-01-05 DOI: 10.1177/10442073211066780
Tiina Itkonen, Bryan Tomlin, Manuel G. Correia, L. Sánchez, T. Schneider, Kellie Kooker
This research examined the associations between Schaffer v. Weast (2005) and special education due process hearing decisions in California. Using a database we coded from the state’s due process hearings for cases that reached a decision (years 1995–2019), this study analyzed (1) how legal representation and the filing party affected the probability of the student fully or partially prevailing in these cases, and (2) how Schaffer affected student representation and the prevailing party before and after this ruling. The results indicate that while students were statistically as likely to be plaintiffs and/or represented by an attorney before and after the 2005 time break in the study, the decision raised the bar for students as the likelihood of favorable outcomes for students fell significantly in the wake of the ruling.
这项研究考察了Schaffer诉Weast案(2005年)与加州特殊教育正当程序听证会裁决之间的关系。使用我们从州正当程序听证会中为做出裁决的案件(1995-2019年)编码的数据库,本研究分析了(1)法律代表和申请方如何影响学生在这些案件中完全或部分获胜的概率,以及(2)谢弗在裁决前后如何影响学生代表和获胜方。研究结果表明,虽然在2005年研究休息前后,学生成为原告和/或由律师代表的可能性在统计上是一样的,但这一决定提高了学生的门槛,因为裁决后,学生获得有利结果的可能性显著下降。
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引用次数: 1
Mapping of Financial Support Programs for Children With Neurodisabilities Across Canada: Barriers and Discrepancies Within a Patchwork System 加拿大全国神经残疾儿童财政支持计划的映射:补丁系统中的障碍和差异
IF 1.6 4区 医学 Q3 REHABILITATION Pub Date : 2022-01-05 DOI: 10.1177/10442073211066776
Caitlin Salvino, Connor Spencer, A. Filipe, L. Lach
A cross-jurisdictional pan-Canadian environmental scan was conducted to identify provincial, territorial, and federal financial supports available to families with children living with neurodisabilities. In partnership with the organization Childhood Disability LINK, flowchart-styled pathway documents were developed for each financial support identified, mapping out the processes required to access each support. A critical analysis was completed as it relates to structural barriers, accessibility of program information, and geographic discrepancies. The results revealed that, despite almost universal availability of programs to support families of children living with neurodisabilities, significant barriers and inequity remain. This included considerable variation in access to financial support based on geographic and jurisdictional discrepancies, absence of adequate and accurate information about programs, and minimal support provided to families in the application process. We argue that the barriers and discrepancies identified were an inherent result of the Canadian federalist fragmentation of the delivery of social care and financial support programs for children living with neurodisabilities. A more unified response by Canadian provincial, territorial, and federal governments is clearly needed to take positive steps to address the consequences of federalist fragmentation and respond to the structural barriers and geographic discrepancies identified by this study.
进行了一次跨司法管辖区的泛加拿大环境扫描,以确定有神经残疾儿童的家庭可以获得的省、地区和联邦财政支持。与儿童残疾链接组织合作,为确定的每一项财政支持制定了流程图式的路径文件,列出了获得每一项支持所需的流程。完成了一项关键分析,因为它涉及结构障碍、项目信息的可访问性和地理差异。结果显示,尽管支持神经残疾儿童家庭的计划几乎普及,但仍存在重大障碍和不公平现象。这包括由于地理和司法管辖区的差异,获得财政支持的机会有很大的差异,缺乏关于项目的充分和准确的信息,以及在申请过程中为家庭提供的支持很少。我们认为,所发现的障碍和差异是加拿大联邦政府在为神经残疾儿童提供社会护理和财政支持计划方面各自为政的固有结果。加拿大各省、地区和联邦政府显然需要采取更统一的应对措施,以采取积极措施解决联邦制分裂的后果,并应对本研究发现的结构性障碍和地理差异。
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引用次数: 4
Leadership as an Implementation Driver: Identifying Best Practices to Support Organizational Change 作为实施驱动者的领导力:识别支持组织变革的最佳实践
IF 1.6 4区 医学 Q3 REHABILITATION Pub Date : 2021-12-29 DOI: 10.1177/10442073211066793
Stephanie Lancet, L. McKittrick, Lauren Morando Rhim
This article explores implementation science with a focus on the strategies leaders use to address organizational challenges. Using part of a larger study, we employed a qualitative multiple case study design of 20 charter schools to contribute to an evidence base about how leadership at the charter school and charter management organization levels can influence their school communities regarding commitment to students with disabilities. From our exploratory research, key themes emerged that align with effective leadership strategies for implementation, demonstrating the positive influence of leaders who prioritize students with disabilities by maintaining a clear vision and strong sense of purpose, creating a safe environment where diversity of perspectives is encouraged, and making sure all voices are heard and valued. Public schools across the nation can leverage lessons learned from the charter sector, as leaders work to ensure that their school practices and policies support success for students with disabilities. By ensuring that school leaders are trained and supported to use effective leadership strategies, policymakers, and schools of higher education can influence the adoption and advancement of innovative and effective practices.
本文探讨了实施科学,重点是领导者用来应对组织挑战的策略。作为一项更大研究的一部分,我们采用了20所特许学校的定性多案例研究设计,为特许学校和特许管理组织层面的领导力如何影响学校社区对残疾学生的承诺提供证据。从我们的探索性研究中,出现了与有效的领导策略相一致的关键主题,展示了领导者的积极影响,他们通过保持清晰的愿景和强烈的目标感,创造一个鼓励观点多样性的安全环境,并确保所有声音都被听到和重视,优先考虑残疾学生。全国各地的公立学校都可以利用从特许部门吸取的经验教训,因为领导者们努力确保他们的学校实践和政策支持残疾学生取得成功。通过确保学校领导得到培训和支持,以使用有效的领导策略,决策者和高等教育学校可以影响创新和有效做法的采用和推进。
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引用次数: 0
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Journal of Disability Policy Studies
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