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This article reviews the theoretical basis and methods for disability measurement. Different methods arise from different theoretical perspectives. Recent efforts to develop a general international disability measure consistent with the social model of disability aim to produce an internationally comparable measure of disability with which to assess the equalisation of opportunities. Such a measure cannot consistently identify disabled people in need of health and social services. Correctly identifying those in need of these services particularly concerns developing countries where government revenues and disability services are severely limited. This review highlights the need for multiple disability measures to meet different purposes of measurement. The Washington Group general measure on disability and Katz's Activities of Daily Living Index are recommended as valid measures of varying functioning level consistent with the International Classification of Functioning, Disability and Health.

This article reviews the theoretical basis and methods for disability measurement. Different methods arise from different theoretical perspectives. Recent efforts to develop a general international disability measure consistent with the social model of disability aim to produce an internationally comparable measure of disability with which to assess the equalisation of opportunities. Such a measure cannot consistently identify disabled people in need of health and social services. Correctly identifying those in need of these services particularly concerns developing countries where government revenues and disability services are severely limited. This review highlights the need for multiple disability measures to meet different purposes of measurement. The Washington Group general measure on disability and Katz's Activities of Daily Living Index are recommended as valid measures of varying functioning level consistent with the International Classification of Functioning, Disability and Health.

Emeritus Professor A. J. "Tony" McMichael (1942–2014) was an internationally renowned and pioneering Australian academic and advocate in epidemiology, who was passionate about understanding the influences of the environment on human health. In an illustrious career spanning more than four decades, he made significant contributions to the scientific community and policy discourse—including ground-breaking research related to the health of children. McMichael was a prolific academic writer with over 300 peer-reviewed papers; 160 book chapters and two sole-authored books. However, his outstanding talent was for integrating complex and seemingly unrelated strands from the environmental and health sciences into a cohesive narrative—and highlighting its relevance to lay persons, scientists and governments alike. He was instrumental in validating this nascent field of research and inspiring many others to follow his lead.

Background: There are no analytical studies of individual risks for Ross River virus (RRV) disease. Therefore, we set out to determine individual risk and protective factors for RRV disease in a high incidence area and to assess the utility of the case-control design applied for this purpose to an arbovirus disease. Methods: We used a prospective matched case-control study of new community cases of RRV disease in the local government areas of Cairns, Mareeba, Douglas, and Atherton, in tropical Queensland, from January 1 to May 31, 1998. Results: Protective measures against mosquitoes reduced the risk for disease. Mosquito coils, repellents, and citronella candles each decreased risk by at least 2-fold, with a dose-response for the number of protective measures used. Light-coloured clothing decreased risk 3-fold. Camping increased the risk 8-fold. Conclusions: These risks were substantial and statistically significant, and provide a basis for educational programs on individual protection against RRV disease in Australia. Our study demonstrates the utility of the case-control method for investigating arbovirus risks. Such a risk analysis has not been done before for RRV infection, and is infrequently reported for other arbovirus infections.

Background: There are no analytical studies of individual risks for Ross River virus (RRV) disease. Therefore, we set out to determine individual risk and protective factors for RRV disease in a high incidence area and to assess the utility of the case-control design applied for this purpose to an arbovirus disease. Methods: We used a prospective matched case-control study of new community cases of RRV disease in the local government areas of Cairns, Mareeba, Douglas, and Atherton, in tropical Queensland, from January 1 to May 31, 1998. Results: Protective measures against mosquitoes reduced the risk for disease. Mosquito coils, repellents, and citronella candles each decreased risk by at least 2-fold, with a dose-response for the number of protective measures used. Light-coloured clothing decreased risk 3-fold. Camping increased the risk 8-fold. Conclusions: These risks were substantial and statistically significant, and provide a basis for educational programs on individual protection against RRV disease in Australia. Our study demonstrates the utility of the case-control method for investigating arbovirus risks. Such a risk analysis has not been done before for RRV infection, and is infrequently reported for other arbovirus infections.

AbstractBackgroundIn a cohort of adults with intellectual disability who were followed for up to 16‐years, we investigated characteristics associated with frequent emergency department (ED) presentations, hospitalisation, and psychiatric care.MethodCommunity‐dwelling adults with intellectual disability residing in Queensland, Australia, were followed from 1999 to 2015. Healthcare presentations were extracted from administrative databases. Adults who presented frequently were identified and characteristics associated with frequent presentations were identified.ResultsData from 445 adults were analysed. Chronic disease and challenging behaviour were associated with frequent ED presentations (adjusted odds ratio = 1.8, 95% confidence interval = 1.1–3.0 and aOR = 2.2, 95% CI = 1.2–3.9 respectively). Chronic disease and severe/profound intellectual disability were associated with frequent hospitalisations (aOR = 1.9, 95% CI = 1.2–3.2 and aOR = 2.0, 95% CI = 1.2–3.3 respectively). Psychotropic medication use was associated with frequent psychiatric presentations (aOR = 1.9, 95% CI = 1.0–3.4).ConclusionsAdults at high risk of frequent healthcare presentations should be identified for programmes of optimising health system use, and potentially improving health care quality.

Purpose
The authors reviewed studies of validated tools to screen for cognitive impairment among prisoners. The purpose of this paper is to assist organisations in identifying cognitive impairment in correctional facilities.


Design/methodology/approach
A targeted literature review identified peer-reviewed articles on screening of adults in jails, prisons, police watch-houses, custody suites, rehabilitation facilities and forensic settings or community settings for offenders. Validation of screening tools in secure settings, psychometric properties and cultural discrimination is included in this review.


Findings
Eight screening tools are considered suitable for use in correctional settings. Two screening tools are recommended for cognitive impairment, one is recommended for adaptive functioning assessment and one is recommended for screening of brain injury. Two screening tools are noted to be subject to piloting and further development for use with First Nations people, and two screening tools for cognitive impairment are noted for positive consideration.


Research limitations/implications
Recommendations for screening tools are based on review only and evaluation was infeasible.


Practical implications
Short, reliable measures of cognitive ability for use in correctional facilities are needed. Such tools must be appropriate with respect to their purpose, feasible within the clinical capability of staff and sufficiently cheap to administer to allow widespread use.


Originality/value
Screening of prisoners for cognitive impairment allows early detection to facilitate rehabilitation and therapy. This research is at the systems level. Therefore, the authors do not purport to provide guidance for individual clinicians.

Purpose
This literature review identifies instruments for diagnostic assessment of cognitive impairment in prison populations. The purpose of this paper is to promote procedures for early screening and identification of cognitive impairment using instruments appropriate to prisons.


Design/methodology/approach
A targeted literature review identified studies on screening and diagnostic assessment of adults in jails, prisons, police watch-houses (custody suites), rehabilitation facilities and forensic settings or community settings for offenders. Discriminant validity, suitability, reliability and feasibility of instruments in correctional and forensic settings are presented.


Findings
From 135 peer-reviewed articles relating to diagnostic assessment of cognitive impairment, 15 instruments were considered appropriate for use in prison settings.


Research limitations/implications
Selection of instruments for prison use considers suitability of the instrument(s) and clinical workforce capability. Cultural and gender validity of the instrument, its feasibility for use in the prison environment and cost and time to administer are also important. Using appropriate tools as part of a staged and targeted process in the screening and diagnosis of cognitive impairment is demonstrated by two case vignettes presented in this paper. As this was a desk review, the authors did not evaluate the instruments.


Originality/value
Identification of instruments that are suitable for diagnosis of cognitive impairment in forensic populations informs the rehabilitation of offenders with cognitive impairment in prison and upon release to probation and parole.

Background: Data on the health of adolescents with intellectual disability are scarce. This study describes carer-reported symptoms, chronic illnesses, level of functioning, and behaviour among Australian adolescents with intellectual disability. We compare students attending mainstream and special schools. Methods: Cross-sectional questionnaire data were obtained from a cohort of 592 adolescents (10–21 years) with intellectual disability attending school and living in South-East Queensland, Australia, in May 2007. We analysed data from a subset (176) who completed a health check before visiting their general practitioners. Results: Adolescents had significant health needs, and those in special education schools had worse health than those from mainstream schools. There was a discrepancy between the prevalence of significant psychopathology detected via the short form Developmental Behaviour Checklist (DBC-P24) and psychiatric conditions reported by carers. Conclusions: Given the significant health needs of this population, carefully designed and targeted programs, potentially including medical visits to these schools, are needed.

Background: This study was conducted in the Pacific island nation of Vanuatu. Our objective was to assess knowledge, attitudes and practice of traditional healers who treat lung diseases and tuberculosis (TB), including their willingness to collaborate with the national TB programme. Methods. This was a descriptive study using both qualitative and quantitative methods. Quantitative analysis was based on the responses provided to closed-ended questions, and we used descriptive analysis (frequencies) to describe the knowledge, attitudes and practice of the traditional healers towards TB. Qualitative analysis was based on open-ended questions permitting fuller explanations. We used thematic analysis and developed a posteriori inductive categories to draw original and unbiased conclusions. Results: Nineteen traditional healers were interviewed; 18 were male. Fifteen of the healers reported treating short wind (a local term to describe lung, chest or breathing illnesses) which they attributed to food, alcohol, smoking or pollution from contact with menstrual blood, and a range of other physical and spiritual causes. Ten said that they would treat TB with leaf medicine. Four traditional healers said that they would not treat TB. Twelve of the healers had referred someone to a hospital for a strong wet-cough and just over half of the healers (9) reported a previous collaboration with the Government health care system. Eighteen of the traditional healers would be willing to collaborate with the national TB programme, with or without compensation. Conclusions: Traditional healers in Vanuatu treat lung diseases including TB. Many have previously collaborated with the Government funded health care system, and almost all of them indicated a willingness to collaborate with the national TB programme. The engagement of traditional healers in TB management should be considered, using an evidence based and culturally sensitive approach.