Objective. To explore the incidence of disability pension (DP) due to RA as an estimation of permanent work disability before and after introduction of biologic drugs. less thanbrgreater than less thanbrgreater thanMethods. The annual incidence of DP was derived from the Swedish National Social Insurance Register and rates of DP due to RA were compared with the total amount of new DPs. less thanbrgreater than less thanbrgreater thanResults.The incidence of DP due to RA has decreased over recent years, coinciding with earlier and more aggressive treatment with DMARDs and biologics. A similar declining incidence of DP was simultaneously seen in patients with all diagnoses in the general population. The decrease in DPs was, however, larger for RA and was evident even before introduction of biologics. In 1990, the proportion of DPs caused by RA was 1.9% out of total amount of DPs, decreasing to 1.5% in 2000 and to 1% in 2009. This may reflect effects of treatment, but may also be due to changing political policies as well as changes in age structure, increasing educational level and less physically demanding jobs. less thanbrgreater than less thanbrgreater thanConclusion. The decrease in DPs due to RA coincides with new treatment strategies as well as with decreasing levels of DPs in patients with all diagnoses. Prevailing political and economic conditions have a large impact on permanent work disability and may affect patients with various diagnoses in different ways. To determine if the decline is a true effect of better treatment, there is a need for further investigations, taking possible confounding factors into account. ; Funding Agencies|County Council in Ostergotland||Swedish Rheumatism Association||Medical Research County Council of South-East Sweden (FORSS)||Eugenia-Norrbacka Foundation||
PurposeThe purpose of this paper is to describe a study which investigated the diverse needs of multiple stakeholders in an adapted sex offender treatment programme (ASOTP) and then evaluated a pilot programme set up to respond to the identified needs efficiently and effectively. The paper reports on an innovative approach to delivering ASOTP in secure learning disability services. It aims to address many of the criticisms and concerns of conventional closed format programmes, particular in the climate of value for money and payment by results.Design/methodology/approachThe multiple views of stakeholders were identified by means of questionnaires and semi‐structured interviews in order to ascertain the key issues necessitating change. Stakeholders included purchasers of Partnerships in Care Learning Disability Services (PiC LDS), referred clients, internal and external clinicians involved in their care, group facilitators and, in some cases, clients' families or advocates. A rolling format ASOTP (based on the content of the Prison and Probation Service ASOTP) was designed and piloted to address highlighted needs, including time frames for the commencement and completion of treatment.FindingsInitial feedback obtained by means of structured interviews and discussions with all stakeholders has been positive. In particular, participants have shown an increase in motivation, knowledge, and, unexpectedly, enhanced levels of risk disclosure. Facilitators have reported increased satisfaction and decreased stress levels. These findings are tentative in light of the small numbers involved and the absence of a randomised control trial.Research limitations/implicationsThis study has a number of implications for future research in terms of improving treatment effectiveness by means of increasing knowledge retention and enhancing risk disclosure, as well as a reduction in facilitator burnout.Originality/valueThe programme was tailored to respond to individual treatment needs within a group setting whilst ensuring programme integrity and effective risk management within a forensic learning disability service.
Although a great deal has been written about the complexities of engagement in learning, this is less true for students with severe intellectual disability. The concept of engagement of these students remains strictly behavioral. Engagement as a complex construct, consisting of behavioral, cognitive, and emotional components, must be addressed as conversations continue to grow around instructional practices for these learners. The current study employed phenomenological analysis to examine the perceptions of 23 scholars with expertise in the field of severe disability related to cognitive and emotional components of engagement. The findings demonstrate that the essence of cognitive engagement involves academic responding, meaningful instruction, and learning outcomes, while the essence of emotional engagement consists of both the factors influencing emotional engagement and the variety of means with which to express it. Across both topics, the challenges with defining and measuring engagement remain.
AbstractResearch conducted in the 1990s revealed the tragic irony that exposure to the disability support system, and particularly to its institutional forms, was a major risk factor related to the neglect and abuse of children and adults with a disability. Subsequently, a range of policies have been introduced to minimize risk. However, recurring events of abuse and neglect in the disability services sector in high and middle income countries demonstrate that processes geared to safeguard children and adults with a disability from abuse and neglect remain insufficient. To establish the wider fabric of organizational factors that contribute to effective safeguarding practices within the Australian disability support sector, a modified online Delphi study was conducted, capturing the views of disability services staff and managers (n = 249) regarding barriers and enablers to effective safeguarding. This study identified issues concerning organizational culture, management practice, workforce development, client capacity building and contextual factors. During Round Two of the Delphi, participants were asked to rate the categorized enabler statements according to importance on a 10‐point Likert scale, to ascertain the degree of consensus. A total of 262 of the statements were regarded as important or very important. The Delphi result highlighted the considerable gap between the wider systemic and cultural processes that, in the eyes of disability services staff and management, contribute to good safeguarding practice and the safeguarding measures currently in place. The article calls for a holistic approach to safeguarding that addresses procedural issues and to the transformation of the wider systemic and cultural fabric of an organization.
BACKGROUND: Due to their occupational status, military personnel are a high-risk group for low back pain (LBP). PURPOSE: The aim of this study was to investigate the effect of neuromuscular exercises on the severity of pain, functional disability, proprioception, and balance in military personnel with LBP. METHODS: Military personnel with LBP were randomly assigned into two groups: intervention (n=15) and control (n=15). The intervention group performed 60 minutes of neuromuscular exercises three times per week for eight weeks while the control group continued their routine physical activities. RESULTS: The mean post-intervention pain intensity, disability, and proprioception error significantly decreased in the intervention group. Whereas their mean post-interventions static and dynamic balance scores significantly increased. CONCLUSIONS: The results indicate eight weeks of neuromuscular exercise decreased pain intensity and improved functional ability, static and dynamic balance, and proprioception among military staff suffering chronic low back pain.
Background Previous research with mothers of children with intellectual disabilities has shown that psychological acceptance is related to maternal psychological well‐being. The present research extended this line of enquiry to fathers and explored the potential for psychological acceptance to mediate the impact of children's behaviour problems on paternal well‐being.Method Ninety‐nine fathers of 67 boys and 32 girls with intellectual disability, between 6 and 18 years of age, participated in a questionnaire study. Psychological acceptance of difficult/negative emotions and thoughts associated with interactions with the child with intellectual disability were measured alongside ratings of the child's behaviour problems and paternal negative (stress, anxiety, depression) and positive ('positive gain') well‐being.Results Psychological acceptance was found to partially mediate the impact of child behaviour problems on paternal stress, anxiety, and depression. Acceptance was also a positive predictor of fathers' perceptions of positive gain associated with raising their child with intellectual disability. However, it could not function as a potential mediator of positive gain in the present research because fathers' ratings of their child's behaviour problems were not associated with paternal positive gain.Conclusions Implications for practice include the potential of acceptance‐based interventions, and other psychological interventions targeting acceptance and avoidance processes (e.g. mindfulness‐based approaches), to positively affect paternal psychological adjustment.
"The implementation of the first human rights and development treaty of the twenty-first century in Southeast Asia has global impact. This book explores the Convention on the Rights of Persons with Disabilities implementation in all ten countries of ASEAN, and is a resource to development, human rights, and disability scholars around the world"--
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Abstract Purpose The perspectives of children and young people with disability who experience domestic and family violence are under-researched, impeding the development of approaches that meet their needs. Knowledge gaps stem from the layered discursive positioning of disability, childhood/youth, or domestic and family violence in addition to the methodological, ethical and pragmatic complexity of research needed to understand their priorities and be attuned to their lived experience. This article explores methodological, ethical and practical challenges to centring their voices in research about domestic and family violence.
Method A conceptual framework of feminist disability theory and intersectionality informed our co-designed research, across three phases: (1) quantitative large-scale data linkage and case file analysis; (2) qualitative research with children and young people, their families and service providers and (3) stakeholder engagement workshops.
Results We reflect on how our research was able to prioritise the contextual agency of children and young people with disability, ways it could not, and other constraints.
Conclusion Children and young people with disability experiencing domestic and family violence hold an expert and unique vantage point on what happens to them. Amplifying their priorities for directing policy and organisational change requires more of researchers in terms of methods, but also more flexibility in how projects are funded to enable creativity and innovation. We call for collective attention to frameworks for supported decision-making and child ethics to progress inclusive research which recognises the importance of participation for children and young people with disability.
This article critically analyzes the U.S. military's contradictory use of violent video gaming technologies for recruiting young gamers to the military, training soldiers for combat, and clinically treating soldiers for posttraumatic stress disorder (PTSD) caused by military service. Using a Disability Studies lens, I discuss the commercial video game Full Spectrum Leader/Warrior, the U.S. Army's free video game America's Army, and the virtual reality exposure therapy application Virtual Iraq. I also discuss missions and omissions from the literature on these gaming technologies, which bolsters the underlying ableism of military culture that inhibits soldiers from recovering from PTSD.
This article critically analyzes the U.S. military's contradictory use of violent video gaming technologies for recruiting young gamers to the military, training soldiers for combat, and clinically treating soldiers for posttraumatic stress disorder (PTSD) caused by military service. Using a Disability Studies lens, I discuss the commercial video game Full Spectrum Leader/Warrior, the U.S. Army's free video game America's Army, and the virtual reality exposure therapy application Virtual Iraq. I also discuss missions and omissions from the literature on these gaming technologies, which bolsters the underlying ableism of military culture that inhibits soldiers from recovering from PTSD.
Purpose: This study aimed to explore the role of Community Disability Workers (CDWs) in facilitating livelihood opportunities for disabled youth in rural Southern Botswana. The CDWs in the study worked in Community- based Rehabilitation (CBR) programmes. The elements of the Livelihood component of CBR Guidelines include skills development, self-employment, waged employment, financial assistance and social security. In particular, the study presented the knowledge, skills, practices (activities and methods), and strategies used by CDWs to facilitate access to the livelihood opportunities for disabled youths in rural areas. The literature review explored CBR as a strategy for addressing the needs and demands of people with disabilities. Botswana has implemented a CBR programme which is co-ordinated at the Rehabilitation Division of the Ministry of Health and involves disabled people, health professionals, the community and Non-Governmental Organisations (NGOs). Community health workers coordinate disability activities in rural as well as urban areas and comprise a range of health care practitioners namely physiotherapists, social workers, rehabilitation technicians, rehabilitation officers and health education assistants. In this study, community health workers were referred to as CDWs and only those with tertiary qualifications (certificate, diploma or degree level of training) were used as participants. Methodology: A qualitative research approach using a case study design was adopted. Purposive sampling was used to select seven participants from districts in the southern part of Botswana to participate in the study. The unit of study were the practices of the CDW in facilitating access to livelihood opportunities for disabled youth. Qualitative data was collected through semi-structured interviews with the CDWs. Interviews were digitally recorded and later transcribed verbatim. Analysis of data involved coding for themes and categories emerging from the data in the context within which it appeared. The environmental chapters of the International Classification of Functioning, Disability and Health (ICF) were used for data interpretation. Findings: The findings of the study illustrated the role of CDWs in facilitating livelihood opportunities for disabled youth. Five themes that emerged were related to CDWs' own experience of disability and rural environments, their knowledge and experience in facilitating livelihoods; their practices and strategies; the barriers to participation experienced by disabled youth; and lastly, the CDWs' suggestions for increasing participation and inclusion of disabled youth in livelihood opportunities. The findings established that CDWs were involved in facilitating access to health facilities and assistive devices as well as education and skills development. Some strategies used were advocacy, networking, information dissemination, role modelling and follow-ups on former students. The barriers identified were inadequate disability policy; absence of disability friendly public facilities and transport; a poorly resourced public education system and inaccessible job markets. Suggestions made by CDWs included having inclusive policies and structures; addressing educational and training needs; accountability regarding employment; and community sensitisation and mobilisation. The Discussion chapter interpreted the findings in terms of current literature and developed two further themes. One addressed the environmental factors impacting on disability and the other one addressed successful strategies to enhance livelihood opportunities in light of these environmental factors. Recommendations included facilitating information on accessibility of assistive devices; minimising barriers to natural and made-made changes to the environment; building a network of supportive relationships; changing attitudes of community as well as government leadership; and facilitating implementation of inclusive services, systems and policies. In Conclusion, CDWs are well placed to facilitate accessibility of livelihood opportunities for disabled youth. However, they need to be empowered with necessary resources such as disability inclusive policies, systems and services, attitudinal changes and revision of their training modules.
