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The need to meet the healthcare needs of people with a learning disability is increasingly being highlighted. Reports such as the Health of the Nation Strategy for People with Learning [...]

You can build a nurturing library environment but patrons won't come--unless you tell them it's available. Many a library program has failed because staff had either been lackadaisical about marketing […]

In December 2003 The Pew Internet & American Life Project completed a study on computer use. The research found that the number of people using the Internet for information-seeking activities [...]

Doctors describe ways of making medical schools and hospitals accessible to disabled faculty members based on initiatives introduced at the University of Pennsylvania School of Medicine. This includes eliminating physical and non-physical barriers, creating different pathways in evaluations and promotions, and providing reasonable accommodations.

Americans with disabilities are rarely considered a distinct group of health care users in the same way as are older Americans, children, racial and ethnic minorities, and others who are perceived to have different needs and access issues. Indeed, to some extent individuals with disabilities overlap with all these groups. But they also have distinct needs with material implications for the organization, delivery, and financing of health care services. Despite the disproportionate health care needs and expenditures of many--though not all--individuals with disabilities, the mainstream health services research community has largely neglected them. This article outlines the most pressing health service research issues in addressing the health care needs of individuals with disabilities.

Outcomes and effectiveness research is a category of health services research that gauges how well the health care needs of persons with disabilities are being met. Using Patrick's Model of Health Promotion for people with disabilities as a framework for analysis, this article examines outcomes and effectiveness research related to the health care needs of persons with disabilities. The three most pressing research priorities are clear theoretical conceptualizations and qualitative research on health outcomes relevant to the needs of persons with disabilities; a systemic analysis of existing assessment instruments' utility for disability outcomes research; and the development and testing of new outcome instruments.

Administrative data result from administering health plans--tracking service utilization, paying claims, monitoring costs and quality--and have been used extensively for health services research. This article examines the strengths and limitations of administrative data for health services research studies of people with disabilities. Administrative data offer important advantages: encompassing large populations over time, ready availability, low cost, and computer readability. Questions arise about how to identify people with disabilities, capture disability-related services, and determine meaningful health care outcomes. Potentially useful administrative data elements include eligibility for Medicare or Medicaid through Social Security disability determinations, diagnosis and procedure codes, pharmacy claims, and durable medical equipment claims. Linking administrative data to survey or other data sources enhances the utility of administrative data for disability studies.

Background. Efforts to evaluate the effectiveness of clinical and community-based interventions designed to impact late-life disability have been hindered significantly by limitations in current instrumentation. More conceptually sound and responsive measures of disability are needed. Methods. Applying Nagi's disablement model, we wrote questionnaire items that assessed disability in terms of frequency and limitation in performance of 25 life tasks. We evaluated their validity and test-retest reliability with 150 ethnically and racially diverse adults aged 60 and older who had a range of functional limitations, using factor analysis and Rasch analytic techniques to examine and refine the instrument. Results. Our analyses resulted in a 16-item disability component with two dimensions, one focused on frequency of performance and the other addressing limitation in performance of life tasks, with two disability domains within each dimension. The frequency dimension consisted of a personal and a social role domain, and the limitation dimension consisted of an instrumental and a management role domain. Expected differences in summary scores of known-functional limitation groups support the validity of this instrument. Test-retest intraclass correlations of the reproducibility of each overall dimension summary score were moderate to high (intraclass correlation coefficients .68-.82). Conclusions. The Late-Life Function and Disability Instrument has potential to assess meaningful concepts of disability across a wide variety of life tasks with relatively few items.

For many Americans with disabilities, transit is the only path to real opportunities. An open society for them depends upon increased transit services for all Americans. Many transit professionals, however, daunted by transit needs and worn down by their critics, wallow in cost issues, ignoring transit's real value to their communities. The key to improvement is to measure transit benefits that are intuitively obvious to most taxpayers. Empirically, accessible transit proves to be the most valuable transit to passengers and to other taxpayers as well., This discussion of the AMERICANS WITH DISABILITIES ACT (ADA) implementation in public transit proceeds in three sections. The first section examines the transit industry's perception of the ADA, including a [...]

It is estimated that 43 million Americans have one or more physical or mental disabilities (Americans with Disabilities Act of 1990; Brown, 1995). Individuals with disabilities have historically confronted discrimination [...], The present study involved a sample of 58 clients with disabilities representing all the files closed during the course of one fiscal year by a single Protection and Advocacy of Individual Rights (PAIR) program. Descriptive information was provided concerning characteristics of clients served, clients' problem areas, case outcomes, and PAIR methods for resolving cases. This study yielded two findings with important implications for advocacy on behalf of persons with disabilities. First, the success of any such advocacy was significantly related to a staff member's attendance at a meeting between the client and responding party. Second, the level of PAIR staff attendance found at such client meetings was primarily limited to juvenile clients. These results support a call for advocates to engage in fieldwork intervention between parties in all cases but particularly in those involving adult clients.

This article examines the relationship between disability, generation and social policy. The moral and legislative framework for the post-war welfare settlement was grounded in a long-standing cultural construction of 'normal' life course progression. Disability and age (along with gender) were the key components in this construction, defining broad categories of welfare dependency and labour force exemption. However, social changes and the emergence of new policy discourses have brought into question the way in which we think about dependency and welfare at the end of the twentieth century. The article suggests that, as policy-makers pursue their millennial settlement with mothers, children and older people, they also may be forced to reconstruct the relationship between disabled people and the welfare state.

We tested the reliability and validity of an automated telephone monitoring system for assessing changes in the functional status of disabled elders living in the community. The sample consisted of 20 adults older than 60 years of age enrolled in a home care program due to functional disabilities. Within a 72-hour period, each participant received, in random order, two automated and one personal telephone functional assessment as well as a home visit assessment by a case manager. The results indicated similarities between the personal and automated telephone assessments, but neither telephone method captured as many impairments as the case manager's home assessment. These findings suggest that the automated system cannot substitute for a case manager's in-home assessment, but it does offer a means to target individuals for additional professional assessment. Key Words: Medical informatics, Computers, Home care

Data from a comparative study of 1975 African American, Puerto Rican, and non-Hispanic White persons age 60 and older in a large Northeastern city were used to investigate the relative contribution of ethnicity and socioeconomic status (SES) to explaining differences in the need for and receipt of informal care. It was hypothesized that differences in disability would be related largely to SES, whereas ethnicity would account for most of the differences in the amount of informal care. The results of a path analysis argue in favor of a cultural rather than a socioeconomic explanation for between-group differences. SES had no direct effect on disability when controlling for ethnicity. Ethnicity did explain between-group differences in the amount of care. Even when controlling for disability, elders in the two minority groups received more informal care than did older White persons. The findings illuminate the important role played by ethnicity in explaining an older person's need for and receipt of long-term care assistance.

The United States economy is experiencing an environment of diminishing resources for social and human service programs. Government expenditures for such programs, as a percentage of the Gross National Product [...], As a public program, the State-federal Rehabilitation Program continues to be affected by public policy and public opinion. In order to justify continuous and increased public funding, both vocational and medical rehabilitation must be responsive to the call for accountability and fiscal responsibility in healthcare and service delivery. The purpose of this article is to discuss healthcare policy development and reform as it relates to persons with disabilities who receive medical and vocational rehabilitation services. Attention is given to trends in acute care, financial issues, and programmatic issues.

Videotape analogues portrayed an intake interview with a client presenting issues related to sexual abuse. Two 30-min analogues were identical except for 19 s that portrayed the client as (a) apparently nondisabled or (b) using a wheelchair. Participants (36 therapists and 11 graduate students) viewed one of the conditions and completed a case conceptualization task. Therapists gave different priorities to treatment themes depending on whether the client had a disability and whether they, the therapists, had received any training in disability issues. Untrained therapists were more likely to focus on extraneous issues and less likely to focus on appropriate themes for a sexual abuse survivor with a disability.

Service dogs could provide substantial psychological benefits for people with ambulatory disabilities as well as reduce health care costs. Researchers evaluated the economic and psychological impact of providing a service dog to 48 people who had been in a wheelchair for at least two years. Half got their dog almost immediately and the other half (the control group) had to wait one year. Within six months of receiving a dog, the participants experienced greater self esteem, became more active in their communities and needed less assistance from other humans. At 12 months, the need for paid assistance dropped 68% and the need for unpaid assistance from friends and family members dropped 64%. Some of the participants were able to work part-time or attend school. Despite the high cost to train the dogs, service dogs could save their owners thousands of dollars a year in paid human assistance costs.

Sociocultural factors germane to African American families need to be recognize and incorporated into the counseling process of African Americans with disabilities. It is imperative that counseling professionals develop a thorough understanding of the family, community, and cultural ecologies of African Americans who are disabled. This article includes an analysis of the African American family system and its inherent strengths. A family strengths model of adjustment to disability for African American clients is presented, and potential applications of the model to the adjustment process are provided.

The success of persons with severe physical disabilities in living independently in the community, engaging in self-directed productive activities, and staying healthy depends, in part, on getting and maintaining adequate [...]

With the passage of the Americans with Disabilities Act of 1990, there is a renewed emphasis on library collection accessibility for persons with disabilities. Modem computer technology can be adapted […]

During the past ten years, people with disabilities have become a major concern of the U.S. healthcare system for three masons. Our society is just becoming aware of the size [...]

President George W. Bush's January 29 State of the Union Address focused on the terrible attacks on the country just over four months earlier and the overwhelming national and international [...]

Martin Block is director of Special Olympics International's Motor Activities Training Program. He is also an assistant professor in the Department of Human Services, Curry School of Virginia in Charlottesville. [...]

Many of the principles of the Community Care White Paper (DoH, 1989) bear a striking resemblance to the Welsh mental handicap strategy launched six years earlier (Welsh Office, 1983). This paper considers the lessons to be learnt from the Welsh strategy for the development of needs-led services as promulgated by the White Paper. Similarities and differences between the two policy initiatives are first identified before considering the conceptual basis of needs-led services. Attention is drawn to two interdependent dimensions of needs-led services, user participation and management delegation, as a means of depicting three underlying models, each with different value stances. By drawing from a case study of one area in Wales, an attempt is made to test the expectations for needs-led services in terms of local planning and management requirements of the three models against the experiences of those charged with putting them into practice. Implications for the White Paper are explored in connection with user involvement strategies and assessment and care management processes.

American Indians exhibit health-related problems at younger ages, as compared with the general population. They also have a disproportionate number of deaths related to alcoholism, accidents, homicides, pneumonia, influenza, diabetes mellitus, and tuberculosis as compared with the general population. In terms of mental health, depression and adjustment reactions are common problems, with the suicide rate among American Indian adults being more than twice as high as that for the general population. This article delineates specific steps necessary to successfully recruit and retain American Indians in counselor training programs, proposes a curriculum for training counselors to effectively provide services to American Indians with disabilities, and discusses the responsibility of counselor educators to concern themselves with the "job placement" of their graduates.

States and local school districts are currently required to provide services for disabled and severely disabled children. The financial burdens involved, as well as specific cases, are discussed.

Dreaming of sailing the high seas? Here are a few possibilities to get you on your way. * If you're headed to Cabo San Lucas, Mexico, check out Right Reasons!, [...]