International disability studies最新文献

The motor, perceptual, and cognitive abilities of 99 Filipino children, aged 4-6 years with a documented history of malnutrition from a nutritionally depressed area of Manila were determined using the Revised Manila Motor-Perceptual Screening Test. They were classified into four groups of: (1) normal; (2) acutely malnourished; (3) stunted but not malnourished; and (4) chronically malnourished using the Waterlow classification. Thirty-one normal children of comparable ages and background from a nationwide pool were similarly tested and served as the control group. Motor (p = 0.001) and perceptual skill (p less than 0.03 to less than 0.001) scores were significantly lower than in their normal counterparts, especially in the chronically malnourished children. Cognitive abilities were not evidently affected by malnutrition.

The study consisted of 276 patients who were hospitalized between 1980 and 1982 because of suspected lumbar disc herniation. No randomization of treatment was used. On the basis of clinical indications 179 patients were operated on and 97 had further conservative treatment. Results of physical, social, and psychological examinations performed after 1 year were related to the 5-year outcome defined by occupation handicap of the WHO system. For operated patients, subjective working incapacity, sensory deficit of leg, tightness of hamstrings, age, and pain in lumbar extension predicted a poor outcome. Predictive factors for non-operated patients were increased occurrence of occupational hazards and co-morbidity.

This study aimed to examine physical and psychosocial changes after injury in a range of trauma patients. Three groups were selected for comparison purposes: severely head-injured patients, patients with major trauma, and those with minor trauma (n = 102). Outcomes were assessed by questionnaires and inventories administered to a family member or friend of the trauma survivor, approximately 1 year post-injury. Severely head-injured patients were reported to have the greatest degree of difficulty in self-care and mobility, and in community living skills, followed by other major trauma patients and then minor trauma patients. Severely head-injured patients also had relatively more frequent reports of behavioural changes than the other two groups. None the less, more than half of the major trauma group were reported to act differently after the accident. The relative frequency of adverse outcomes in the major trauma group was greater than expected and should be the focus of further research.

Disability has emerged as a major public health problem worldwide, common to nations presenting disparate levels of socioeconomic development. Failure to integrate social welfare programmes within national development planning exacerbates difficulties arising from limited resources, with a disproportionate impact on disabled persons and other vulnerable groups. Such policy failure allows flagrant inequalities and social injustice to persist. Strategies are emerging, however, that are useful for solving common international problems. Community-based disability prevention and rehabilitation is one emerging solution that has attracted considerable attention worldwide, including in the United States. Following a review of global estimates of disability, which reveal the magnitude of the problem and provide background information for this report, I will summarize major international initiatives designed to prevent disability and ensure comprehensive rehabilitation for disabled persons. I will also analyse the relationships between health, socioeconomic development, and disability. Finally, I will describe community-based rehabilitation, an innovative approach evolving from the World Health Organization's Global Strategy for Health for All by the Year 2000, an approach with potential to eliminate barriers to equal opportunities and social integration for disabled persons.

Knowledge is lacking about the nature of stressors experienced by persons with epilepsy and the strategies used to cope with these stressors. This study explored epilepsy-specific stressors, coping strategies used, level of trait anxiety, and perception of health in 107 adults who had had epilepsy for 1 year or longer. 'Need to take medications regularly' and 'Uncertainty about when a seizure will occur' were the stressors subjects ranked highest. 'Try to maintain some control over the situation', 'Hope things will get better', and 'Think through different ways to solve the problem' were the top coping strategies used. Persons who perceived their health as better used more problem-oriented strategies than did those who rated their health as poor. The mean level of trait anxiety was 42.1, which is higher than that for a normal population. Continued studies are needed to more clearly identify stressors experienced at various times in the trajectory of epilepsy and the precise coping strategies used for specific stressors.

Objective: to evaluate whether an exercise and education-based rehabilitation programme is sufficient treatment for individuals with clinically significant levels of anxiety or depression following coronary artery bypass graft (CABG) surgery.

Design: follow-up and repeated assessment after surgery.

Setting: outpatient cardiac rehabilitation programme.

Patients: all 88 attenders after CABG surgery.

Assessments: structured interview and Hospital Anxiety and Depression (HAD) scale (using 8 as the cut-off) administered by rehabilitation nurses at start of course and HAD repeated at 12 weeks and 6 and 12 months (by post after discharge).

Results: return rates of 76 and 80% at 6- and 12-month assessments, respectively; statistically significant reductions in levels of anxiety and depression found between first and all subsequent assessments; subdividing into groups revealed significant reduction in anxiety and depression in the anxious and depressed groups at 12 weeks and 6 months, respectively, but at 12 months there was no significant reduction.

Conclusions: there is a need to address the problems of anxiety and depression directly by screening and treatment, and to provide more psychologically-orientated cardiac rehabilitation programmes.

Objective: to extend a preliminary study of the internal structure of six measures comprising the 'conventional' subtests of the Behavioural Inattention Test (BIT) in order to develop a short screening test for visual neglect.

Design: discriminant function analysis of the 15 tests constituting BIT.

Setting: rehabilitation centre.

Patients: 59 selected from consecutive stroke patients entering the centre.

Selection criteria: absent prior history of major CNS disorder, at least 1 week post-stroke, right-handed for writing, absent significant visual impairment other than visual field deficit, no psychiatric overlay or generalized intellectual deterioration, and ability to comprehend and respond to the visuomotor tasks administered. COMPARISON GROUP: 50 non-brain-damaged subjects (hospital employees, members of University subject panel, and local community volunteers).

Assessments: the 15 tests constituting the BIT.

Results: two subtests, letter cancellation and star cancellation, were the most sensitive measure, identifying 74% of neglect patients with no false positives.

Conclusions: letter and star cancellation offer an adequate yet brief screening test for determining which patients might benefit from administration of the complete neglect test battery.

We prospectively evaluated gait recovery in 197 elderly subjects after hemiplegic stroke by measuring serial walking speed. Fifty-seven per cent of subjects (113/197) could not walk without human assistance on day 7 post-stroke. About 40% of this group achieved gait independence at months 1, 2, 3, and 4 post-stroke. In contrast, about 95% of those walking on day 7 maintained gait independence 1, 2, 3, and 4 months post-stroke. Using multiple logistic regression, the best predictors of independent ambulation among the 113 subjects not walking on day 7 were age, line bisection error, and leg power.

There is an increasing number of self-help groups. The British Diabetic Association has recently supported the development of such groups for people with diabetes. In the present research, eight self-help groups for diabetics were studied. This report describes the reasons given by group leaders for wanting to start such groups and analyses what was discussed in them. The observations reported suggest that the groups provided social-psychological support.

Unlabelled: Factors pertaining to post-surgical rehabilitation were investigated. These included personality, mental, and pain issues. The investigation covered the first year of bypass operations.

Subjects: 60 patients undergoing coronary artery bypass graft (CABE) operations.

Instruments: a questionnaire, a personality inventory (MMPI), and a test of mental status (Raven's). The questionnaire was first administered a few days before and then after surgery and then repeated at intervals of 3, 6, and 12 months after surgery.

Results: 76% were within normal limits on the Raven while 54% of those tested had significant depression. Both the depressed patients' dates of surgery and their ages were evenly distributed, and no significant differences were found between these and those not tested. Other MMPI results were that 36% scored above normal on the hysteria scale, 27% were quite anxious, and 24% were above average on the schizophrenia scale. The answers to the questionnaire items were relatively stable. In a comparison of the answers of the depressed versus the non-depressed, no significant differences were found. The reason for the depression is not apparent, but it is not considered to be the result of medication or of a greater severity of pain. The depression was not found to have affected the rehabilitation progress.