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Purpose: The object of this systematic review is to examine the stigma status of people with disabilities and their families. Design and Methods: The systematic review was prepared based on the preferred reporting items for systematic review and meta‐analysis protocols systematic review guidelines. The review was included thirteen studies. Findings: In the results of the study, it was revealed that people with disabilities experienced inequality and social exclusion, negative attitudes were observed regarding their appearance, also their families were subjected to stigmatization by the society, could not participate in social environments. Practice Implication: To prevent stigmatization, it is recommended that awareness in public be raised by providing community educations. [ABSTRACT FROM AUTHOR]

Background: Health disparities among individuals with disabilities remain underrecognized. The objective of the current study was to investigate: 1) whether disparities exist in breast cancer screening rates among women with disabilities compared with women without disabilities; 2) whether breast cancer screening rates vary according to the type and severity of disabilities; and 3) trends in breast cancer screening disparities according to disability status over time.Methods: Using national administrative databases concerning disability status and national cancer screening programs in Korea, age-standardized participation rates were calculated according to the type and severity of disabilities.Results: The age-standardized rate for breast cancer screening in individuals with disabilities increased from 30.2% in 2006 to 53.7% in 2015 (change of +23.5%), whereas that among those without a disability increased from 29.3% to 60.1% (change of +30.8%). In general, disability was associated with slightly lower breast cancer screening rates (adjusted odds ratio [aOR], 0.824; 95% CI, 0.820-0.828). However, screening rates were especially low in women with severe disabilities (aOR, 0.465; 95% CI, 0.461-0.469) and among women with autism (aOR, 0.235; 95% CI, 0.143-0.388), renal failure (aOR, 0.342; 95% CI, 0.337-0.348), brain injury (aOR, 0.349; 95% CI, 0.346-0.352), intellectual disabilities (aOR, 0.403; 95% CI, 0.397-0.410), mental disorders (aOR, 0.494; 95% CI, 0.488-0.501), or ostomies (aOR, 0.529; 95% CI, 0.512-0.546).Conclusions: Even without a cost barrier, significant disparities were found in breast cancer screening participation, especially in women with severe disabilities and brain-related and/or mental disabilities. Policy efforts, such as ensuring the accessibility of information and equipment, transportation support, and access to a usual source of care, should be made to decrease this disparity. [ABSTRACT FROM AUTHOR]

Purpose: Driven by the shortage in qualified nurses and the high percentage of aging populations, the past decade has witnessed a significant growth in the use of robots in nursing, especially in countries like Japan. This article is a scoping review of the different tracks in which robots are used in nursing. Whereas assistive robots are used for physical care, including service and monitoring tasks, social assistive robots focus on the cognitive and emotional well‐being of patients in need of companionship. Methods: A total of six electronic databases were used in the search for journal papers and conference proceedings. The key words used in searching the databases were nursing OR nurses, AND robots OR robotics. Topics covering surgical robotics, nursing education robotics, and clinical procedures were excluded. Findings: A total of 1,758 articles were retrieved, from which 69 articles were included in the final review. The analysis of the chosen papers led to the categorization of robots into two main categories: assistive robots and social assistive robots. Conclusions: After a detailed review of the state of the art in assistive robots and social assistive robots, an insight into the future of robotics in this field is provided. The recommendations include the need to intensify research on human robot interaction, greater focus on monitoring robots, and analysis of the psychological barriers that need to be surmounted to achieve more tolerance and higher acceptance of robots. Clinical Relevance: For researchers and developers to provide suitable technological solutions, a full understanding of robotics in nursing is needed. An overview of the most recent applications and their proper categorization is key to finding areas for contribution. [ABSTRACT FROM AUTHOR]

This study investigated the associations between cross‐group friendships and psychological well‐being among a sample of physically disabled adults. A total of 269 disabled people (Mage = 39.13, SD = 13.80; 114 females, 152 males, 3 unknown) completed questionnaires including the quality of their friendships with non‐disabled people, perceived majority group's attitudes towards the minority group, collective self‐esteem, collective action tendencies, own outgroup attitudes, and psychological well‐being. Findings demonstrated that disabled people's cross‐group friendships were directly and indirectly associated with higher levels of psychological well‐being via two routes: one by promoting perceived majority attitudes which consequently led to more positive own outgroup attitudes (well‐being through social integration hypothesis) and the other by leading to higher levels of collective self‐esteem which enhanced collective action tendencies (well‐being through empowerment hypothesis). Findings offer important insights into the study of cross‐group friendships in relation to the psychological well‐being of stigmatized minority group members. [ABSTRACT FROM AUTHOR]

Background There is widespread acceptance that parents should be fully involved in decisions about their son or daughter's health and social care. This is reflected in partnership models of practice as well as local and national policy across the United Kingdom. Previous research indicates that parents' experiences of decision making with professionals are mixed. Aim The research reported here aimed to explore parents' experiences of participating in decisions made with professionals about their disabled son or daughter's care. Design This research used mixed methods including survey methodology and qualitative in depth interviews. Setting and participants The research was conducted in one Trust in Northern Ireland. Participants were 77 parents of children and young people with a range of impairments aged between 3 and 28 years. Results Three themes emerged from the data: taking the lead, not knowing, and getting the balance right. Parents wanted to be involved in all aspects of decision making. Although parents reported many examples of good practice, there were also times when they did not feel listened to or did not have enough information to inform decisions. Discussion and conclusion Parents in this research recounted positive as well as negative experiences. Parents took on a protective role when decisions were made about their son or daughter and at times, reported the need to 'fight' for their child. The provision of information remains problematic for these families, and at times, this created a barrier to parents' participation in decision making. Partnership approaches to care that recognize parents' expertise are particularly important to parents when decisions are made with professionals. [ABSTRACT FROM AUTHOR]

This paper presents data on the movement speeds of occupants with various types of mobility impairments evacuating two residential facilities for older adults located on the East Coast of the USA with the goal of better understanding of behavior and movement speeds during stairwell evacuation with and without assistance. The building populations who took part in the current study comprised 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 were 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 of 0.31 ± 0.16 m/s (with individual speeds ranging from 0.07 to 0.91 m/s), which in some cases, approximate the speeds of disabled people and older adults found in earlier studies, and in other cases are slower than those observed in previous studies. Slower speeds reported here may have resulted from observing a wider variety of mobility impairments (because one of the buildings observed was an assisted-living facility) and from 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 © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This study compares the digital literacy of people with and without disabilities in Korea, using data from the 2011 Information Divide Index Data of the National Information Society Agency ( NIA). We extracted Internet and smart device users from the NIA samples and examined the main effects of disability, gender and age, as well as their interaction effects on Internet and smart device use and production literacy. Of the 1500 public individuals examined, 1190 (79.3%) were Internet users and 535 (35.7%) were smart device users. Of the 5300 with disabilities, 2110 (63.9%) were Internet users and 324 (8.8%) were smart device users. Generalized linear modelling showed significant main effects of disability, gender, age and education on Internet use and production literacy. The disability × age and disability × education interaction effects on Internet use literacy were statistically significant. We also observed a significant disability × age interaction effect on Internet production literacy. However, the main and interaction effects of disability, gender and education on smart device use and production literacy were not significant. [ABSTRACT FROM AUTHOR]

Transplantation is the treatment of choice for patients with end-stage renal disease. Despite complete or partial restoration of renal function, many recipients after transplant continue to self-identify as disabled. It is a designation required for federal healthcare assistance pre-transplant, but in some cases, post-transplantation, the designation is misapplied. When kidney recipients bear the label of disabled, regardless if the disability is real or perceived, they are less likely to participate in work and social activities. Although transplantation improves quality of life, for many recipients the designation of disability can extend an unintended, negative impact. It is well recognized that kidney recipients return to employment, education, and social activities after transplantation. However, there is a portion of the recipient population that can work but chooses not to engage. A large part of the phenomenon is related to disability status and the federal financing of kidney disease. This paper summarizes the history of the relationship between disability and kidney transplantation, the potential pitfalls associated with the relationship, and evidence-based strategies designed to mitigate or lead to mitigation of the unfavorable effects associated with misappropriated, perceived disability after kidney transplantation. [ABSTRACT FROM AUTHOR]

Background: Tetrazepam is a muscle relaxant belonging to the benzodiazepine group. Drug eruptions following ingestion of tetrazepam tablets are well known. Objective: To draw the attention to occupational airborne dermatitis and/or hand dermatitis in nurses resulting from crushing of tablets for elderly or disabled people. Methods: Since 2003, 16 nurses with facial (eyelid) and/or hand dermatitis, suspected to be of occupational origin, were patch tested with the medication they handled during work. Results: Ten nurses presented with a positive patch test reaction to tablets containing tetrazepam, 14 controls remaining negative. Some of them also reacted to other drugs. Conclusion: Occupational airborne and/or hand contact dermatitis from tetrazepam might be much more common than suspected by dermatologists, particularly in view of the short period in which all cases have been observed. [ABSTRACT FROM AUTHOR]

The goal of this study was to elicit the views of patients or parents/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients/parents/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector. [ABSTRACT FROM AUTHOR]

In Sweden adults with major and sustainable disabilities can be granted publicly financed support in the form of personal assistance after assessment and decision-making in accordance with government rules. The purpose of the present study was to explore more deeply the encounters in close care relations between personal assistants and disabled persons of working age, as well as the prerequisites for and obstacles to the success of such encounters, this from the perspective of the personal assistants. Thirty-two personal assistants (22- to 55-year old) who worked for 32 persons with serious neurological diseases living at home were interviewed. The transcribed unstructured interviews were qualitatively analysed using latent content analysis. The analyses resulted in five main themes: Perceptive awareness, Entering into the other’s role, Mutuality, Handling the relationship and Personal difficulties facing the assistant. These themes illustrated that a prerequisite for the encounter’s being meaningful is that the assistant should be able to observe and understand the unique needs of the disabled person. The assistant must furthermore be able to put herself/himself into the other person’s position. It is also important that the personal chemistry between the assistant and the disabled person should be good. Being able to share feelings and interests with the functionally impaired person provides the assistant with positive emotional confirmation of a good relationship. A distressing dilemma the assistant faces is that of distinguishing between the working relationship and the personal friendship. In this borderline area are found experiences, feelings and events that the assistant may view as negative or even unacceptable. This study contributes to the understanding of the complexity underlying the daily community care of disabled persons with an extensive need for care and assistance. [ABSTRACT FROM AUTHOR]

Background The limitations of reliable and accessible UK national and local quantitative data on the prevalence of childhood disability and the characteristics and circumstances of disabled children and their households have been recognized for some time. This paper reports the findings from a study that scoped and quality-assessed existing quantitative UK national and regional data sets on disabled children and their families. Methods A comprehensive search of relevant data sources with information on disabled children was undertaken. Data sources were evaluated with reference to: disability definitions and questions; potential to generate nationally representative prevalence estimates of disabled children; study design; population coverage; sampling issues; social and demographic data; appropriateness for identifying childhood as opposed to adult disability. Results Thirty-seven data sources with information on childhood disability were identified, of which 30 met the inclusion criteria: nine cross-sectional surveys, nine longitudinal and panel studies, seven administrative data sets, four specific condition databases and one was another type. Definitions and questions varied across data sources. Long-standing illness and limiting long-standing illness were the most consistently used definitions. Repeated cross-sectional surveys were found to be most appropriate for estimating overall prevalence but, with the exception of the Population Census, sample sizes were too small to study prevalence and characteristics by some population sub-groups such, including age by year, minority ethnic status and socio-economic position. Few data sources included questions appropriate for identifying childhood as opposed to adult disability or collected information from disabled children themselves. Conclusions Our findings summarize the currently available quantitative data sources on childhood disability and highlight the limitations. We make recommendations for the future development of more robust childhood disability data and issues requiring further research. To assist policy makers and service providers to make use of current data sources we have produced a brief online guide based on our findings. [ABSTRACT FROM AUTHOR]

In 'Sacrifice of the Social Outcasts', C.L. Kieffer proposes that the disabled formed a socially marginal group that might have been preferentially targeted for human sacrifice in ancient Maya society. Extensive ethnohistoric and iconographic evidence exists that the disabled and deformed held high status in pre-contact Mesoamerica precisely because of their physical disabilities and played well-defined social roles. Several incidences of the sacrifice of these individuals are produced, but they are associated with extraordinary events. The actual cultural context suggests that the sacrifice of a disabled individual may have larger social implications. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The synthesis and release of the neurotrophic factor oleic acid requires internalization of albumin into the astrocyte, which is mediated by megalin. In this study, we show that the binding and internalization of albumin involve its interaction with megalin, caveolin-1, caveolin-2 and cavin, but not with clathrin in astrocytes from primary culture. Electron microscopy analyses revealed albumin-gold complexes localized in caveolae, but not in clathrin-coated vesicles. Neither chlorpromazine nor silencing clathrin expression modified albumin uptake. Silencing caveolin-1 strongly reduced the binding and internalization of albumin and the distribution of megalin in the plasma membrane. However, silencing caveolin-2 only decreased albumin internalization, suggesting that caveolin-1 is responsible for megalin recruitment to the caveolae and that caveolin-2 participates in caveolae internalization. In most tissues, the cytosolic adaptor protein disabled (Dab)-2 connects megalin to clathrin, astrocytes lack Dab-2; instead, they express Dab-1, which interacts with caveolin-1 and megalin and is required for albumin internalization. The transcytosis of albumin in astrocytes, including the passage through the endoplasmic reticulum, which is a compulsory step for oleic acid synthesis, was confirmed by electron microscopy analyses. Thus, whereas silencing clathrin did not modify the synthesis and release of oleic acid, the knock-down of caveolin-1, caveolin-2 and Dab-1 strongly reduced the synthesis and release of this neurotrophic factor. In conclusion, caveola-mediated endocytosis of albumin requires megalin and the adaptor protein Dab-1 in cultured astrocytes. Albumin endocytosis may be a key step in brain development because it stimulates the synthesis of oleic acid, which in turn promotes neuronal differentiation. [ABSTRACT FROM AUTHOR]

The purpose of this study was to gain a more comprehensive understanding of how the elderly cope with being sick, unhealthy and living alone. Qualitative research interviews using a hermeneutic approach was undertaken to explore how the patients experienced coping with their daily life. Twenty patients with an average age of 82 years having different injuries and diseases were interviewed. The interviews were audiotaped, transcribed and analysed in a hermeneutical tradition of the hermeneutic circle: part–whole, pre-understanding–understanding, and primary, secondary and basic themes. Findings showed that even if physical constraints put limits on their level of activity, the elderly were able to adapt and carry out different activities that did not require any physical strength. The main coping strategy was to accept the situation, but the acceptance was often coloured by a resigned and passive acceptance. If the elderly tend to be passive and resigned, it can be necessary for the community nurses to have a more active problem-solving approach to these patients, in order to help them creating a daily rhythm with which they can feel comfortable. [ABSTRACT FROM AUTHOR]

The oral health of disabled persons is strongly associated with oral hygiene practices. However, many difficulties limit them from removing dental biofilms (plaque). Purpose: This pilot study evaluates changes in toothbrushing capability among 135 disabled individuals enrolled in an institution for the disabled. Methods: Direct observation of toothbrushing behaviour of the disabled was used to recommend changes required in daily toothbrushing programme. The simplified Debris Index (DI-S) was used to compare plaque removal outcomes over a 3-month period. Results: At baseline, of the 135 participants, 114 completed a routine toothbrushing procedure and 10 (8.8%) of them brushed all tooth surfaces. At the end of the study, 52 (48.6%) brushed all tooth surfaces. The mean difference between the initial and final DI-S was 0.62 ( P < 0.01). Conclusion: Toothbrushing was not a common procedure at this institution. This study shows that it is possible to implement daily oral hygiene maintenance in disabled individuals. Furthermore, most participants will adopt more efficient toothbrushing behaviour when monitored daily. [ABSTRACT FROM AUTHOR]

Objective. To examine how a new model of consumer-directed care changes the way that consumers with disabilities meet their personal care needs and, in turn, affects their well-being. Study Setting. Eligible Medicaid beneficiaries in Arkansas, Florida, and New Jersey volunteered to participate in the demonstration and were randomly assigned to receive an allowance and direct their own Medicaid supportive services as Cash and Counseling consumers (the treatment group) or to rely on Medicaid services as usual (the control group). The demonstration included elderly and nonelderly adults in all three states and children in Florida. Data Sources. Telephone interviews administered 9 months after random assignment. Methods. Outcomes for the treatment and control group were compared, using regression analysis to control for consumers' baseline characteristics. Principal Findings. Treatment group members were more likely to receive paid care, had greater satisfaction with their care, and had fewer unmet needs than control group members in nearly every state and age group. However, among the elderly in Florida, Cash and Counseling had little effect on these outcomes because so few treatment group members actually received the allowance. Within each state and age group, consumers were not more susceptible to adverse health outcomes or injuries under Cash and Counseling. Conclusions. Cash and Counseling substantially improves the lives of Medicaid beneficiaries of all ages if consumers actually receive the allowance that the program offers. [ABSTRACT FROM AUTHOR]

The easy exchange of rich information between often geographically dispersed parties is an important precursor of successful tourism transactions. Internet-based technologies, in particular the World Wide Web, offer possibilities to both buyers and sellers to exchange information without the constraints of geography and time diminishing its richness. The disabled, representing a significant part of any marketplace, may, however, have difficulties accessing the content of the Web and therefore sharing the benefits of rich information exchange. This is the principal concern of ‘Web content accessibility’. Focusing on the tourism sector, in particular UK-based hotels, this paper examines the accessibility of their websites. However, recognising that it is not just access to information that is important for the disabled, but also the quality of that information, the paper also examines the extent to which the information contained on websites serves their particular needs. Utilising the accessibility testing software ‘Bobby’, disappointingly low levels of Web content accessibility were found amongst the sample of websites. Against a framework of information needs developed from criteria provided by disability organisations, the sample also revealed disappointingly low levels of specific (relevant) information for the disabled. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: To describe and compare patterns of Home and Community Care (HACC) utilisation among culturally and linguistically diverse (CALD) people and Australian-born residents of rural Victoria. Design: The HACC Minimum Data Set provides information regarding levels of service provision and coverage in Victoria. Data from January to June 2002 were analysed to provide a profile of client characteristics and service usage in rural Victoria. Patterns of service utilisation were compared with the profile of the CALD population in the 2001 Census. Results: The proportion of CALD residents who are HACC clients is consistent with demographic profiles. However, their extent of service usage is not consistent with patterns of use by Australian-born residents. HACC clients born in non-English-speaking countries, receive 35% less hours of HACC service than their Australian-born counterparts. HACC clients born overseas in English-speaking countries receive nine per cent less hours of HACC service than the Australian-born group (F = 8.9, P = 0.00). Both groups of overseas-born clients use a smaller range of HACC services (F = 1.9, P = 0.16). Conclusion: Planners and service providers need to monitor levels of HACC service delivery among population groups to ensure that CALD population groups receive equitable levels of HACC services. The HACC Minimum Data Set is one source of data that can assist in this process. [ABSTRACT FROM AUTHOR]

The changing British society with new commitments to educational inclusion for disabled people should mean increased individual freedom of choice and greater chance of participation. However, juggling this with the continuing emphasis on education for the economy brings the danger of new forms of social exclusion of those who do have different needs and require additional support to take advantage of opportunities and make informed decisions about their professional futures. This contradiction encourages the deteriorating academic and career-oriented foresight of special schools and the inclusion of all disabled students in mainstream education, without providing enough support to cater for the diversity and differentiation it generates. This paper adds to this debate by reporting on the work in progress of a project funded by the European Social Fund, concerning the educational experiences of a group of young disabled people still in full-time mainstream or special education. It presents some personal accounts of the young people's perceptions of how their educational environment influences their personal aspirations for future careers and post-school choices. This research strives to give a voice to young disabled people, informing policy concerned with young people, education and transitions to work. [ABSTRACT FROM AUTHOR]

Increased participation and success in education for disabled people will improve their social inclusion and benefit society in general. In this article Louca-Mai Wilson discusses Disability Rights Commission research on education and its implications for policy and practice. Research findings are considered in relation to the need for the voices of young disabled people to be heard in research, policy and planning. A key finding was that young disabled people want to be regarded and treated as equal to their peers, with the same rights of access and educational opportunity. But schools and educational establishments vary in their willingness and capacity to address and remove existing access barriers. Inclusion is a key issue for many young disabled people; many feel isolated at school and college and often have lower expectations about their future than their non-disabled peers. Inclusive practice and participation are key to ensuring that disability equality in education is achieved. [ABSTRACT FROM AUTHOR]

There has been much debate concerning the pros and cons of special and mainstream education for young people with a disability. This paper adds data to this debate by reporting the educational experiences of 20 high-achievers with congenital disabilities who live in the United Kingdom and were born between 1950 and 1970. It presents personal accounts of the high-achievers’ perceptions of how their education, which was either purely in special schools, in mainstream schools or a combination of both, had influenced their transition to adulthood. While those who attended special school considered it to provide a supportive environment that permitted the cultivation of their personalities without the constraints of non-disabled barriers, many others thought it prevented them as disabled children from interacting with non-disabled peers, thus inhibiting social integration between the disabled and non-disabled world. This was the main perceived advantage of mainstream education although problems of physical access meant that some choices were out of reach. The findings highlight how both special and mainstream education can be compatible with career success of individual disabled people. The paper implies that a combination of the two systems may be needed to facilitate disabled students to develop psychologically, socially and cognitively at the rate of their non-disabled peers, and proposes that link schools and partial integration could contribute to the achievement of such goals. [ABSTRACT FROM AUTHOR]

Objective: To establish the percentage prevalence of hypovitaminosis D in chronically ill or disabled children in Melbourne, Australia.Methodology: A group of inpatients at the Royal Children's Hospital, Melbourne, Victoria, as identified by the primary unit, were sampled to measure serum vitamin D and parameters of bone turnover. A second group of disabled children (outpatients) were also measured to establish vitamin D status.Results: Of the total population, 54.9% were found to have low serum 25 hydroxy (25OH) vitamin D levels. Of the inpatient group, 25.4% were vitamin D deficient (<30 nM/L), and 27.1% were vitamin D insufficient (30-50 nM/L). The mean 25OH vitamin D was 52.1 nM/L. Of the outpatient group, 15.4% were vitamin D deficient, whilst 42.3% were found to be insufficient. The mean vitamin D level was 41.2 nM/L. No difference attributable to intellectual versus physical disability was found. Anticonvulsant use and ambulatory status was not predictive of vitamin D status in the children examined. Of the total population, 0.05% were found to have secondary hyperparathyroidism. The mean 25OH vitamin D level of this subgroup was 30.6 nM/L. Dark skin tone was found to be significantly associated with hypovitaminosis D (P = 0.001), where all five children with dark skin tone were found to have serum 25OH vitamin D levels <50 nM/L. Of the seven disabled children (outpatients) found to be iron deficient, four had coexistent hypovitaminosis D.Conclusion: The percentage prevalence of hypovitaminosis D is high in both chronically ill, and physically/intellectually disabled children in Melbourne, Australia. Increased vigilance and recognition of this deficiency state is needed as an important health prevention strategy. [ABSTRACT FROM AUTHOR]

Abstract This study estimates the probability of being satisfied with community-based health care services in a rural area and compares the formation of satisfaction for elders and younger disabled adults. Using data from a state in New England, USA, a multivariate binomial logit model was used to estimate the probability of being satisfied. The formation of satisfaction differs for rural disabled adults and elders. Two out of five need characteristics were found to influence satisfaction with quality of care, and four out of six enabling characteristics were found to influence satisfaction. The impact of these characteristics differs for disabled elders and adults, pointing to the need to differentiate the disabled population when developing systems of home-based care. [ABSTRACT FROM AUTHOR]

As part of a larger epidemiological survey of a stratified sample of 12-year-old handicapped children in Flanders, Belgium, the present study describes gingival health, gingival hypertrophy, oral cleanliness and the presence of calculus. Statistical analysis was performed with motor skills, brushing help, the use of chemical agents, the use of anti-epilectic drugs, the knowledge of parents and educators (or caregivers) and their opinion of the oral hygiene of their children/pupils as response variables. From this study, it became clear that mildly mentally retarded and learning-impaired children had significantly better manual dexterity skills than moderately and severely mentally retarded and physically impaired children. However, this was not reflected in improved oral hygiene. The use of chemical plaque controlling agents was found to be extremely low and, with the exception of children with gingival hyperplasia, the users of these agents did not have better oral hygiene. No difference was found between subtypes in the opinion of parents and educators on oral status. There was, however, a difference between their assessment and the clinical picture. It was concluded that there was a need for in-service training programmes in oral health care for educators as well as for parents. [ABSTRACT FROM AUTHOR]

Objective: To investigate paediatricians' practices in disclosure of disability and the influences on their practices, including attitude to people with disabilities.Methodology: Interviews were conducted with 26 paediatricians regarding their disclosure practices and their experience, training, contact with children with significant disabilities and influences on practices. Anonymous self-report questionnaires to the same group of practitioners relating to attitude to disability were also employed.Results: Paediatricians' practices in the disclosure process scored relatively low on an index based upon recommended practices. No significant relationships were found between index scores and the experience or training of the paediatrician or the amount of contact of the paediatrician with children with disabilities. However, more experienced paediatricians were found to be more likely to mention the practice of informing both parents together and the presence of a support person at the time of disclosure. Paediatricians having more contact with children with disabilities were more likely to mention that they would disclose disability in a child as soon as possible. The major modifying influences on disclosure practices were reported to be the intelligence of the parents and their emotional state of at the time of disclosure. Time was the most frequently reported constraint upon disclosure practices.Conclusions: The low 'disclosure practice index' scores in this study are not necessarily an indication that practices are poor, as there are challenges to the validity of the advocated practices. There were few significant associations found between the practices of paediatricians in disclosure and their experience, training, contact with children with disabilities and attitude to people with disabilities. [ABSTRACT FROM AUTHOR]

Objective: To investigate the level of parent satisfaction with the first communication of a diagnosis of developmental disability in their child ('disclosure') and the determinants of this satisfaction.Methodology: Interviews with parents of children with developmental disabilities regarding their experiences at the time of disclosure and their level of satisfaction with the process were carried out.Results: Parent satisfaction with disclosure overall was found to be high (82.6%). Parents were more likely to be satisfied if they received a large amount of information. Parent satisfaction was found to be higher when the disclosing professional communicates well with the parents, has an understanding of parental concerns, and is direct in manner. Having both parents, the child or support people present were not found to have any significant relationship to parent satisfaction.Conclusions: The high level of satisfaction with disclosure in this study supports the claim made by earlier researchers that parental dissatisfaction with the disclosure process is not inevitable. The major determinants of parental satisfaction with disclosure are directness, understanding of parental concerns and good communication on the part of the disclosing professional, and receiving a large amount of information. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to describe the labour force status in Victorian adults with vision impairment and any factors associated with unemployment and under-employment. Methods: Participants were recruited in 1997. A telephone interview was conducted by trained interviewers. Results: A total of 250 people participated. They ranged in age from 19 to 59 years (mean 40.7 years) and 119 (48%) were male. Thirty-nine (16%) people regarded themselves to be totally blind. Nearly everyone (n = 241, 96%) had been employed at some time during their lifetime; however, only 149 (60%) were currently employed. The current rate of participation in the labour force was 73.3% (95% CL, 67.8%, 78.8%) and the current unemployment rate was 18.2% (95% CL, 12.6%, 23.9%). The current rate of under-employment was 16.0% (95% CL, 10.7%, 21.4%). A total of 126 (50%) people had used services that help with employment at some stage; this was not significantly associated with current employment status (P > 0.10). The factors significantly associated with unemployment in multivariate analyses were a self-report of eyesight limiting time available for work or other activities (OR = 3.02; 95% CL, 1.56, 5.85) and currently looking for work (OR = 5.92; 95% CL, 2.94, 11.9); never having worked was of borderline significance (OR = 5.26; 95% CL, 0.85, 32.7) as a result of the small numbers of people surveyed. The only factor significantly associated with under-employment was self-employment (OR = 5.46; 95% CL, 1.95, 15.3). Discussion: Results from this study reveal that visual function is not a predictor of labour force status. The relatively low use of specialty employment services and the rather high rate of discouraged job seekers suggest that the employment outcomes of people who use these services should be investigated further, and that attention should be directed at improving retention of employment in people with vision impairment. [ABSTRACT FROM AUTHOR]

Introduction . Variations in local population age structure have attracted less attention than national population ageing. As moderate and severe cognitive impairment is a major cause of need for long-term care, population-based estimates of the numbers and characteristics of this group were calculated, to explore the effects of local differences. Method . The UK Office of Population Census and Surveys (OPCS) study of disability in adults (N > 14000) was reanalysed. A group with moderate or severe cognitive impairments was identified and age-specific estimators of sociodemographic characteristics, household types, disabilities and service use were combined with population estimates for district health authorities in England and Wales. Results . The proportion of the 65 plus population who are 85 plus varies from 8% to 15% across districts, equivalent to national population projections for 1986 and 2031 respectively. The estimated prevalence of the study group varies from 53 to 70 per 1000 population aged 65 plus, with 34–48% of cases aged 85 plus. Curiously, the proportion with severe disabilities varies little across districts. If national norms applied, local rates of institutionalization would vary from 18 to 27 per 1000 aged 65 plus. Conclusion . Local differences in population age structure are large compared to national changes over decades. Local differences have substantial effects on overall prevalence and on the proportion of the cognitively impaired who would be institutionalized if national patterns applied. Service design should be influenced by these complex variations, with estimates modified by local surveys. © 1997 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]