Resocialisation of Disabled Veterans in Former Yugoslavia

The team examined 147 amputated war veterans in the former Yugoslavia between February and December 1998. The official end of the war, substitution of lost body parts and adjustment to the new state of physical disability added extra tasks to these people's efforts to rejoin "normal life". The resocialisation process of amputated persons, i.e. the process of their return into the social environment with the related readjustment and establishment, was observed through its objective and subjective indicators. In addition to obtaining information about socio-demographic characteristics and current working status, the group focused on the psychological dimension, i.e. the individual reality of the disabled persons. In this sense they began with research into the personal, social and professional identity (how they see themselves under these altered circumstances and how they determine their place in the world). To do so they used the model of basic personality supports and observed the resocialisation according to the psychological support systems. They therefore focused on the following topics: body, social identity and belonging, personal identity, working status and engagement, individual responsibility and expectations from the social environment, and orientation towards the future. These were considered with respect to certain significant socio-demographic characteristics of the interviewees. The data were gathered through standardised interviews. Bearing in mind the unpopularity of this subject among experts in the country and the lack of material in specialist literature, the group chose to use descriptive research logic in order to "record" the situation in this field and to establish a framework for future studies which may be methodologically and statistically more complex and thematically more focused.

Development, feasibility and performance of a health risk appraisal questionnaire for older persons

BACKGROUND: Health risk appraisal is a promising method for health promotion and prevention in older persons. The Health Risk Appraisal for the Elderly (HRA-E) developed in the U.S. has unique features but has not been tested outside the United States. METHODS: Based on the original HRA-E, we developed a scientifically updated and regionally adapted multilingual Health Risk Appraisal for Older Persons (HRA-O) instrument consisting of a self-administered questionnaire and software-generated feed-back reports. We evaluated the practicability and performance of the questionnaire in non-disabled community-dwelling older persons in London (U.K.) (N = 1090), Hamburg (Germany) (N = 804), and Solothurn (Switzerland) (N = 748) in a sub-sample of an international randomised controlled study. RESULTS: Over eighty percent of invited older persons returned the self-administered HRA-O questionnaire. Fair or poor self-perceived health status and older age were correlated with higher rates of non-return of the questionnaire. Older participants and those with lower educational levels reported more difficulty in completing the HRA-O questionnaire as compared to younger and higher educated persons. However, even among older participants and those with low educational level, more than 80% rated the questionnaire as easy to complete. Prevalence rates of risks for functional decline or problems were between 2% and 91% for the 19 HRA-O domains. Participants' intention to change health behaviour suggested that for some risk factors participants were in a pre-contemplation phase, having no short- or medium-term plans for change. Many participants perceived their health behaviour or preventative care uptake as optimal, despite indications of deficits according to the HRA-O based evaluation. CONCLUSION: The HRA-O questionnaire was highly accepted by a broad range of community-dwelling non-disabled persons. It identified a high number of risks and problems, and provided information on participants' intention to change health behaviour.

Atividade motora adaptada : o conhecimento produzido nos programas Stricto Sensu em Educa����o F��sica no Brasil

Universidade Estadual de Campinas . Faculdade de Educa����o F��sica

Trabalho resistido adaptado visando a independencia de pessoas com paraplegia nas suas atividades de vida diaria

Universidade Estadual de Campinas . Faculdade de Educa����o F��sica

Acessibilidade aos servi��os de sa��de por pessoas com defici��ncia

OBJETIVO: Analisar as dificuldades de acessibilidade aos servi��os de sa��de vividas por pessoas com defici��ncia. PROCEDIMENTOS METODOL��GICOS: Estudo qualitativo realizado com pessoas que relataram ter algum tipo de defici��ncia (paralisia ou amputa����o de membros; baixa vis��o, cegueira unilateral ou total; baixa audi����o, surdez unilateral ou total). Foram entrevistados 25 indiv��duos (14 mulheres) na cidade de S��o Paulo, SP, de junho a agosto de 2007, que responderam perguntas referentes a deslocamento e acessibilidade aos servi��os de sa��de. A metodologia utilizada para an��lise foi o discurso do sujeito coletivo e as an��lises foram conduzidas com recurso do programa Qualiquantisoft. AN��LISE DOS RESULTADOS: A an��lise dos discursos sobre o deslocamento ao servi��o de sa��de mostrou diversidade quanto ao usu��rio ir ao servi��o sozinho ou acompanhado, utilizar carro particular, transporte coletivo, ir a p�� ou de ambul��ncia e demandar tempo variado para chegar ao servi��o. Com rela����o ��s dificuldades oferecidas de acessibilidade pelos servi��os de sa��de, houve relatos de demora no atendimento, problemas com estacionamento, falta de rampas, elevadores, cadeiras de rodas, sanit��rios adaptados e de m��dicos. CONCLUS��ES: As pessoas com algum tipo de defici��ncia fizeram uso de meios de transporte diversificados, necessitando de companhia em alguns casos. Problemas na acessibilidade dos servi��os de sa��de foram relatados pelos sujeitos com defici��ncias, contrariando o princ��pio da eq��idade, preceito do Sistema ��nico de Sa��de.

Uso de medicamentos por pessoas com defici��ncias em ��reas do estado de S��o Paulo

OBJETIVO: Analisar o consumo de medicamentos e os principais grupos terap��uticos consumidos por pessoas com defici��ncias f��sicas, auditivas ou visuais. M��TODOS: Estudo transversal em que foram analisados dados do Inqu��rito Multic��ntrico de Sa��de no Estado de S��o Paulo (ISA-SP) em 2002 e do Inqu��rito de Sa��de no Munic��pio de S��o Paulo (ISA-Capital), realizado em 2003. Os entrevistados que referiram defici��ncias foram estudados segundo as vari��veis que comp��em o banco de dados: ��rea, sexo, renda, faixa et��ria, ra��a, consumo de medicamentos e tipos de medicamentos consumidos. RESULTADOS: A percentagem de consumo entre as pessoas com defici��ncia foi de: 62,8 por cento entre os visuais; 60,2 por cento entre os auditivos e 70,1 por cento entre os f��sicos. As pessoas com defici��ncia f��sica consumiram 20 por cento mais medicamentos que os n��o-deficientes. Entre as pessoas com defici��ncia visual, os medicamentos mais consumidos foram os diur��ticos, agentes do sistema renina-angiotensina e analg��sicos. Pessoas com defici��ncia auditiva utilizaram mais analg��sicos e agentes do sistema renina-angiotensina. Entre indiv��duos com defici��ncia f��sica, analg��sicos, antitromb��ticos e agentes do sistema renina-angiotensina foram os medicamentos mais consumidos. CONCLUS��ES: Houve maior consumo de medicamentos entre as pessoas com defici��ncias quando comparados com os n��o-deficientes, sendo os indiv��duos com defici��ncia f��sica os que mais consumiram f��rmacos, seguidos de deficientes visuais e auditivos

Language and disability in Japan

Language relating to disability in the public arena has been a sensitive issue in Japan as elsewhere. Since the 1970s and 80s, major media organisations have replaced words considered derogatory with more acceptable equivalents; laws, statutes and other legal documents have likewise been revised. This article examines how the language used to portray people with disabilities has changed, how the changes came about and how they were received. The debate has largely been played out in four public spaces, which to some extent intersect and overlap: the media (both print and visual), the laws, literature and, increasingly now, the Internet. I argue that while the laws were rewritten primarily as the result of external international trends, such as the International Year of Disabled Persons, disability groups achieved media compliance mainly by exploiting the keen desire of Japanese media organisations to avoid public embarrassment resulting from vocal protests over infractions.

Disability in instrumental activities of daily living among older adults: gender differences

OBJECTIVE To analyze gender differences in the incidence and determinants of disability regarding instrumental activities of daily living among older adults. METHODS The data were extracted from the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Ageing) study. In 2000, 1,034 older adults without difficulty in regarding instrumental activities of daily living were selected. The following characteristics were evaluated at the baseline: sociodemographic and behavioral variables, health status, falls, fractures, hospitalizations, depressive symptoms, cognition, strength, mobility, balance and perception of vision and hearing. Instrumental activities of daily living such as shopping and managing own money and medication, using transportation and using the telephone were reassessed in 2006, with incident cases of disability considered as the outcome. RESULTS The incidence density of disability in instrumental activities of daily living was 44.7/1,000 person/years for women and 25.2/1,000 person/years for men. The incidence rate ratio between women and men was 1.77 (95%CI 1.75;1.80). After controlling for socioeconomic status and clinical conditions, the incidence rate ratio was 1.81 (95%CI 1.77;1.84), demonstrating that women with chronic disease and greater social vulnerability have a greater incidence density of disability in instrumental activities of daily living. The following were determinants of the incidence of disability: age ≥ 80 and worse perception of hearing in both genders; stroke in men; and being aged 70 to 79 in women. Better cognitive performance was a protective factor in both genders and better balance was a protective factor in women. CONCLUSIONS The higher incidence density of disability in older women remained even after controlling for adverse social and clinical conditions. In addition to age, poorer cognitive performance and conditions that adversely affect communication disable both genders. Acute events, such as a stroke, disables elderly men more, whereas early deficits regarding balance disable women more.

Brazilian version of the Quality of Care Scale: the perspective of people with disabilities

OBJECTIVE To analyze evidence of the validity and reliability of a Brazilian Portuguese version of the Quality of Care Scale from the perspective of people with physical and intellectual disabilities.METHODS There were 162 people with physical disabilities and 156 with intellectual disabilities from Porto Alegre and metropolitan region, who participated in the study in 2008. Classical psychometrics was used to independently analyze the two samples. Hypotheses for evidence of criterion validity (concurrent type) were tested with the Mann-Whitney test for non-normal distributions. Principal components analysis was used to explore factorial models. Evidence of reliability was calculated with Cronbach alpha for the scales and subscales. Test-retest reliability was analyzed for individuals with intellectual disabilities through intra-class correlation coefficient and the Willcoxon test.RESULTS The principal components in the group with physical disabilities replicated the original model presented as a solution to the international project data. Evidence of discriminant validity and test-retest reliability was found.CONCLUSIONS The transcultural factor model found within the international sample project seems appropriate for the samples investigated in this study, especially the physical disabilities group. Depression, pain, satisfaction with life and disability may play a mediating role in the evaluation of quality of care. Additional research is needed to add to evidence of the validity of the instruments.

Functional disability of adults in Brazil: prevalence and associated factors

ABSTRACT OBJECTIVE To estimate the prevalence and factors associated with functional disability in adults in Brazil. METHODS We used information from the health supplement of the National Household Sample Survey in 2008. The dependent variable was the functional disability among adults of 18 to 65 years, measured by the difficulty of walking about 100 meters; independent variables were: health plan membership, region of residence, state of domicile, education level, household income, economic activity, self-perception of health, hospitalization, chronic diseases, age group, sex, and color. We calculated the gross odds ratios (OR), and their respective confidence intervals (95%), and adjusted them for variables of study by ordinal logistic regression, following hierarchical model. Sample weights were considered in all calculations. RESULTS We included 18,745 subjects, 74.0% of whom were women. More than a third of adults reported having functional disability. The disability was significantly higher among men (OR = 1.17; 95%CI 1.09;1.27), people from 35 to 49 years (OR = 1.30; 95%CI 1.17;1.45) and 50 to 65 years (OR = 1.38; 95%CI 1.24;1.54); economically inactive individuals (OR = 2.21; 95%CI 1.65;2.96); adults who reported heart disease (OR = 1.13; 95%CI 1.03;1.24), diabetes mellitus (OR = 1.16; 95%CI 1.05;1.29), arterial systemic hypertension (OR = 1.10; 95%CI 1.02;1.18), and arthritis/rheumatism (OR = 1.24; 95%CI 1.15;1.34); and participants who were admitted in the last 12 months (OR = 2.35; 95%CI 1.73;3.2). CONCLUSIONS Functional disability is common among Brazilian adults. Hospitalization is the most strongly associated factor, followed by economic activity, and chronic diseases. Sex, age, education, and income are also associated. Results indicate specific targets for actions that address the main factors associated with functional disabilities and contribute to the projection of interventions for the improvement of the well-being and promotion of adults' quality of life.

ezGo: A voice operated wheelchair with biosignal monitoring for home environments

In this paper we present ezGo, an electric powered wheelchair with a speech based interface and biosignal monitoring instrumentation. The user can use the voice, a natural communication method, for controlling the chair movement and obtain information about his health. Additionally a set of semi-autonomous modes with macro recording enable the execution of navigation tasks with little effort and improved precision. The main purpose of the system is to provide severely disabled persons with an assistive device that can improve their confidence and daily independence. The obtained results on usability tests showed that users consider ezGo a valuable help on their daily tasks and a very desirable addition to standard wheelchairs.

Predictors of temporary and permanent work disability in patients with inflammatory bowel disease: results of the swiss inflammatory bowel disease cohort study.

BACKGROUND: Inflammatory bowel disease can decrease the quality of life and induce work disability. We sought to (1) identify and quantify the predictors of disease-specific work disability in patients with inflammatory bowel disease and (2) assess the suitability of using cross-sectional data to predict future outcomes, using the Swiss Inflammatory Bowel Disease Cohort Study data. METHODS: A total of 1187 patients were enrolled and followed up for an average of 13 months. Predictors included patient and disease characteristics and drug utilization. Potential predictors were identified through an expert panel and published literature. We estimated adjusted effect estimates with 95% confidence intervals using logistic and zero-inflated Poisson regression. RESULTS: Overall, 699 (58.9%) experienced Crohn's disease and 488 (41.1%) had ulcerative colitis. Most important predictors for temporary work disability in patients with Crohn's disease included gender, disease duration, disease activity, C-reactive protein level, smoking, depressive symptoms, fistulas, extraintestinal manifestations, and the use of immunosuppressants/steroids. Temporary work disability in patients with ulcerative colitis was associated with age, disease duration, disease activity, and the use of steroids/antibiotics. In all patients, disease activity emerged as the only predictor of permanent work disability. Comparing data at enrollment versus follow-up yielded substantial differences regarding disability and predictors, with follow-up data showing greater predictor effects. CONCLUSIONS: We identified predictors of work disability in patients with Crohn's disease and ulcerative colitis. Our findings can help in forecasting these disease courses and guide the choice of appropriate measures to prevent adverse outcomes. Comparing cross-sectional and longitudinal data showed that the conduction of cohort studies is inevitable for the examination of disability.

Infections and functional impairment in nursing home residents: a reciprocal relationship.

OBJECTIVES: To determine the relationship between infections and functional impairment in nursing home residents. DESIGN: Prospective cohort study (follow-up period, 6 months). SETTING: Thirty-nine nursing homes in western Switzerland. PARTICIPANTS: A total of 1,324 residents aged 65 and older (mean age 85.7; 76.6% female) who agreed to participate, or their proxies, by oral informed consent. MEASUREMENTS: Functional status measured every 3 months. Two different outcomes were used: (a) functional decline defined as death or decreased function at follow-up and (b) functional status score using a standardized measure. RESULTS: At the end of follow-up, mortality was 14.6%, not different for those with and without infection (16.2% vs 13.1%, P=.11). During both 3-month periods, subjects with infection had higher odds of functional decline, even after adjustment for baseline characteristics and occurrence of a new illness (adjusted odds ratio (AOR)=1.6, 95% confidence interval (CI)=1.2-2.2, P=.002, and AOR=1.5, 95% CI=1.1-2.0, P=.008, respectively). The odds of decline increased in a stepwise fashion in patients with zero, one, and two or more infections. The analyses predicting functional status score (restricted to subjects who survived) gave similar results. A survival analysis predicting time to first infection confirmed a stepwise greater likelihood of infection in subjects with moderate and severe impairment at baseline than in subjects with no or mild functional impairment at baseline. CONCLUSION: Infections appear to be both a cause and a consequence of functional impairment in nursing home residents. Further studies should be undertaken to investigate whether effective infection control programs can also contribute to preventing functional decline, an important component of these residents' quality of life.

Estudio de accesibilidad de sitios Weborientados al comercio electr��nico y a laprestaci��n de servicios

An��lisi de diverses p��gines que tinguin com a finalitat el comer�� electr��nic o la prestaci�� de serveis, de cara a trobar els principals problemes a qu�� s'enfronten les persones amb discapacitat en utilitzar aquests llocs i extreure conclusions per proposar possibles procediments de desenvolupament dels mateixos que facilitin la seva accessibilitat / usabilitat final.