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Background: People with disabilities (PWD) are at increased risk of poor mental health. However, this association and the pathways involved remain under-researched in many parts of the world. This study examined the association between disability and psychological distress in nine countries of the former Soviet Union (FSU).Methods: Data were analysed from 18,000 adults aged ≥18 years collected during the Health in Times of Transition (HITT) survey undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine in 2010 and 2011. Information was obtained on disability status, the severity of the disability and psychological distress. Logistic regression analysis was used to estimate associations.Results: In a fully adjusted combined country analysis, disability was associated with over two times higher odds for psychological distress (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.86-2.58). The strength of the association varied across the individual countries. Among PWD more severe disability was associated with significantly higher odds for psychological distress (OR: 2.12, 95%CI: 1.26-3.55).Limitations: The data were cross-sectional and disability status was self-reported, possibly resulting in underreporting.Conclusions: Disability is associated with worse psychological health in FSU countries, especially among those with more severe disabilities. As poor mental health may also increase the risk of negative outcomes in PWD, this finding highlights the importance of the early detection and treatment of mental disorders in PWD in these countries. [ABSTRACT FROM AUTHOR]

The International Classification of Functioning, Disability and Health (ICF) is part of the Family of International Classifications of the World Health Organization (WHO) and acts as a tool for describing and organizing information about the functioning and disability of people with and without disabilities, providing a language standard. Marajó is a region with infrastructure peculiarities and disabled people who face very specific and little-known challenges there. Classify the mobility of people with physical disabilities in the Marajó archipelago according to the ICF. Cross-sectional study, with a quantitative approach, referring to the activity profile of physical PCD residents in the municipalities of Marajó. The subjects were selected by convenience through the dissemination of the action in Basic Health Units visited by the group of the "Abrace o Marajó'' Project between August 2021 and January 2022. The participants underwent a structured interview where they answered an adapted checklist, based on the ICF biopsychosocial model, which provides a standardized language. The ICF data used are related to the "activity and participation" domains, with a focus on mobility. The study included 51 physically disabled persons, with a predominance of age between 40 and 59 years (39.22%), men (54.90%), browns/mulattoes (62.75%). Most respondents had mobility problems, with 88.24% having difficulty walking (d450), 84.31% having difficulty lifting and carrying objects (d430), 78.43% having difficulty using transportation (d470), 64.71% using some locomotion device (d465), and 41.18% with impaired fine use of the hands (d440). These data suggest that the mobility deficit combined with the lack of accessibility may be one of the factors that most interfere with the lives of these participants, as it limits and/or restricts their participation in daily activities. Disabled persons residing in Marajó have several limitations and/or restrictions on participation in day-to-day activities related to lack of mobility, the main limitations are those with the highest percentages, that is, walking, lifting, and carrying objects, and using means of transport. In this regard, it is vital to adopt public policies aimed at improving the infrastructure of streets and sidewalks in order to facilitate access for this population, thus promoting an increase in the level of activity and participation. This study can contribute to the visibility of the needs of disabled persons who live in Marajó and the implementation of public policies to assist this population, as well as to understand their main difficulties and what accessibility measures can bring more autonomy. [ABSTRACT FROM AUTHOR]

• The safety and effectiveness of ocrelizumab in MS patients with higher levels of disability is not known. • We reviewed primary and secondary progressive MS patients, with EDSS ≥ 6.5 at the time of treatment initiation. • Ocrelizumab was well tolerated. ∼1/3rd of patients reported disease stabilization on ocrelizumab. Ocrelizumab is a commonly used anti-CD20 monoclonal antibody with efficacy in the treatment of both relapsing-remitting (RRMS) and primary progressive (PPMS) multiple sclerosis. Real world use of ocrelizumab in MS patients with higher levels of motor disability requiring a walker or a wheelchair is not well characterized as these populations were excluded from initial studies. Higher levels of disability may be a barrier to treatment access. This study aimed to describe the access to, and tolerability and therapeutic outcomes of ocrelizumab in highly disabled MS patients in a real-world setting. As part of an ongoing study of ocrelizumab treatment access, barriers, and outcomes in MS patients at the Brigham MS Center, we retrospectively reviewed all patients with an Expanded Disability Status Scale (EDSS) of 6.5 or greater at the time of ocrelizumab initiation. All patients were started on ocrelizumab by their treating providers prior to this study initiation. Patients were excluded for recent rituximab exposure, co-treatment with more than one immunosuppressant, or alternative diagnoses contributing to high EDSS. Data was collected on incidence and severity of side effects while on ocrelizumab, persistence of treatment beyond one year, and MS stabilization versus progression while on this treatment. Of the 1219 patients on ocrelizumab between 2017 and 2021, 113 (9.3 %) had EDSS of 6.5 or greater at the time of ocrelizumab initiation. Of the 113, 51 (45.1 %) were excluded: 6 (5.3 %) because they were duplicates or didn't receive ocrelizumab at our center, 25 (22.1 %) due to rituximab treatment in the previous year, 16 (14.2 %) due to lack of at least 1 year of follow up, and 4 (3.5 %) due to relevant comorbidities/treatment with other immunosuppressants. 62 patients were included in the final analysis. At ocrelizumab start, mean age was 62.1 +/- 8.7 years and median EDSS was 7.0 (range 6.5 to 9.5). Ocrelizumab was started in 26 of the included 62 patients (41.9 %) because of objective clinical disease worsening, in 17 (27.4 %) because of subjective worsening, in 8 (12.9 %) to prevent future progression. 32 patients (51.6 %) continued ocrelizumab throughout the study period, with average length of ocrelizumab use of 36.5 +/- 17.0 months. 29 patients (46.8 %) experienced no side effects during the study period. 29 (46.7 %) patients discontinued treatment, and of those, 9 (31.0 %) cited more than one reason for discontinuation: 17 (58.6 %) cited side effects, 12 (41.4 %) cited progression/lack of benefit, 6 (20.7 %) cited the Covid19 pandemic, and 1 (3.4 %) cited financial issues as a reason for discontinuation. Over the course of the study, 16 (25.8 %) patients had disability worsening by EDSS, 5 (8.1 %) had disability improvement, and 41 (66.1 %) remained stable, with a median end EDSS of 7.0 (range 6.5 to 9.5). Importantly, 18 patients (29.0 %) reported subjective disease stability while on ocrelizumab. Ocrelizumab may lead to disease stabilization in a subset of highly disabled MS patients, but possible benefits need to be carefully balanced against the incidence of adverse events in this high-risk patient population. [ABSTRACT FROM AUTHOR]

Background: Male sexual assaults were long ignored, possibly because of the myth acceptance that a man can only be the perpetrator of sexual assaults. It is increasingly admitted that all males can be victims of rape. We described the characteristics of a series of male adolescent and adult victims of sexual assault who had a forensic medical examination.Methods: We conducted an observational study over 8 years.Results: We included 98 male patients aged 15 years and older (range 15-66, median 25) at the time of a reported sexual assault. Assailants were known by the victim in 59 cases (60%). Forty-four patients (45%) had physical or mental vulnerability. Anal penetration was reported in 49 cases (50%). Genital examination showed abnormalities compatible with traumatic injuries in 23 cases (24%). Psychological symptoms were found in 81 victims (83%), including shame (39, 40%) and anxiety (38, 39%). Of 98 victims, sperm could be detected in 6 cases (6%) (anal, 4; oral, 1; skin, 1). Male victims were more frequently disabled or vulnerable than female victims examined in the same centre (45% vs. 13%, p<0.001). At the one-month follow-up consultation, psychological symptoms, including sleep disorders and fear, were observed in most patients and the proportions of physical and psychological complaints were similar among male and female victims.Conclusion: Male victims of sexual assault experienced high level of psychological trauma and felt more ashamed than women, which suggests that sexual assaults should be considered as severe among men as among women. [ABSTRACT FROM AUTHOR]

There are less favourable attitudes towards inclusion of children with disabilities in Ghana as a result of historical assumptions concerning Persons With Disabilities (PWDs). These assumptions are cultural beliefs which look down upon persons with disabilities, leading to either the exclusion of PWDs from mainstream schools or including them adversely; for instance, when they are provided with separate facilities which sometimes are not conducive for learning. Using Ghana as an example, the study examined challenges children with disabilities face in mainstream schools as well as perspectives on disability. The study utilised qualitative method of research mainly in-depth interviews and social model of disability, advanced by Mike Oliver as an underpinning research technique theory. The study found that children with disabilities mostly face challenges such as discrimination from their colleagues, teachers, and non-teaching staff in the school. Also, government does not adequately plan for children with disabilities by way of policies and programmes. The number of special education teachers in the mainstream educational facilities are inadequate, and the few available teachers seem to lack the competence to properly impart knowledge to them to ensure the development of their potentials. Besides, findings indicated that, the understanding of the word “disabled” and its explanation associated with cultural beliefs cause and worsen disability in these group of children denying them their rights. These challenges indicate that, children with disabilities educational needs were not properly taken care of and the system does not help them to benefit from education. The study therefore recommends the need to re-orient people’s thoughts and their beliefs towards children with disabilities to reduce or eliminate the challenge they encounter in schools and in the larger society. [ABSTRACT FROM AUTHOR]

To retain and grow ridership, transit agencies continuously survey riders to learn how to improve services and understand what leads to rider satisfaction. Nevertheless, transit riders are not a homogeneous entity and understanding the distinctions between transit riders can help transit agencies in their efforts to provide satisfactory service to retain existing riders and attract new ones. To uncover how diverse aspects of bus services can differentially impact satisfaction of different riders, we use data from a large-scale, multiyear bus satisfaction survey from London, UK. Specifically, we model satisfaction using logistic regressions to learn how encumbered riders and riders with physical disabilities value different features of bus services compared to other types of riders. For riders traveling with large items, shopping bags, or children, we find that satisfaction depends on the presence and condition of a bus shelter and the availability of a seat. Satisfaction of riders with disabilities depends on information availability at the bus stop, as well as trip speed and reliability. Our findings indicate that improving waiting area conditions and providing information at the stop can increase the satisfaction of riders with encumbrances and disabilities, respectively. Findings from this paper can be of benefit to transit planners and policy makers as it offers new insights about the determinants of satisfaction of two groups of bus riders not often considered in the public transport literature. [ABSTRACT FROM AUTHOR]

Despite the non-trivial number of (non-institutionalized) residents with special needs – referred to as the medically fragile population in this paper – there is virtually no research available to guide the hurricane evacuation planning for this population group. One area is their evacuation time choice behavior that can have tremendous implications for their safety as well as the logistics of the evacuation process. In this paper, we fundamentally advance our understanding of the evacuation timing behavior of this heavily understudied, and potentially vulnerable, population group. Analysis indicates that key differences exist between the medically fragile and non-medically fragile population. [ABSTRACT FROM AUTHOR]

Résumé But de l’étude L’objectif de cette recherche est d’analyser les modalités de développement de l’estime de soi d’élèves en situation de handicap scolarisés en classes d’inclusion scolaire (CLIS), en appréhendant les effets du type d’inclusion pratiquée (individuelle et/ou collective) du genre et de l’âge. Population et méthode Quarante élèves scolarisés dans 6 CLIS et présentant une déficience intellectuelle légère (20 filles ; 20 garçons), âgés de 7 à 12 ans (M = 10,15 ; ET = 2,08) ont renseigné la version française de l’échelle auto-évaluative Self Perception Profile for Children (Harter, 1985) traduite par Pierrehumbert, Plancherel et Jankech-Caretta (1987). Parmi ces élèves, 45 % étaient inclus individuellement, 37,5 % collectivement et 17,5 % inclus individuellement et collectivement. Résultats Les élèves bénéficiant d’inclusion individuelle mais aussi d’inclusions individuelle et collective ont un niveau d’estime de soi « Sociale » plus élevé que les élèves bénéficiant uniquement d’inclusion collective. Le niveau d’estime de soi « Sociale » est modulé par un effet d’interaction entre le genre et l’âge des élèves. Ce dernier influence également le niveau d’estime de soi « Valeur propre ». Conclusion Les résultats soulignent l’importance des processus de comparaison sociale dans la construction de l’estime de soi des élèves scolarisés en CLIS. Ces derniers cherchent à maintenir une position d’exception, possible par la pratique d’inclusion individuelle, qui contribuerait à les valoriser. Objective The aim of this study is to analyze self-esteem development of disabled pupils schooled in an inclusive classrooms (CLIS). Recent laws emphasize the importance of disabled people's inclusion in ordinary places. Concerning primary school, this is materialized by CLIS which are classes hosting disabled children in an ordinary school. In this configuration, disabled pupils must have inclusion time in another classroom of the school, in an individual way (a pupil joins another classroom) and/or in a collective way (the CLIS joins another classroom). Those inclusions would deliver pedagogic, educational and personal benefits. Specifically, concerning personal benefits, CLIS would give to these pupils possibility to feel appreciated. To our knowledge, no study has focused on the impact of type of inclusion applied in CLIS on self-esteem levels of disabled children; while this seems to be a substantial factor in self-esteem modulation. The inclusion applied even individual and/or collective, the age and gender of pupils are they factors suspected to guide self-esteem? We focus on the Harter model (1986) related to multidimensional and hierarchic self-esteem. We also refer to Martinot (2002) who develops different self-esteem protection strategies and to the Marsh model (1987) concerning the “Big fish little pond effect”. Methods and population Forty pupils with cognitive troubles schooled into six CLIS (20 girls and 20 boys), aged 7 to 12 years old (A = 10.15; SD = 2.08), filled the French version of the Harter questionnaire (1985): Self Perception Profile for Children translated by Pierrehumbert, Plancherel and Jankech-Caretta (1987). Forty-five percent of the pupils are individually included, 37.5 % are collectively included and 17.5 % are both included individually and collectively. Results Our results reveal that pupils individually included and with both inclusions have a social self-esteem higher that those who are only collectively included. Social self-esteem is modulated by the effect of interaction between age and gender. The age of the pupils is influencing the global self-esteem. Conclusion Results underline the weight of social comparison in self-esteem structure of pupils schooled in CLIS. Those who seek to maintain favored status in order to valorize themselves, which seems to be feasible by individual inclusion. Considering these results would directly influence the daily practice of professionals close to these pupils. [ABSTRACT FROM AUTHOR]

Despite its demonstrated effectiveness, colorectal cancer (CRC) testing is suboptimal, particularly in vulnerable populations such as those who are publicly insured. Prior studies provide an incomplete picture of the importance of the intersection of multilevel factors affecting CRC testing across heterogeneous geographic regions where vulnerable populations live. We examined CRC testing across regions of North Carolina by using population-based Medicare and Medicaid claims data from disabled individuals who turned 50 years of age during 2003-2008. We estimated multilevel models to examine predictors of CRC testing, including distance to the nearest endoscopy facility, county-level endoscopy procedural rates, and demographic and community contextual factors. Less than 50% of eligible individuals had evidence of CRC testing; men, African-Americans, Medicaid beneficiaries, and those living furthest away from endoscopy facilities had significantly lower odds of CRC testing, with significant regional variation. These results can help prioritize intervention strategies to improve CRC testing among publicly insured, disabled populations. [ABSTRACT FROM AUTHOR]

Extent of secondary crashes derived from primary incidents involving abandoned and disabled vehicles are presented in this paper. Method Using years 2004 to 2010 incident and crash data on selected Tennessee freeways, the study identified secondary crashes that resulted from disabled and abandoned vehicle primary incidents. The relationship between time and distance gaps before the secondary crash with respect to individual incident characteristics were evaluated through descriptive statistics and linear regression. Results The time and distance gap analysis indicated that a large portion of secondary crashes occurred within 20min after the primary incidents and within a distance of 0.5miles upstream. While 76% of incidents involved shoulder, most secondary crashes were related to the closing of right lanes. Overall, 58% of the secondary crashes occurred within 30min after the occurrence of the primary incidents. Most of the vehicles in the incidents that involved towing and caused secondary crashes were towed or removed out of the travel way within 60min from the time of occurrence. The study found that most (95%) secondary crashes were property damage only (PDO), while 49% were rear-end crashes. The negative binomial model was used to evaluate the impact of roadway geometry and traffic factors associated with frequency of these secondary crashes. It was found that the posted speed limit, congested segments, segments with high percentages of trucks, and peak hour volumes increased the likelihood of secondary crash occurrence. Roadway segments with wider medians, shoulders, and multilanes decrease the likelihood of secondary crashes caused by abandoned and disabled vehicles as the primary incidents. Practical applications The paper recommends that wider shoulders be provided on any section of freeway to accommodate abandoned or disabled vehicles to avoid blocking of travel lane(s). [ABSTRACT FROM AUTHOR]

In 2007, the 'Aiming High' programme set out to improve outcomes for children with disabilities in the UK. There continues to be a plethora of legislation, acts, guidance and changes in practice but is there any evidence of real change for children with a disability? This article aims to discuss whether the current Children and Families Bill will be the legislation that finally does make a significant difference and facilitate improved interagency working, quicker care plans and simplified and safe transition. [ABSTRACT FROM AUTHOR]

Highlights: [•] Hurricane evacuation behavior of the medically fragile population is studied. [•] Virtually no empirical studies available on the medically fragile population. [•] Key differences with the non-medically fragile population are highlighted. [•] Empirical data from a large-scale phone survey is used (over 7000 samples). [Copyright &y& Elsevier]

Highlights: [•] Comprehension of a set of symbol-based safety warnings/signs across differently abled populations was assessed using the ISO 9186 criteria. [•] Comprehension and compliance intentions regarding the graphical symbol, as well as the surrounding shape–color background, were the measures taken into consideration. [•] The results showed that most of the signs were not well understood and that 5 signs caused critical confusions in at least one of the three measures, by more than 5%. [•] In general, the adult workers and college students achieved higher comprehension scores than the individuals with cerebral palsy. [•] Issues associated to categorizing participant responses, including the use of criteria for evaluating the meaning of the symbols and color–shape codes separately, are discussed. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents the movement speeds and behavioral data for 45 residents evacuating a six-story assisted-living facility located on the East Coast of the United States. The building's population comprised of a diverse array of older adults and disabled residents descending the stairwells by the following methods: self-evacuation without assistance, assistance using a cane, assistance from another occupant or firefighter, or assistance using a stair chair. Movement data of these specific groups was compared and contrasted with other data collected on mobility-impaired individuals. In the current study, the National Institute of Standards and Technology observed overall average speeds ranging between (0.11 to 0.29)m/s, which in some cases, approximate the speeds of disabled people and older adults found in earlier studies, and in other cases is slower than previous studies. Slower speeds in this case may have resulted from observing a wider variety of mobility impairments (since the building observed was an assisted-living facility) and evacuation assistance provided by untrained populations. These data provide an adequate confirmation of exiting literature values typically used for disabled movement speeds in addition to updated values for future analyses. [Copyright &y& Elsevier]

Abstract: Soopramanien A. Mauritius calling: medical care and neurorehabilitation needs in an oceanic idyll. The tropical island of Mauritius, located off the coast of Southern Africa, has greatly improved its health care system, especially for frontline services and procedures such as cardiac surgery. But the post–acute neurorehabilitation care is still problematic, much to the detriment of disabled patients, their families, and Mauritian society overall. Comparisons with neurorehabilitation care in the United Kingdom suggest the scale of the problem in terms of uncoordinated medical teams, limited follow-ups, lack of expertise, and cultural stigma. This article assesses the needs of the neurologic rehabilitation segment in Mauritian health care and submits a set of policy recommendations addressing what medical professionals, hospitals, government officials, and other organizations can do to improve the neurologic rehabilitation infrastructure for Mauritian patients. [Copyright &y& Elsevier]

Abstract: Background: Previous research identifies positive and negative effects of being a sibling in a family which includes a disabled child. Short break services (also known as respite) provide families with a break from caring and offer disabled children the chance to participate in various activities. This paper investigates the effects that these short breaks have on siblings. Methods: The research consists of a qualitative analysis of data collected as part of a survey of families using short break services. Data from 239 parent–carers (mostly biological parents) and 84 siblings are included in the analysis. Data are written responses to open questions about use of services and the effects they have. Results: The effects of short breaks on siblings are described as being mostly positive. Short breaks have the potential to ameliorate some of the negative impacts of being a sibling in a family with a disabled child whilst also promoting the positive impacts of having a disabled brother or sister. However, some siblings also report some adverse effects of short breaks. Conclusion: Short breaks have a significant role to play in promoting the wellbeing of siblings; however, their role currently seems to be largely unrecognised and consequently undervalued. [Copyright &y& Elsevier]

Abstract: Adequate street crossing skills reduce the risk of injury and increase the functional independence of individuals with disabilities. This paper reviews research involving instructional interventions for street crossings with individuals with disabilities. Eight studies were included. There was evidence individuals could be taught street crossings using classroom based interventions, roadside instruction, or virtual reality technology. Classroom based methods were successful when involving strategies which promoted generalization of skills. Task analysis found the steps involved in street crossing included: stopping at the curb, looking left and right, walking quickly, walking within the crosswalk, and continuing to look left and right. A variety of instructional strategies were used, but the small body of literature did not allow clear identification of superior strategies. [Copyright &y& Elsevier]

Oral health care for disabled patients is an important health issue in Taiwan. Disabled patients seeking dental care include those with mental retardation, cerebral palsy, epilepsy, Down syndrome, autism, xerostomia, AIDS, loss of function of major organs, and neurologic diseases. Current dental health care policies do not completely address this critical oral health issue. Most of these physically or mentally disabled patients cannot find suitable or qualified dental services in local dental clinics or even hospitals. Our current health care insurance system should provide greater benefits for dental practitioners who are willing to care for such disabled patients. The Department of Health (DOH) should legislate policies to provide greater financial support and equipment and encourage hospital dental clinics and dentists to join this special oral care program. Dental schools, hospitals, and the DOH can also provide curricula and special training programs for both dentists and undergraduate dental students so that they can learn about diseases and dental, care of these patients. The government and DOH should cover the fees of lawsuits if dentists have medical legal problems while treating patients with disabilities. Questions on special care dentistry can possibly be included in the National Board Dental Examination. The government can establish some national oralhealth care centers to treat these disabled patients. Through the development of effective preventive and treatment strategies, the incidence of oral diseases in these patients can be reduced in the future. [ABSTRACT FROM AUTHOR]

Abstract: A retrospective study was carried out on 71 dogs to determine the parameters influencing the quality of service provided by service dogs and to modify the dog training and selection. The questionnaires were mailed 3 years after placing the dogs with disabled people. Two co-joined medical and veterinary studies were carried out. The questionnaires covered the quality of life and service evaluation of the dogs and owners. The response rate was 76%. Two classes of dogs were set up according to the capacity of carrying out the commands and then crossed with dog and owner characteristics to determine any correlation. No dog characteristics correlated with the quality of response to commands. The human population was very heterogeneous and the mobility of some owners was very restricted. However, the quality of service only correlated with the vocal capacity of the owners and did not correlate with the physical capacity of the owner. The study emphasizes the importance of nonverbal communication and voice strength when communicating with dogs, and stresses the importance of the applicant selection process to ensure the success of the program. [Copyright &y& Elsevier]

Abstract: The paper discusses a series of driving trials that were conducted to investigate postural stability of disabled drivers and to assess the effectiveness of a representative sample of support aids. Twenty-three disabled drivers with varying levels of physical disability and seven non disabled drivers participated in the study. The test car was equipped with transducers to measure vehicle velocity and acceleration (longitudinal and lateral), steering wheel movement and torque, and the bracing forces exerted by the driver on the steering wheel. Video cameras were installed to record postural support strategies and displacement of the driver and to record deviation of the car from the specified path. Subjective data regarding driver attitudes and acceptance were also collected through the administration of questionnaires. Findings from the study showed that support aids significantly improved driving performance and reduced physical exertion to maintain an upright driving position for disabled drivers. However, ergonomics design aspects regarding the ease of use and acceptance of the support aids by the end users were identified as obstacles to their sustained use in everyday driving. [Copyright &y& Elsevier]

Abstract: Despite the existence of a large volume of literature on subjective well-being (SWB) of the general population, very few studies have focused on individuals with disabilities. The present study uses data on 24,036 Canadians with disabilities to investigate factors affecting their SWB. It found that SWB, measured here by level of happiness, decreases with severity of disability but is independent of the type of physical disability. Those born with a disability are likely to be happier as compared to those disabled later on in life. Per capita family income has no effect on happiness. However, unemployment decreases happiness. Happiness is found to be U shaped in age, bottoming out around 40 years of age. Some of these results vary when the sample is split according to the timing, type or severity of disability. [Copyright &y& Elsevier]

Abstract: The European Road E12 through the community center of Storuman, Sweden was reconstructed in 1999 and 2000. Pedestrian walkways, traffic islands, chicanes of a type referred to as “Danish buns”, a roundabout and a two-directional cycle track along the E12 were installed. The purpose of the reconstruction was to improve safety for pedestrians and bicyclists, primarily for children, the elderly and the disabled, and to reduce the barrier effect of the E12 thoroughfare. In May 2000, the code governing the conduct of drivers at marked crosswalks in Sweden became stricter to improve safety and mobility for pedestrians. The combined effect of reconstructions and change of code was analyzed. Traffic behavior was studied at the intersection where the roundabout was constructed. Yield behavior towards pedestrians changed significantly. The difference was even greater with respect to yielding to child bicyclists – from 6% before to 84% after – even though the code change only related to pedestrians. Crash data analysis suggests a minor increase in fall injuries after reconstructions and change of code. Measures of speed, behavioral studies, questionnaires, face-to-face interviews and crash data analysis suggest that safety has increased not only along the E12 but also along adjacent roads. The final conclusion is that a bypass is not needed in a case like Storuman. Traffic calming of the main arterial through the town seems sufficient. [Copyright &y& Elsevier]

Abstract: A ubiquitous characteristic of elderly and patients with gait disabilities is that they walk slower than healthy controls. Many clinicians assume these patients walk slower to improve their stability, just as healthy people slow down when walking across ice. However, walking slower also leads to greater variability, which is often assumed to imply deteriorated stability. If this were true, then slowing down would be completely antithetical to the goal of maintaining stability. This study sought to resolve this paradox by directly quantifying the sensitivity of the locomotor system to local perturbations that are manifested as natural kinematic variability. Eleven young healthy subjects walked on a motorized treadmill at five different speeds. Three-dimensional movements of a single marker placed over the first thoracic vertebra were recorded during continuous walking. Mean stride-to-stride standard deviations and maximum finite-time Lyapunov exponents were computed for each time series to quantify the variability and local dynamic stability, respectively, of these movements. Quadratic regression analyses of the dependent measures vs. walking speed revealed highly significant U shaped trends for all three mean standard deviations, but highly significant linear trends, with significant or nearly significant quadratic terms, for five of the six finite-time Lyapunov exponents. Subjects exhibited consistently better local dynamic stability at slower speeds for these five measures. These results support the clinically based intuition that people who are at increased risk of falling walk slower to improve their stability, even at the cost of increased variability. [Copyright &y& Elsevier]

Abstract: Background and aim: Obesity, cardiovascular diseases, diabetes and osteoporosis are the most frequent pathologies among people with a severe reduction of physical activity. The impairment in nutritional status, consequent to quantitative and qualitative inadequacy of diet, could be one of the first steps in the development of co-morbidities in disabled subjects. In order to evaluate this hypothesis we investigated the nutritional status and the food intake in patients with physical or mental disabilities. Methods and results: Thirty-seven disabled subjects (24 with exclusively physical inactivity and 13 with mental retardation and physical inactivity) mean age 33.5±9.2years and 25 healthy subjects (mean age 31.0±9.3years) were enrolled. Anthropometric measurements, indirect calorimetry, dual-energy X-ray absorptiometry, dietary intake and biochemical parameters were collected for each subject. Forty percent of disabled were overweight and 14% were obese. Fat free mass (FFM) and bone mineral content (BMC) was lower and fat mass (FM) was higher than able-bodied control. Absolute resting energy expenditure (REE) was lower in disabled subjects, but this difference disappeared when REE was normalized to FFM. Dietary intake resulted unbalanced (16%, 31%, 50% of total daily energy intake derived from protein, lipid and carbohydrate respectively) with a distribution of dietary fatty acid quite far from the recommended ratio [3.1(SFA):4.1(MUFA):1.0(PUFA)] and an excessive consumption of simple carbohydrates (mean intake 17.5±4.9%). Insufficient intake of fibre, iron, calcium, potassium and zinc was also found. Finally, alterations in the cholesterol profile were evident in more than one third of the disabled subjects, whereas fasting glucose intolerance was evident in one fourth. Conclusion: This study shows a consistent nutritional status impairment in disabled patients resulting in an reduction of FFM and BMC, in an over-representation of FM and in a number of biochemical risk factors for cardiovascular disease. The altered nutritional status is counterparted by a widespread inadequacy of dietary patterns. This nutritional and dietary impairment occurs both in subjects with mental and physical diseases. [Copyright &y& Elsevier]

Objectives: To evaluate the effects of tea catechin inhalation on methicillin-resistant Staphylococcus aureus (MRSA) in disabled elderly patients. Design: Seven days, randomized, prospective study. Setting: Three hospitals in Japan. Participants: Seventy-two patients aged 78 ± 11 years (mean age ± standard deviation) with cerebrovascular diseases, classified as disabled according to the activity of daily living and were either bedridden or required assistance for standing, and showing presence of MRSA in sputum. Interventions: Inhalation of 2 mL tea catechin extract solution along with saline (3.7 mg/mL catechins, 43% of catechins are composed of epigallocatechin gallate), or saline alone, 3 times daily using a handheld nebulizer for 7 days. Measurements: The endpoint of efficacy was the reduction rates of MRSA in sputum. The safety measure was the adverse events observed during the 7 days of inhalation. Results: The reduction rates calculated as the summation of decrease and disappearance of MRSA in sputum at 7 days were 47% (17 of 36 patients) in the catechin group and 15% (5 of 33 patients) in the control group; the difference in the reduction rates between the 2 groups was statistically significant (P = .014). The disappearance rate of MRSA in sputum was higher in the catechin group (31%; 11 patients) when compared with the control group (12%; 4 patients), however the difference in the disappearance rate between the 2 groups was not statistically significant (P = .091). No adverse events, such as respiratory tract obstruction, allergic bronchial spasm, or skin eruption, including laboratory changes, were observed during the study. Conclusion: The catechin inhalation appeared to reduce the MRSA count in sputum. However, the application of tea catechin inhalation as a supplementary treatment for controlling MRSA infection remains controversial. [Copyright &y& Elsevier]

Abstract: A stratified random sample of 457 people in the UK with sight problems between 16 and 60 years was interviewed in their own homes to ascertain their employment status, their views on employment, and other relevant matters. Of those who might be characterised as blind or partially sighted (<6/18), 27% were working; of those who were not working, 3% were actively seeking work, 22% were not searching but would like work, and 75% were not searching and would not like to work. Virtually no one who had lost their sight within the last 2 years wanted work, suggesting that encouraging people to work quickly after sight loss will not be welcome. The authors suggest four typical groups: “definitely early retired,” “reluctantly early retired,” “job loss imminent,” and “safe in work.” [Copyright &y& Elsevier]

Abstract: Objective: Those aged <65 in nursing homes (NHs) are substantially different from elderly residents. This study uses data gathered from the Resident Assessment Instrument''s Minimum Data Set (MDS) to describe these relatively rare residents. Study design and setting: The study uses MDS assessments of close to three-quarter million residents in nine states from 1994 to 1996. Residents are described within chronological age group (0–4, 5–14, etc.). Factor analysis is used to develop diagnostic clusters, and the prevalence of these clusters, functional problems, other conditions, and treatments is described for each group. Results: Thirteen diagnostic clusters describe nearly 85% of all NH residents and highlight differences between age groups. Pediatric residents are substantially more physically and cognitively impaired than young adult residents, and have the highest case mix burden of care. The youngest population primarily has diagnoses related to mental retardation and developmental disabilities, young adults have the highest prevalence of hemi- and quadriplegia, while older residents are typified by increasing prevalence of neurological diagnoses. Conclusion: This study offers an initial description of NH residents <65. The prevalence of residents with unique conditions may suggest the need to modify the MDS assessment instrument. [Copyright &y& Elsevier]

The paper presents a review of the interests and limits of oxygen uptake measurement in the functional testing of athletes and disabled people. The validity of the oxygen uptake as an estimation of the oxygen consumption and aerobic synthesis of ATP is discussed in the introduction of the review. The author discusses the interests of oxygen uptake measurements for the study of energy cost in addition to maximal oxygen uptake. The limits of the study of oxygen uptake kinetics at the beginning of exercise are discussed. The methodology of oxygen measurement is mainly focused on the characteristics of the different ergometers and the choice of an exercise protocol. The review ends with short statements related to the current knowledge on maximal oxygen uptake, its limiting factors and the effects of age, gender, body mass, active muscle mass and training. [Copyright &y& Elsevier]

Formation of the mammalian six-layered neocortex depends on a signaling pathway that involves Reelin, the very low-density lipoprotein receptor, the apolipoprotein E receptor-2 (ApoER2), and the adaptor protein Disabled-1 (Dab1). The 1.5 A˚ crystal structure of a complex between the Dab1 phosphotyrosine binding (PTB) domain and a 14-residue peptide from the ApoER2 tail explains the unusual preference of Dab1 for unphosphorylated tyrosine within the NPxY motif of the peptide. Crystals of the complex soaked with the phosphoinositide PI-4,5P2 (PI) show that PI binds to conserved basic residues on the PTB domain opposite the peptide binding groove. This finding explains how the Dab1 PTB domain can simultaneously bind PI and the ApoER2 tail. Recruitment of the Dab1 PTB domain to PI-rich regions of the plasma membrane may facilitate association with the Reelin receptor cytoplasmic tails to transduce a critical positional cue to migrating neurons. [Copyright &y& Elsevier]

• Qualitative data from a semi-structured interview with disabled commuters in Nigeria. • Disabled commuters express their satisfaction both internally and externally. • Mood is an internal expression of satisfaction in the form of worry and anxiety. • Emotions are external expression in the form of anger and frustration. • Cognitive actions are taken based on the evaluation of their satisfaction level. While previous studies, often based in developed countries, have established that travel satisfaction contributes to the overall well-being of individuals, there is a shortage of insight regarding travel satisfaction in terms of vulnerable groups in developing countries, including those with lower income, and the impact of this travel satisfaction on the essential areas of life. Accordingly, this study focuses on disabled commuters in Nigeria, one of the world's largest developing countries. Qualitative data from semi-structured interviews with 32 disabled individuals were thematically analysed to investigate the participants' travel satisfaction. The findings revealed three key themes: (1) mood, which is the internal expression of satisfaction; (2) emotion, which is the external expression of satisfaction; and (3) cognitive action, referring to disabled commuters' plans of action based on self-evaluation of their satisfaction level. This study makes theoretical contributions to the existing literature on travel satisfaction, travel behaviour and the experiences of disabled commuters. Further, practical implications for transport operators, policy-makers, charity organisations and social enterprises are discussed. [ABSTRACT FROM AUTHOR]

Paratransit services represent a primary reliable transportation service for older adults and/or persons with disabilities in the U.S., but transformative services like micro-transit, in the form of ride-hailing and other shared services, may offer new mobility options. However, scant research exists on paratransit system riders' barriers and opportunities to adopt on-demand micro-transit service as an alternative mobility option. This study focused on the identification of potential barriers and system benefits for switched users from paratransit to on-demand micro transit. Face to face and telephone interview surveys were conducted with 128 paratransit users in the city of Arlington, Texas to identify potential barriers towards accepting on-demand micro-transit. Secondary data analysis was performed on the city's real-time paratransit database. The survey results showed that 15% of the respondents reported lack of spatial coverage, 13% indicated lack of walking access, and 18% specified difficulty in use as potential barriers in the path of adopting on-demand micro-transit. Although the overall adoption of Via by current paratransit users remains low, the secondary data analysis indicated that riders who are not disabled, without an assistive device, and older (age>54) who have frequent healthcare and discretionary trips are willing to adopt on-demand micro-transit (Via) service. This paper will provide transit authorities a better understanding of the needs of on-demand micro-transit users and the potential benefits of providing micro-transit service. [ABSTRACT FROM AUTHOR]

Purpose To explore the needs for basic community-based rehabilitation services for disabled persons in Xuanwu District, Beijing, China, and to identify factors which influence disabled persons to accept rehabilitation services. Method One hundred and eight disabled persons were selected by systematic sampling and simple random sampling to assess their needs for community-based rehabilitation services. Results Of the interviewees, 57.4% needed the community-based rehabilitation services, but only 13.9% took advantage of it. The main factors influencing the interviewees to accept these services were cost (P<0.05), knowledge about rehabilitation medicine (P<0.05); and the belief in the therapeutic benefit of the community-based rehabilitation service (P<0.05). Conclusion A considerable gap exists between the supply of community-based rehabilitation services in Beijing and the needs for these services by disabled residents underscoring the need for improved availability, and for additional research. [ABSTRACT FROM AUTHOR]