DISABILITY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Disability: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84272-8 1. Disability-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on disability. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON DISABILITY ................................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Disability..................................................................................... 11 E-Journals: PubMed Central ....................................................................................................... 68 The National Library of Medicine: PubMed ................................................................................ 71 Academic Periodicals covering Disability.................................................................................. 106 Dissertations on Disability ........................................................................................................ 106 CHAPTER 2. NUTRITION AND DISABILITY .................................................................................... 111 Overview.................................................................................................................................... 111 Finding Nutrition Studies on Disability ................................................................................... 111 Federal Resources on Nutrition ................................................................................................. 114 Additional Web Resources ......................................................................................................... 115 CHAPTER 3. ALTERNATIVE MEDICINE AND DISABILITY .............................................................. 117 Overview.................................................................................................................................... 117 National Center for Complementary and Alternative Medicine................................................ 117 Additional Web Resources ......................................................................................................... 125 General References ..................................................................................................................... 127 CHAPTER 4. CLINICAL TRIALS AND DISABILITY ........................................................................... 129 Overview.................................................................................................................................... 129 Recent Trials on Disability ........................................................................................................ 129 Keeping Current on Clinical Trials ........................................................................................... 132 CHAPTER 5. PATENTS ON DISABILITY ........................................................................................... 135 Overview.................................................................................................................................... 135 Patents on Disability ................................................................................................................. 135 Patent Applications on Disability.............................................................................................. 137 Keeping Current ........................................................................................................................ 145 CHAPTER 6. BOOKS ON DISABILITY .............................................................................................. 147 Overview.................................................................................................................................... 147 Book Summaries: Federal Agencies............................................................................................ 147 Book Summaries: Online Booksellers......................................................................................... 159 Chapters on Disability ............................................................................................................... 160 Directories.................................................................................................................................. 169 CHAPTER 7. MULTIMEDIA ON DISABILITY .................................................................................... 173 Overview.................................................................................................................................... 173 Video Recordings ....................................................................................................................... 173 Audio Recordings....................................................................................................................... 176 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................. 179 Overview.................................................................................................................................... 179 U.S. Pharmacopeia..................................................................................................................... 179 Commercial Databases ............................................................................................................... 180 Researching Orphan Drugs ....................................................................................................... 180 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 185 Overview.................................................................................................................................... 185 NIH Guidelines.......................................................................................................................... 185 NIH Databases........................................................................................................................... 187 Other Commercial Databases..................................................................................................... 200 APPENDIX B. PATIENT RESOURCES ............................................................................................... 201 Overview.................................................................................................................................... 201 Patient Guideline Sources.......................................................................................................... 201
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News Services and Press Releases.............................................................................................. 230 Newsletters on Disability........................................................................................................... 231 Newsletter Articles .................................................................................................................... 232 Associations and Disability........................................................................................................ 234 Finding Associations.................................................................................................................. 242 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 245 Overview.................................................................................................................................... 245 Preparation................................................................................................................................. 245 Finding a Local Medical Library................................................................................................ 245 Medical Libraries in the U.S. and Canada ................................................................................. 245 ONLINE GLOSSARIES................................................................................................................ 251 Online Dictionary Directories ................................................................................................... 251 DISABILITY DICTIONARY........................................................................................................ 252 INDEX .............................................................................................................................................. 315
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with disability is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about disability, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to disability, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on disability. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to disability, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on disability. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON DISABILITY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on disability.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and disability, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “disability” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Clinical Evaluation of the Hearing Disability and Handicap Scale in Men with Noise Induced Hearing Loss Source: Noise and Health. 6: 67-78. January-March 2000. Contact: Available from NRN Publications. Editorial Manager of Noise and Health, Institute of Laryngology and Otology, University College, London, 330 Gray's Inn Road, London WC1X 8EE, United Kingdom. 44 171 915 1575. Fax 44 171 278 8041. E-mail:
[email protected]. Summary: During the last 30 years, several hearing disability and handicap questionnaires have been designed and used for clinical purposes. This article reports on a study that includes a review of the most frequently used of these scales. The present study evaluates the reliability and validity of the Hearing Disability and
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Handicap Scale (HDHS), which is a shortened and modified version of the Hearing Measurement Scale. Correlations between the Hearing Handicap and Support Scale, the Communication Strategy Scale from the Communication Profile of the Hearing Impaired, pure tone audiometry, and speech recognition scores in noise were analyzed. Data from 168 men with noise induced hearing loss of different degrees was obtained; a test retest was also conducted. The disability section of the HDHS seemed accurate but offered no improvement of prediction compared to previous scales. The authors conclude that the reliability of the handicap section was sufficient, however, they discuss its validity and clinical use and offer suggestions about improvements. Since standardized scales are necessary if results are to be compared worldwide, guidelines regarding the clinical use and benefit of hearing disability and handicap scales are required. One appendix reprints the 20 questions from the HDHS. 4 tables. 34 references. •
Functional Limitations and Disability Among Elders in the Framingham Study Source: American Journal of Public Health. 82(6): 841-845. June 1992. Summary: Researchers measured the differences between self-reported disability and observed functional limitations in six activities of daily living tasks among communitydwelling older people. They also ascertained the value of functional limitations versus disability measures in determining risk factors for disablement. Researchers used the Mini-Mental State Examination and a questionnaire that required each resident to identify his or her normal day-to-day performance of six basic activities of daily living (ADL) as defined by variables from the Kaz and Mahoney and Barthel indexes. Cross tabulations between each functional limitation and disability item were performed to determine the frequency and direction of differences across each of the six activities. Multiple logistic regressions of discrepancies for each ADL were performed to determine the association with selected variables. To demonstrate the potential empirical impact of using functional limitations versus self-reported disability measures, researchers used two multivariate models to predict the presence of disability using both a sum of the observed functional limitation scores and a sum of the selfreported disability scores. Findings show systematic differences among the 1,453 participants. At least 89 percent of the time when a difference was identified, the subjects ranked disability greater than the functional limitations observed. For those who were cognitively impaired, discrepancies occurred up to 11 percent of the time. In determining risk factors, the study found that neurological impairments were associated with functional limitations and disability, while sociocultural factors were associated with disability only. 1 figure, 3 tables, 19 references. (AA-M).
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Disability in Dementia: Assessment, Prevention, and Rehabilitation Source: Disability and Rehabilitation. 16(3): 98-109. July-September 1994. Summary: The author reviews evidence showing that dementia is a major cause of disability in the population; describes some new methods for assessing disability in dementia; examines the possibility of preventing the diseases causing dementia, thereby reducing the prevalence of disability in the population; and assesses the possibilities for rehabilitation in dementia through cognitive training, appropriate environmental design, and the management of disturbed behavior. It is stated that because of the aging of the world's population and the increase in dementia cases, the best solution may be prevention. Short- and long-term primary prevention requires knowledge of the risk factors for dementias, including Alzheimer's disease (AD), and an understanding of the mechanisms of dementing diseases in order to interfere with the disease process.
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Vascular dementia can already be affected using antiplatelet drugs. Greater understanding of the molecular biology of AD could potentially lead to a similar intervention for this disease. According to the author, rehabilitative efforts, while seen as the best possibility for reducing disability in dementia, has not received the research needed to make them more effective. 1 figure, 64 references. •
Cognitive Disability: Managing the Sundowning Patient Source: Journal of Rehabilitation. 59(1): 24-29. January-March 1993. Summary: This article attempts to assist rehabilitation teams in caring for patients with dementia exhibiting sundown syndrome (an increase in confusion, disorientation, and agitation at sunset for older and/or cognitively-impaired patients). It outlines a treatment strategy that addresses the patient's needs and ensures appropriate use of team resources. Assessment and intervention strategies are listed sequentially. Important considerations include determining if the patient's condition is a reversible medical condition, such as dehydration; ensuring that staff and patients communicate appropriately to avoid staff/patient conflicts over care agendas; accounting for the physical and social environments and psychological factors; determining if patients can understand what is being asked of them; and ensuring that the treatment is structured appropriately and allows for continuity with patients' scheduled activities. The authors recommend that caregivers consider each patient's emotional adjustment after traumatic changes in lifestyle or loss of independence due to the disease. Intervention in such cases may need to include supportive counseling. 1 figure, 3 tables, 27 references.
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Vitamin B12 Deficiency in Older People: Improving Diagnosis and Preventing Disability Source: JAGS. Journal of the American Geriatrics Society. 46: 1317-1319. 1998. Summary: This article discusses an investigation that provides information about whether a high prevalence of vitamin B12 deficiency has a deleterious effect on the health of older adults. A goal of diagnosing vitamin B12 deficiency in older adults is to find a treatable condition and relieve suffering or to prevent future disability that would occur should the condition remain untreated. The author discusses the spectrum of B12 deficiency, the primary clinical problem of older adults who have metabolic and/or clinical evidence of B12 deficiency, and how folic acid enrichment of grain products may mask megaloblastic anemia and contribute to problems of diagnosis. 21 references.
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Considerations in Care for Individuals With Intellectual Disability With Advanced Dementia Source: Journal of Gerontological Social Work. 38(1/2): 213-224. 2002. Summary: This article discusses some of the unique considerations for caregivers of individuals with intellectual disabilities and advanced dementia. It explores a variety of physical, psychosocial, and ethical issues that arise in the care of people with late dementia that may be especially difficult for those who support people with intellectual disabilities. These include the use of artificial feeding and hydration treatments, compliance with mandated documentation of care services, maintaining respect for remaining cognitive abilities even if the person appears to be unresponsive, promoting positive emotion, the definition of palliative care, the role of advance directives, and the use of hospice care. The author concludes that caregivers can effectively care for individuals with intellectual disabilities and advanced dementia through anticipation and early service planning. 25 references.
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Psychosocial Intervention and Dementia, Part II: The Cognitive Disability Perspective Source: Occupational Therapy in Mental Health. 7(4): 13-36. Winter 1987. Summary: This article discusses the application of Allen's Cognitive Disability approach to the psychosocial care of individuals with Alzheimer's disease and other dementing conditions. The article describes a behavioral hierarchy for evaluating the individual's competence to perform normal life activities. This framework also suggests different strategies that can be used to adapt normal life activities in an effort to promote maximal functional capacities in the impaired individual. These methods provide a means for the therapists and caregivers to contribute to the individual's sense of competence and quality of life throughout the course of the disease. 15 references. (AA-M).
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Excess Disability During Morning Care in Nursing Home Residents With Dementia Source: International Psychogeriatrics. 12(2): 267-282. June 2000. Summary: This article examines the extent and nature of excess disability during morning care in nursing home residents with dementia. Seventeen residents with severe dementia and functional disability, mean age 81 years, were observed during performance of morning care activities of daily living (ADL) under two conditions: dependence-supporting usual care (UC) and independence-enhancing functional rehabilitation (FR). Data were collected for 5 consecutive weekdays in each condition. Excess disability was defined as the differences in dependent and independent ADL performance under the two conditions. Outcome measures included the time spent on morning care routines; use of nondirective, directive, and physical assists; and frequency of disruptive behaviors and requests for help. Results suggest that excess disability in nursing home residents with dementia can be reduced by increasing opportunities for independent activity and substituting nondirective and directive verbal assists for physical assists. The findings further indicate that increased independence in ADL can be achieved without increasing disruptive behaviors and can foster appropriate requests for task-related help. 3 figures, 2 tables, 33 references. (AAM).
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Excess Disability in Demented Elderly Outpatients: The Rule of Halves Source: Journal of the American Geriatrics Society. 36(1): 82-83. January 1988. Summary: This article presents a simple way of expressing the occurrence and treatability of excess disability in irreversibly demented, called the Rule of Halves. This refers to the fact that about half of elderly demented outpatients will have one or more illnesses in addition to the primary cause of their dementia, and about half will have transient improvement of at least 1 month with appropriate treatment, and about half of those will have persistent improvement of at least 1 year. An explanation and illustration of this finding, including summary patient statistics, are presented. It is concluded that this Rule emphasizes the value of a thorough medical and psychiatric history, physical and mental status examinations, and appropriate laboratory investigations in demented elderly outpatients, without raising false hopes of a cure. 19 references.
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Dementia-Related Care Decision-Making in Group Homes for Persons With Intellectual Disabilities Source: Journal of Gerontological Social Work. 38(1/2): 179-195. 2002.
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Summary: This article presents findings from a survey of group homes serving adults with intellectual disability (ID) and dementia. Information about the home, the resident with dementia, and the agency's decision making process was collected from 54 community group homes who had or were serving at least one person with ID and dementia. The homes served an average of 6.9 residents with a mean age of 40.7 years; the mean age of those with dementia was 55.1 years. Forty-five of the homes kept the resident with ID and dementia in their care, and nine had moved the resident to another care facility. The group homes' ID and dementia care service responses appeared to fall into three general categories: (1) continuing provision of aging in place supports, (2) developing an in-place progression setting, and (3) referring out to a long term care setting. Based on the findings, the authors propose a model for developing dementiacapable supports and services. This model, called the ECEPS approach, consists of early screening and diagnostics, clinical supports, environmental modifications, program adaptations, and specialized care. 2 tables, 32 references. •
Preventing Excess Disability in Patients With Alzheimer's Disease Source: Geriatric Nursing. 7(6): 298-301. November-December 1986. Summary: This article provides suggestions to nurses on prolonging the competence of Alzheimer's disease patients by recognizing and overcoming reversible deficits in functioning that are in excess of what would be expected for the stage of the physical illness. This excess disability may be due to factors such as physical illness, psychological impairment, and social problems, all of which can accentuate behaviors associated with cognitive impairment. The authors give examples of planning care to maximize the use of remaining abilities in the areas of self-care, communication, social skills, and the ability to derive meaning from words, objects, and environmental stimuli.
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Impact of Olfactory Impairment on Quality of Life and Disability Source: Archives of Otolaryngology-Head and Neck Surgery. 127(5): 497-503. May 2001. Contact: Available from American Medical Association. Subscriber Services, P.O. 10946, Chicago, IL 60610-0946. (800) 262-3250 or (312) 670-7827. Fax (312) 464-5831. E-mail:
[email protected]. Website: www.ama-assn.org/oto. Summary: This article reports on a study undertaken to determine whether olfactory (smell) loss affects patents' quality of life or level of disability. The study format was a retrospective survey using questionnaire data and clinic database review at two university medical center smell and taste clinics. A total of 1,407 patients were tested for smell and taste disturbances from 1984 through 1998. Surveys were mailed to 1,093 patients who had abnormal test scores; 420 (38.4 percent) returned completed surveys. Patients were grouped by self rated ability to smell as 'impaired' (those reporting persisting deficits) or 'improved' (those reporting no smell problem when surveyed). Response frequencies were compared between the 2 groups for questions regarding ability to perform common activities of daily living and quality of life issues. The mean number of activities of daily living affected by olfactory loss was 4.70 (plus or minus 3.56) for the impaired group and 0.61 (plus or minus 1.58) for the improved group. Among specific activities, the most commonly cited impairments were ability to detect spoiled food (impaired versus improved groups, 75 percent versus 12 percent), gas leaks (61 percent versus 8 percent), or smoke (50 percent versus 1 percent); eating (53 percent versus 12 percent); and cooking (49 percent versus 12 percent). Differences in quality of life issues were reported primarily in the areas of safety and eating. Overall satisfaction with life was reported by 87 percent of the improved group but only 50 percent of the
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impaired group. The authors conclude that patients reporting persistent olfactory impairment after previously documented olfactory loss indicate a higher level of disability and lower quality of life than those with perceived resolution of olfactory compromised. 4 figures. 2 tables. 17 references. •
Alcohol Use and Functional Disability Among Cognitively Impaired Adults Source: Journal of the American Geriatrics Society. 47(7): 854-859. 1999. Summary: This journal article describes a study of the potential relationship between alcohol use and functional disability among older adults with cognitive impairment. The study sample consisted of 242 consecutive patients who received a comprehensive evaluation at the Dorothy Adler Geriatric Assessment Center at Yale-New Haven Hospital in New Haven, Connecticut during 1996, and who scored 24 or less on the Mini-Mental State Examination. Alcohol use and performance of seven basic activities of daily living (BADL) and seven instrument activities of daily living (IADL) were determined by proxy report. Compared with never drinkers, moderate drinkers demonstrated higher mean BADL and IADL scores, whereas heavy drinkers had higher BADL but lower IADL scores. Former drinkers had lower BADL and IADL scores compared with never drinkers. The ability to ascertain a dose-response effect was limited by the low numbers of light and heavy drinkers. The findings suggest that moderate drinking may reduce risk for impaired function in older adults. 2 tables, 37 references.
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Development of a Functional Measure for Persons With Alzheimer's Disease: The Disability Assessment for Dementia Source: American Journal of Occupational Therapy. 53(5): 471-481. September/October 1999. Summary: This journal article describes the development of an instrument for assessment of functional disability in patients with Alzheimer's disease (AD) to be completed by caregivers or health care professionals. The measure is called the Disability Assessment for Dementia (DAD), and is designed for caregivers of community-dwelling persons. It was developed in six stages, which first defined the content of the instrument, and then tested its validity and reliability. The authors conclude that the DAD scale is highly reliable, practical and easy to administer, and avoids gender bias. It will be available in French and English. By identifying activities that are problematic, and which aspects of performance are impaired, DAD may help guide decisions related to treatment, homecare or institutionalization. As a research tool, it could help describe the functional characteristics of people with AD and the course of the disease. An appendix of the components of the DAD scale is included. 4 tables, 3 figures, 53 references.
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Functional Disability in Alzheimer's Disease Source: International Psychogeriatrics. 9(Supplement 1): 163-165. 1997. Summary: This journal article discusses functional disability in Alzheimer's disease (AD) and the role of functional assessment in the diagnosis of early-stage AD. The authors suggest that the key to distinguishing between benign cognitive impairment and dementia is the detection of a decline in functioning. Several scales are available to assess functional abilities in geriatric and AD populations. Because instrumental activities of daily living (IADLs) are altered early in the course of AD, the IADL items of the Disability Assessment for Dementia (DAD) may provide guidance for primary care
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physicians in the diagnosis of early-stage AD. These items also may be useful for monitoring treatment effects in followup visits. Later stages of AD would require use of the full DAD scale, with its basic activities of daily living items. 1 table, 9 references. •
Mental Competency and Planning for Disability Source: Caring. 10(12): 53-54, 56. December 1991. Summary: This journal article discusses special types of guardianship options when patients with Alzheimer's disease are no longer mentally competent to handle their legal and personal affairs. The article also addresses alternatives to guardianship such as powers of attorney, trusts, unconditional gifts, and representative payees. The advantages and disadvantages of each option are explained.
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Rheumatology Visit Frequency and Changes in Functional Disability and Pain in Patients With Rheumatoid Arthritis Source: Journal of Rheumatology. 24(1):35-42; 1997. Summary: This journal article for health professionals describes a study that examined the association between the number of visits to rheumatologists and changes in functional disability and pain over 6-month study periods among 127 patients who were treated by a rheumatologist at least once each year. The study also explored the association between the average annual frequency of visits to rheumatologists and both the progression of functional disability and average pain levels over periods of up to 10 years among these patients. Information on health care utilization and health status was obtained by biannual mailed Health Assessment Questionnaires (HAQ). Results indicate that the median visit frequency was 7.2 visits per year. The number of rheumatology visits was significantly associated with short-term changes in both functional disability and pain. Each additional visit in a 6-month study interval was associated with a decrease in the pain score in the current interval by an average of 0.02 points, and each additional visit was associated with a decrease in the HAQ Disability Index in the subsequent 6-month interval by an average of 0.0007 points. In analyses of long-term changes in health status, there was a U-shaped relationship between the frequency of rheumatology visits and the rate of progression of functional disability over time, with the lowest rates associated with average visit frequencies of between 7 and 11 visits per year. Average pain scores over time were positively correlated with the average annual frequency of rheumatology visits. Results demonstrate that short-term improvements in functional disability and pain were directly related to the number of visits patients made to rheumatologists. 21 references, 2 figures, and 3 tables. (AA-M).
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Disability Discrimination in America : HIV/AIDS and Other Health Conditions Source: Journal of the American Medical Association: Vol. 281, pp. 745-752: Feb. 24, 1999. Contact: American Medical Association, Book & Pamphlet Fulfillment, PO Box 10946, Chicago, IL, 60610. Summary: This report discusses the American with Disabilities Act (ADA) and how it protects persons with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS)and other genetically linked or predisposed diseases. The report explains the history and structure of the ADA, and the court case, Bragdon versus Abbott, and how it has broadened the protections under this law for persons with HIV/AIDS. It identifies how HIV applies under the ADA's significant risk of
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transmission standard. It explores the protections offered by the ADA for person with other diseases, and how medicinal side effects can help to protect or not protect one under the ADA. Persons who are perceived to have disabilities and are thusly discriminated against, as well as persons genetically predisposed to disease. It reviews the results of the 50 state survey that examines the legal interpretation of the ADA and its standards for protection, and state HIV-specific standards. •
Disability Statistics Report (14): Mobility Device Use in the United States Source: Washington, DC: U.S. Department of Education, National Institute on Disability and Rehabilitation Research. 2000. 60 p. Contact: Available from U.S. Department of Education, OSERS, National Institute on Disability and Rehabilitation Research (NIDRR). Attn: David Keer. Switzer Building, Room 3431, Washington, DC 20202. (202) 205-5633. E-mail:
[email protected]. Website: www.ed.gov/offices/OSERS/NIDRR. Summary: This report provides health professionals, community service professionals, and people who have disabilities with information on mobility device use in the United States. The report provides data on the population using mobility devices, focusing on their age, gender, race and ethnicity, educational attainment, employment and labor force participation, family income, and area of residence. This is followed by data on health and disability status, including self reported health status, hospitalization history, perceived disability status, activity limitation, functional limitation, activities of daily living, and instrumental activities of daily living. The report also examines health conditions and impairments associated with mobility device use. The leading conditions associated with mobility device use among persons of all ages include osteoarthritis (OA) and allied disorders, cerebrovascular disease, orthopedic impairment of a lower extremity, orthopedic impairment of the back or neck, intervertebral disc disorders, senility without psychosis, heart disease, rheumatoid arthritis and other inflammatory polyarthropathies, orthopedic impairment of the hip or pelvis, and chronic injuries. OA is the top ranked condition responsible for disability among users of canes, walkers, and crutches. OA, the most prevalent main cause of disability among mobility device users of all ages, is also the primary cause of disability among working age adults and the elderly. The report concludes with data on accessibility features and problems both inside and outside the home and on health insurance coverage. 24 figures, 26 tables, and 5 references.
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Serving People With Psychiatric Disability at Risk for HIV/AIDS - Special Issue Source: Psychosocial Rehabilitation Journal; Vol. 17; No. 4, April 1994. Contact: Boston University, Sargent College of Allied Health Professions, Department of Rehabilitation Counseling, International Association of Psychosocial Rehabilitation Services, 730 Commonwealth Ave, Boston, MA, 02215, (617) 353-3549. Summary: This special issue of the Psychosocial Rehabilitation Journal addresses the needs of people with psychiatric disabilities who are at risk for HIV/AIDS. It features articles on the HIV infection rates of various populations of mentally ill in New York and how people with mental illness are at risk because they are sexually active and engage in a range of sexual behaviors that put them at high risk for HIV, such as homosexual and heterosexual contact with persons considered to be at high risk, i.e. intravenous drug users and prostitutes. Areas of concentration include the development of AIDS-prevention programs for use with various populations of persons with mental illness; preliminary findings from research being conducted with homeless mentally ill
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men, psychiatric inpatients, persons receiving community-based services and home care services; psychiatric clients with developmental disability; adolescent psychiatric patients; and children of HIV-positive parents. The role of mental health service provider is examined in the light of what must be done to address the issue of HIV/AIDS and various populations of mentally ill. Issues of client sexuality, AIDS prevention training, and mental health service providers collaboration with AIDSprevention researchers are addressed.
Federally Funded Research on Disability The U.S. Government supports a variety of research studies relating to disability. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to disability. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore disability. The following is typical of the type of information found when searching the CRISP database for disability: •
Project Title: A BIOSOCIAL STUDY OF CHILDHOOD DISABILITY Principal Investigator & Institution: Bugental, Daphne B.; Professor; Psychology; University of California Santa Barbara 3227 Cheadle Hall Santa Barbara, Ca 93106 Timing: Fiscal Year 2002; Project Start 01-APR-1996; Project End 31-MAR-2006 Summary: (investigator's abstract): It has long been observed that disabled children are at risk for maltreatment. In this proposal, it is suggested that children who are physically or medically challenged--depending upon their parenting history--may show elevated "promise" as well as "problems." The possibility of positive (as well as negative) responses to adversity reflects an emerging paradigmatic shift within the social and health sciences away from sickness/helplessness/risk to health/optimism/resilience. In the proposed research, we are concerned with the specific mechanisms (including both cognitive and neurohormonal processes) that foster positive versus negative outcomes for "challenged" children. We will study child characteristics (e.g., the apparent unresponsiveness of a hearing impaired child; the apparent dependence of a visually impaired child) and parents' attributional biases that lead them to focus either on problems or promise associated with their physically or medically challenged children. We will assess the future outcomes of "challenged" infants as a function of their early experiences, and the current outcomes of "challenged" young adults as a function of their past experiences. Hypotheses are tested with respect to the interactive effects of parents' attributions/expectations and offspring characteristics on (1) parental practices
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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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(creation of efficacy-promoting experiences vs. abuse/neglect), (2) children's neurohormonal adaptation to stress (habituation vs. sensitization), and (3) children's social/emotional and cognitive/creative outcomes. Children's hormonal patterns and parental practices will be explored as mediators of later outcomes. Finally, we will study the benefits of an attribution-based home visitation program for new parents of "challenged" children as a means of reducing risk and fostering opportunity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ACHILLES TENDON LENGTHENING ON PATIENTS WITH DIABETES Principal Investigator & Institution: Mueller, Michael J.; Associate Professor; Physical Therapy; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 17-AUG-1998; Project End 31-MAY-2004 Summary: (Adapted from the Applicant's Abstract): Patients with diabetes mellitus (DM) and peripheral neuropathy are at high risk for forefoot plantar ulcers and subsequent lower extremity amputation. Total contact casting currently is the most effective treatment for healing neuropathic plantar ulcers but ulcer recurrence is high (30-50%) when patients discontinue casting and resume walking. An equinus deformity (limited ankle dorsiflexion range-of-motion [ROM]) is associated with these recurrent ulcers. Although descriptive evidence indicates an Achilles lengthening procedure (which corrects the equinus deformity) can improve healing rates in chronic ulcers, there have been no controlled trials. The primary purpose of this study will be to conduct a randomized prospective controlled trial to determine if percutaneous Achilles lengthening and total contact casting is more effective than total contact casting alone to heal forefoot plantar ulcers. Secondary purposes are to determine the effects of casting and percutaneous Achilles lengthening on measures of impairments, functional limitations, and disability in patients with DM and peripheral neuropathy. The specific aims of this project are to determine the effect of the Achilles lengthening procedure on patients with DM, peripheral neuropathy, a forefoot ulcer, and an equinus deformity in regards to 1) Wound healing, 2) Impairments (dorsiflexion range-of-motion, plantar flexor muscle performance), 3) Functional Limitations (Physical Performance Test, Functional Reach, walking ability), and 4) Disability (SF36). The results will have important implications for prevention of wound infection and lower extremity amputation; and improvement in impairments, functional limitations, and disability in this group of high risk patients with chronic disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SCLEROSIS
ACQUIRED
&
GENETIC
DETERMINANTS
OF
MULTIPLE
Principal Investigator & Institution: Mack, Thomas M.; Professor; Preventive Medicine; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2002; Project Start 30-SEP-2001; Project End 31-JUL-2006 Summary: The long-term goal of this proposal is to identify links between specific environmental exposures and/or specific gene alleles, and multiple sclerosis onset and progression. A cohort of 1294 pairs of North American twins affected by multiple sclerosis was assembled from 1980-92, detailed medical records, exposure and disability information were gathered independently from affected and unaffected individuals, and follow-up for new diagnoses and new records has subsequently proceeded. An additional set of 195 pairs of affected California native resident twins has been identified
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within a cohort of 41,000 twins participating in a population-based registry. The up-date on all cases will be completed, diagnoses will be systematically validated using the additional records, and age-specific disability information will be gathered. Blood specimens from both members of each pair and from specific family members as controls will be collected. The affected twins will be compared to their unaffected cotwins with respect to historical evidence of infection and other exposures and characteristics such as reproductive evidences of endogenous estrogen production. Cases will be compared to both co-twins and family member controls with respect to serological evidence of past infection with Chlamydia pneumoniae and members of the herpes virus family. We will compare cases to relatives with respect to the prevalence of alleles at the HLA (DR) locus as well as at various other candidate loci, found by genome-wide screening or that affect immune competence, myelin basic protein, and other pertinent functions. Within the set of cases only, both environmental and genetic factors will be assessed as determinants of age at onset and age-specific progression. If links to both acquired exposure and genome are identified, given adequate power, specific gene- environment interactions will be assessed. Analyses for both etiology and progression will consist of logistic regression and sub-analyses stratified on gender, zygosity, and HLA (DR) status. Additional descriptive evidence of environmental etiology will also be sought. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ADULT ONSET MOBILITY LOSS: PERSONAL MEANING & WELLBEING Principal Investigator & Institution: Luborsky, Mark R.; Professor; Occupational Therapy; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2002; Project Start 01-JAN-1999; Project End 31-DEC-2004 Summary: This proposed study of mobility loss, the leading cause of adult disability, responds to PA number AHPP96, NICHD Areas of High Program Relevance, and extends the applicants' research program to develop theories and data on sociocultural factors in disability experiences. The goal of the proposed study is to describe the personal meanings for adult-onset mobility loss and to examine how the discontinuity in physical function relates to the continuity of life themes. Continuity theories posit that hardships are buffered by the internal continuity offered by personal life themes. The specific aims are to answer three empirical questions. What are the contents of personal meanings and experiences of mobility loss? What are the perceived disruptions and continuities of life themes? How does impairment trajectory and severity relate to meanings for the loss, well-being, and life themes? A further aim is to build on those data to refine continuity theories of psychosocial functioning. The 48 month anthropological study will examine 216 subjects representing 3 contrasts in functional trajectory (new losses, new losses added to lifelong impairment, and lifelong impairment), 2 levels of severity (moderate vs. severe), women and men equally. Interviews and standardized measures will be conducted with persons unpaired by polio, spinal injury, accidents and arthritis in Detroit and Washington, DC. Notably, the study combines the gerontological and biosocial rehabilitation perspectives and resources of the applicant organizations to address mid-life disability, and will assure sufficient subjects. The study will contribute significant data about how adults reconstruct a continuity of personal meaning after mobility loss and how that process is linked to well-being. These understandings will be valuable for rehabilitation and gerontology, and will assist clinicians, program planners, disabled persons and their families.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AN EXPERT SYSTEM TO REDUCE DEPRESSION IN PRIMARY CARE Principal Investigator & Institution: Levesque, Deborah A.; Pro-Change Behavior Systems, Inc. 2 Chafee Rd Kingston, Ri 02881 Timing: Fiscal Year 2002; Project Start 25-SEP-2001; Project End 31-DEC-2002 Summary: A variety of effective interventions exist for people who seek help for depression. However, there is a lack of effective interventions for individuals who do not seek help or follow through with treatment referrals. We propose to fill this gap in services by developing and testing a Transtheoretical Model-based intervention that will be delivered proactively, on a population basis, to primary care patients who are experiencing symptoms of depression but are not currently involved in treatment. It is the first intervention for depression that is appropriate for individuals in all stages of change-not merely the minority who are prepared to take action. In Phase I of this Fast Track Initiative, the aims are to norm TTM measures, develop the TTM interventions, and determine the feasibility of this approach by assessing study recruitment rates and reactions to the intervention materials. Primary care patients who screen positive for mild to moderate depression and are not involved in treatment will complete surveys for measurement norming (n=100) or participate in a pilot-test of the intervention materials (n=50). If feasibility conditions are met, we will conduct a randomized clinical trial in Phase II to assess the efficacy of the expert system intervention for depression. PROPOSED COMMERCIAL APPLICATIONS: Depression is a costly illness for health care organizations, disability insurers, and employers because of increased health service utilization, disability claims, and lost productively among depressed individuals. An effective, low-cost expert system that can reduce the prevalence of depression on a population basis has significant commercial potential. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: APOLIPOPROTEIN E AND OUTCOMES IN SUBARACHNOID HEMORRHAGE Principal Investigator & Institution: Ko, Nerissa U.; Neurology; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Subarachnoid hemorrhage (SAH) accounts for nearly one-third of potential years of life lost among stroke patients before age 65, with an economic burden estimated at over five billion dollars per year. Prognostic indicators have been unreliable in predicting long-term disability from functional and cognitive impairment. Using genetic predictors like the apolipoprotein E (APOE) genotype will help us with risk stratification and identification of therapeutic targets. We hypothesize that the APOE e4 allele is an independent risk factor for long-term disability after SAH. We will perform a prospective observational study in a cohort of all patients with aneurysmal SAH to examine the relationship between APOE e4 allele and outcome measured by the modified Rankin scale, Barthel Index, and a battery of neuropsychological tests at 3, 6, and 12 months after rupture. Blood collection for genotyping will be obtained after informed consent from routine blood draws during hospitalization. Clinical risk factors will be analyzed using univariate and multivariate statistics. We will create a DNA bank in this rigorously characterized cohort for future genetic studies. The proposed project will take advantage of one of the busiest referral centers for intracranial aneurysms with expertise in genetic and cognitive testing. This
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research will provide useful information about clinical risk factors for long-term disability and the role of APOE in genetic susceptibility after SAH. Identification of genetic susceptibility from APOE in SAH will provide a clinical model to study other candidate genes that may provide the basis for future treatment strategies. A program of didactic courses and mentoring in this project will build upon the candidate's clinical training, and allow her to develop into an independent clinical investigator in neurovascular neurology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ARTHRITIS AMONG LATINOS: A STUDY BASED ON NATIONAL DATA Principal Investigator & Institution: Abraido-Lanza, Ana F.; Sociomedical Sciences; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 01-JUN-2000; Project End 31-MAY-2003 Summary: The broad aim of this study is to assist in uncovering factors underlying the observed differences between Latinos (Hispanics) and non-Latinos in the prevalence rate of arthritis and associated levels of disability. This information can ultimately guide policy and intervention programs to reduce physical disability and promote health in this population. According to recent national data, Latinos arthritis have a higher arthritis prevalence rate, but among those with arthritis, more Latinos than non-Latino whites report activity limitations (CDC, 1996a). Reasons for these differences are unknown, but may include disparities in sociodemographic factors, access to health care, and acculturation factors. Therefore, the aims of the proposed study are to: (1) examine whether socioeconomic factors (e.g., income, education) and health insurance coverage account for differences in the prevalence of arthritis among Latinos and nonLatino whites, (2) document levels of disability, both in activities of daily living and inability to work, among Latinos and non-Latino whites with arthritis, and identify sociodemographic (e.g., income, education, type of occupation) and health care factors (e.g., lack of health insurance, quality of health care) that predict disability in the different groups; and examine whether health care factors explain the differences in disability levels of Latinos vs. non-Latino whites after controlling for sociodemographic variables, (3) examine the effects of nativity status (U.S. vs. foreign-born) and length of time in the U.S. (acculturation) on arthritis prevalence and disability. These issues will be examined using data from the National Health Interview Survey (NHIS) on Disability, Phase I: Person and Condition Data, 1994. The proposed study will control for age and SES differences between the various ethnic groups, and conduct detailed analyses by Latino groups. This study will, therefore, contribute to a systematic program of research attempting to understand arthritis prevalence and disability among understudied populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BENZODIAZEPINE USE AND RISK OF DISABILITY IN THE ELDERLY Principal Investigator & Institution: Gray, Shelly L.; Pharmacy; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 15-JAN-1998; Project End 31-DEC-2003 Summary: (Adapted from applicant's abstract): The applicant states that her long-term career goal is to become an independent investigator, focusing on the adverse health outcomes of medication use in the elderly, by utilizing principles of
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pharmacoepidemology. She currently holds the rank of Assistant Professor in the School of Pharmacy at the applicant institution. She has completed a 2-year research pharmacy fellowship in geriatrics, has conducted research in the area of adverse drug effects in the elderly, and provides clinical services as part of geriatric team. To meet her career objectives, she is proposing to merg her clinical pharmacy background with expertise in epidemiologic methods over a 5-year period by: 1) completing course-work towards a master's degree in the School of Public and Community Health, University of Washington; and 2) conducting supervised research under the guidance of her sponser (David Buchner and co-sponsers (Andreas Stergachis and Andrea LaCroix) Some adverse health consequences of benzodiazepine use in elderly are established and represent a significant public health concern. Yet, according to the applicant, little is known about whether these agents contribute to the disability process. During the proposed award, the applicant plans to determine if benzodiazepine use is associated with the losss of mobility, loss of independence in activities of daily living (ADLs), use of health services, and mortality over a 3- year study period in community dwelling elderly. This research will use data from four large, federally-funded, population-based logitudinal studies of the elderly, containg data on approximately 17,000 individuals. Use of the following data sets is proposed: Established Populations for Epidemiologic Studies of the Elderly; Women's Health and Aging Study; Cardiovascular Health Study; and Group Health Cooperative Demonstration Project. The four outcomes will be evaluated within each dataset, and the data will be poooled for a meta-analysis. Beginning in the third year of the proposed award period, the applicant plans to submit additional competitive grants, and initiate research in other areas related to medication use and adverse health outcomes in the elderly, working closely with her sponsors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BIOBEHAVIORAL NURSING RESEARCH TRAINING PROGRAM Principal Investigator & Institution: Mitchell, Pamela H.; Elizabeth S. Soule Professor and Associa; Physiological Nursing; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 01-JUN-1999; Project End 31-MAR-2004 Summary: Behavioral, social and biological processes interact in maintaining health, in causing all ten of the leading sources of death, and in sustaining the major chronic illnesses that account for most of health care spending in the United States. Nursing science is one of the disciplines that integrates behavioral, social and biological processes in understanding and intervening in various states of health and illness. Nursing science demands an interdisciplinary biobehavioral perspective in order to develop interventions to prevent onset or progression of impaired functioning, disability and pathology along the dual continua of health and illness. Yet the number of nurse scientists prepared to integrate biobehavioral theory and methodology is relatively small. In the past decade a serious shortage has been identified of nurse scientists prepared to conduct innovative research at the interface of biological and behavioral science. These are scientists who can translate fundamental cellular processes to the integrative functioning of whole living beings in terms of life processes and therapies. Biobehavioral trained nurse scientists are prepared with depth in an area of inquiry, yet with sufficient breadth to understand the interactions among the traditional disciplines, and trained to use innovative research technologies and analytic strategies. The goal of this training program is to train eight (8) predoctoral and three (3) postdoctoral scholars each year in order to increase the cadre of nurse scientists skilled in biobehavioral theory and methodology. The University of Washington is unique in
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having a cadre of nurse scientists who work exemplifies research in biobehavioral theory and methodology and in preventive interventions. The specific aims of this training program are for trainees to attain theoretical and methodological capability to (1) expand understanding of the biobehavioral interface between individual vulnerability and environmental risk as foundational for generating new interventions; (2) integrate biological and behavioral instrumentation and state of the art biomethodologies for studying transactions between individual vulnerability and environmental risk for disease, disability, or progression of these adverse health responses; and (3) test nursing therapeutics aimed at managing biobehavioral vulnerability and risk in preventing disease, impairment and functional disability, or progression of disease, impairment and disability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BIPOLAR DISORDER ACROSS THE LIFE SPAN Principal Investigator & Institution: Calabrese, Joseph R.; Professor and Director; Psychiatry; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2003; Project Start 03-SEP-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Bipolar disorder (BPD) affects a minimum of 2.3 million American adults aged 18 and older (1.2% of US population) and in the 5-9% of children with serious emotional disturbances, the prevalence of BPD is unknown, in 1990, BPD in established market economies resulted in 1.7 million years of lost healthy life due to premature death or disability, third only to major depression and schizophrenia. About 15% of patients with BPD commit suicide. The proportion of the NIMH dollar that goes to support research in BPD is less than expected by NIMH leadership, and there are no NIMH-funded BPD research centers. These data suggest there exists an urgent need for an NIMH research center dedicated to BPD research across the life cycle. The proposed Center addresses many of the recommendations in the 1999 "Bridging Science and Services" report by focusing on the utilization of novel longitudinal study designs in complex comorbid groups of patients with BPD from ages 5 through the end of life, as well as by focusing on function and disability, not just symptom improvement. The scientific theme of this Center will be conduct of studies designed to "improve clinical outcomes in underserved population of BPD, including those receiving care within community mental health centers (CMHC), children and adolescents, and adults currently abusing alcohol and/or drugs. The pilot projects include: 1) a single-center psychosocial intervention study designed to develop an efficient and practical way of improving treatment adherence in 166 adults with BPD in a CMHC, 2) a single-center child services project intended to improve the early and accurate recognition of BPD in 615 children and adolescents evaluated at a CMHC, and 3) a six-month, two-center, double-blind, parallel-group comparison of two regimens of combination therapy (lithium/divalproex/lamotrigine versus lithium/divalproex/placebo) for the acute and continuation outpatient management of 90 adult patients with rapid cycling BPD comorbid with alcohol, cannabis, and/or cocaine abuse/dependence at Case Western Reserve University/University Hospitals of Cleveland and a CMHC. This application will be used to build and maintain a network of sites to conduct clinical trials research that concurrently addresses issues of efficacy and effectiveness in BPD across the life cycle. This Developing Center application will be used to develop research partnerships with community settings and grow ongoing relationships, and is intended to lead to an Advanced Center submission in five years. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BODY COMPOSITION CHANGES IN THE ELDERLY--SARCOPENIA Principal Investigator & Institution: Baumgartner, Richard N.; Professor; Internal Medicine; University of New Mexico Albuquerque Controller's Office Albuquerque, Nm 87131 Timing: Fiscal Year 2002; Project Start 30-SEP-1993; Project End 31-MAY-2004 Summary: (Adapted from Investigator's Abstract) The main objectives of this competing continuation application are to develop methods of estimating the prevalence and incidence rates of sarcopenia, or deficient relative muscle mass, and to determine sex and ethnic differences in risk factors and consequences of sarcopenia in communitydwelling elderly. It is accepted that muscle mass and strength are gradually lost with age. Because there are few methods of quantifying muscle mass in population studies, and criteria for defining "deficient" muscle mass remain to be established, estimates of the prevalence and incidence of sarcopenia are lacking and the extent of the public health problem posed is unknown. Age-related loss of muscle mass is undoubtedly multifactorial. Although a variety of possible mechanisms and etiological factors have been indicated, there are few data for multivariate associations of risk factors with sarcopenia. Sarcopenia is believed to be a major factor associated with physical functional impairment, and a number of studies have reported that indicators of muscle strength and function (e.g., balance, gait speed, etc.) are associated with disability and falls in elderly people. There are few reports, however, for direct associations between sarcopenia and disability or falls. Sex and ethnic differences in rates of loss for muscles mass and strength, risk factors and consequences remain to be established. The proposed study will establish methods for defining sarcopenia using cross-sectional data collected previously in the New Mexico Elder Health Survey (NMEHS, 1993-1996, n = 883) and reference data to be collected for a population-based sample of 300 young adults 20 to 40 years of age. Risk factors and long-term consequences of sarcopenia will be studied using 4 to 10 years of follow up data by continuation of the New Mexico Aging Process Study (NMAPS, current n = 404). The following variables have been measured in the NMAPS since 1993: muscle mass from dual-energy X-ray absorptiometry, serum nutrient and hormone levels (e.g. free-T, estrone, IGF1, DHEAs, leptin), dietary intake, physical activity and resting energy expenditure, cognitive and physical functional status, disability, incident falls and morbidity. Data collected for these variables will be extended another 5 years. The NMEHS included Hispanic elderly men and women: 200 new Hispanic participants will be recruited in the NMAPS to further facilitate ethnic comparisons for risk factors and consequences of sarcopenia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BOTULINUM TOXIN FOR SPASTICITY IN CEREBRAL PALSY Principal Investigator & Institution: Hays, Ross M.; Associate Professor; Children's Hospital and Reg Medical Ctr Box 5371, 4800 Sand Point Way Ne, Ms 6D-1 Seattle, Wa 98105 Timing: Fiscal Year 2001; Project Start 15-AUG-1997; Project End 31-JUL-2004 Summary: (Adapted from the applicant's description): The purpose of this study is to evaluate the effectiveness of botulinum toxin injection (BTX) in reducing spasticity and improving function and mobility in children with spastic diplegia, a common form of cerebral palsy (CP). This study proposes to evaluate the effects of the treatment across the five domains of science relative to disability: pathophysiology, impairment, functional limitation, disability, and societal limitation. The study design is a prospective, randomized, double-masked clinical trial with a 6 month evaluation period.
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Forty children, ages 4-12 years, will be recruited and randomized into two groups. Group A will receive BTX. Group B will receive a placebo injection. Outcomes will be assessed in a masked evaluation at baseline, 3 weeks, 8 weeks, 12 weeks, and 24 weeks. Group B subjects will have the opportunity for BTX treatment after 24 weeks. Outcome variables are proposed to provide information in the five different domains. Change in pathophysiology will be represented by quantitative electromyographic kinesiology measurements. Change in impairment will be represented by electromechanical measurement of joint torque across the ankle joint using the Spasticity Measurement System. Change in functional limitation will be represented by changes in gross motor function as measured by the Gross Motor Function Measure, physical exam parameters, energy expenditure using the Energy Cost Index, and kinematic gait analysis. Changes in disability will be represented by serial assessments of age appropriate task performance using the Canadian Occupational Performance Measure. Any change in societal limitation will be measured by the use of Goal Attainment Scaling in the areas of community and school activities. Sample size has been based on the power calculation necessary to demonstrate a change in the Gross Motor Function Measure and the Spasticity Measurement System. The large number of assessments required for each patient necessitate that subject enrollment be distributed over the first four and one half years of the study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CHILD DISABILITY AND THE FAMILY Principal Investigator & Institution: Hogan, Dennis P.; Professor of Sociology; None; Brown University Providence, Ri 02912 Timing: Fiscal Year 2002; Project Start 12-APR-1999; Project End 31-MAR-2004 Summary: This is a proposal for an interdisciplinary team from Brown University, led by Dennis Hogan, to join NICHD's Family and Child Well-Being Research Network to strength studies of child disability and the family. This team would contribute its focus on disability among school-age children: The measurement of disability among children, differentials in its antecedents and in medical services and rehabilitation inputs, and disabled but who have a disabled sibling, and for the parents of a disabled child. W make baseline comparisons with children and parents from families without child disability. The individual research plan focuses on identifying children with disability and measuring disability in order to investigate (a) its effects on the health, education, family, security, family stability and structure, and social development and problem behavior of all children, distinguishing between children with disability, siblings of children with disability, and children in families without child disability; and (b) the demographic and economic consequences for parents. The cooperative research plan focuses on methodological innovations to improve the measurement of disability among children and its dynamics in families. This includes two elements: (a) the collection of pilot data on the functioning and disability of a cohort of 90 very low birth weight babies at ages 3 and 5, to more satisfactorily address issues of selectivity and controls in medical studies of child disability and to develop improved methodologies to measure child disability in population surveys, including those in use in the Network; and (b) the merging of two secondary data sets to obtain maternal and family life histories, and thus to clarify the dynamics of maternal antecedents of child disability and maternal responses to child disability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CHRONIC PAIN TIVR TO PREVENT PRESCRIPTION DRUG ABUSE Principal Investigator & Institution: Naylor, Magdalena R.; Psychiatry; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-JUL-2004 Summary: (provided by applicant): This is an R21 application by a new investigator to utilize Interactive Voice Response (IVR) to develop a new strategy for preventing prescription drug abuse in patients with persistent pain. IVR is a computer-based, automated telephone that enables callers to respond to a recorded voice via the telephone keypad. Using this technology, we developed Therapeutic IVR (TIVR) as an intervention in patients using prescription medication for chronic pain. The TIVR reinforces group Coping Skills Training (CST) given in our pain clinic. It includes an automated daily diary for self monitoring, guided behavioral rehearsals of key CST coping skills, and monthly personalized feedback, all of which can be accessed by patients on demand. In our pilot test, ten subjects with severe, chronic musculoskeletal pain participated in 10 weeks of group CST followed by four months of TIVR. Subsequently, we recruited a second sample of eight patients as a comparison group who were given group CST but not the TIVR. Within subjects analysis (ANOVA) of the TIVR group showed that, compared to baseline values, the maximum mean positive change for nearly all outcome measures occurred at the post TIVR point. Several measures were significantly improved post TIVR despite lack of significance after CST. These included SF-36 Mental Health Composite Score (p<.0004), MPQ pain (p<.01), CSQ Catastrophizing (p<.0006), TOPS Total Pain Experience (p<.03) and Perceived Family/Social Disability (p<.02). Between subjects analysis (ANCOVA) of TIVR treatment and comparison groups revealed significantly higher TIVR group scores for TOPS Total Pain Experience (p<.01), TOPS Perceived Social Disability (p<.002) and SF36 Mental Composite (p<.05). Finally, Hierarchial Linear Regression of the TIVR daily diary confirmed significant reductions in the highest level of pain (p<.0001), highest stress level (p<.0001), and frequency of resorting to maladaptive coping skills such as catastrophizing (p<.0001). Analyses of these daily data also revealed a significant (.0002) decrease in the use of medication during the TIVR trial. However these latter results are tentative since we asked only two general questions about medication use, and neither question related to specific types of medication. This R21 would enable us to pretest a revised TIVR designed specifically to monitor and reduce reliance on medication and to prevent prescription drug abuse in patients with persistent pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COGNITIVE, INSTRUCTIONAL, & NEUROIMAGING FACTORS IN MATH Principal Investigator & Institution: Fletcher, Jack M.; Professor; Pediatrics; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2003; Project Start 26-SEP-2003; Project End 31-JUL-2008 Summary: Cognitive, Instructional, & Neuroimaging Factors in Math. The objective of this program project in respond to RFA HD-02-031 is to integrate investigations of the cognitive, instructional, and neurobiological factors that account for individual differences in the development of mathematical proficiencies in children with different types of learning disabilities in math. The central theme is that children vary in the degree to which they learn mathematical proficiencies and that these individual differences manifest themselves in different subtypes of math disability. To understand the sources of variability, the types must be defined and evaluated against cognitive,
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instructional, and neurobiological measures, and in relation to other learning and attention difficulties. The proposed program project includes four projects and three cores. Project I (Cognition) proposes to evaluate mathematical and cognitive processes that underlie the difficulties experienced by children with specific math disabilities as well as comorbid math and reading disabilities. Project II (Instruction) provides randomized controlled studies of children with only reading and comorbid reading and math disabilities, including interventions addressing of fact retrieval, procedural knowledge, and arithmetic word problems. Project III (MRI) proposes functional and structural neuroimaging studies of the subtypes of math disability evaluated in Projects I and II, specifically examining the neural correlates of these subtypes and response to intervention. Project IV (MSI) proposes magnetic source imaging studies of the subtypes evaluated in Projects I and II, also identifying the neural correlates and response to intervention with a different, but complementary functional neuroimaging modality. The cores include the Administrative Services Core (A), the Recruitment and Evaluation Core (B), and the Database and Statistics Core (C). This research program will lead to a more comprehensive classification of learning disabilities in general, a more integrated understanding of how children develop mathematical proficiencies and why some struggle, provide specific evaluations of remedial interventions, and provide important cross-discipline insights into the nature of math disabilities in children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COHORT STUDY Principal Investigator & Institution: Tucker, Katherine L.; Director; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2008 Summary: Cultural and ethnic minorities tend to face more stressors quantitatively and qualitatively than the majority population and this stress is thought to contribute to health disparities. However, the links between these remain unclear. We, and others, have shown that Puerto Rican elders living in the US mainland are at particularly high risk for several conditions, including physical frailty, depression, diabetes and cognitive impairment, relative even to non-Hispanic white elders living in the same neighborhoods. Allostatic load has been proposed as a conceptualization of cumulative biological burden exacted on the body through attempt to adapt to daily physical and emotional stress. We propose to conduct a prospective cohort study of Puerto Rican adults in the greater Boston area to investigate the impact of life experiences and psychosocial stress on allostatic load as a marker of biological risk; to assess crosssectional and two year prospective interrelationships between measures of allostatic load and depression, cognitive function and physical disability; to determine the extent of social support and assess how this moderates the above associations; and to assess vitamin intake and nutritional status and to investigate how this moderates the above associations. Based on preliminary studies and our experience with the Hispanic community, our working hypothesis is that older Puerto Ricans living in Massachusetts have experienced, to a variable degree, social and psychological stressors related to conditions of poverty, migration, acculturation, perceived discrimination, language and social isolation, and these accumulated stressors are associated with significant and progressive allostatic load. This load, in turn, is associated with greater prevalence and progression of depression, cognitive decline and physical disability. We also hypothesize that older Puerto Rican adults with strong social networks are less vulnerable to physiologic responses of allostatic load and to its effects on cognitive and physical function than those without such contacts, and that allostatic load is more
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pronounced and its impact on depression, cognitive decline and physical disability greater in those individuals with the poorest nutritional status. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COMPUTERIZED ADAPTIVE VERSION OF THE PEDI Principal Investigator & Institution: Ware, John E.; Chief Executive Officer; Qualitymetric, Inc. 640 George Washington Hwy, #201 Lincoln, Ri 02865 Timing: Fiscal Year 2002; Project Start 22-JUL-2002; Project End 31-DEC-2002 Summary: (provided by applicant): Our objective is to achieve a major advance in the technology used to assess disability in children and youth. Measurement and practical requirements to identify disability and to evaluate individual progress across pediatric age groups and care settings present a serious dilemma to current fixed-item survey instruments. To address these deficiencies, the principal aims of Phase I are to: (1) build a prototype computer adaptive testing (CAT) system based on existing Pediatric Evaluation of Disability Inventory (PEDI) normative and clinical databases; (2) estimate the accuracy and responsiveness of scores based on the prototype PEDI-CAT in comparison with scores for the full-length PEDI (PEDI-Fixed) using existing databases; and (3) evaluate reductions in respondent burden and acceptance of parallel versions of the PEDI-CAT and PEDI-Fixed in a pilot field test in four pediatric clinical settings. The product in Phase I will be a prototype version of a PEDI-CAT as well as preliminary evidence regarding how well it works. In Phase II, we will examine the questionnaire item calibrations of the original PEDI, add new items to broaden the age range coverage, conduct field studies to re-calibrate items, and create algorithms for a fully operational PEDI-CAT system. A practical and feasible PEDI-CAT will greatly improve the information used in making decisions about disability status, service eligibility, program needs and outcomes of rehabilitation interventions. The product of this SBIR project will be a marketable CAT system for the assessment of disability in children and youth between the ages of 6 months and 18 years. Adapted from the PEDI, and expanded to a broader age group, this new disability assessment will fill a critical void with a system that is more practical and precise. It will have the advantage of greatly reduced data collection costs, reduced respondent burden and will meet the standards of score precision required for clinical decisions at the individual patient level throughout the scale range. Many rehabilitation settings may also find this system helpful in meeting accreditation and institutional requirements for standardizing outcome monitoring in groups of children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DEVELOPMENT & EARLY IDENTIFICATION OF READING DISABILITY Principal Investigator & Institution: Lonigan, Christopher J.; Associate Professor; Psychology; Florida State University 97 South Woodward Avenue Tallahassee, Fl 323064166 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 31-MAY-2005 Summary: The primary objective this proposal is to produce an understanding of the developmental sequence, correlates, and long-term significance of preschool children's emergent literacy skills and to use this knowledge to improve (a) early identification of children at risk for reading disabilities, (b) the understanding of the developmental and causal relations between preschool emergent literacy skills and the acquisition of beginning reading skills, and (c) the understanding of potential pathways to provide
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early intervention for children at risk of reading disabilities. The proposed project involves two longitudinal studies. One represents a longitudinal investigation of an existing large cohort of 2-, 3-, 4-, and 5- year-old children recruited for the applicant's ongoing cross-section study concerning the measurement of phonological processing skills in prereaders. The proposed study will provide longitudinal assessments of these children 1-1/2 years from their initial assessment (n greater than 130 per age-group) and yearly thereafter until children are in the third grade. The second study involves an intensive examination of growth in phonological processing skills during the middle and late preschool period (i.e., from 3 to 4 and from 4 to 5) using growth curve modeling and a two-year longitudinal follow-up period. There are six specific aims for this proposal, three with primarily practical importance and three with primarily theoretical importance. The first aim is to identify the preschool skills and time period that are most valid for identifying children who will develop reading disabilities. We will achieve this aim by using latent means and covariance structure analyses in structural equation modeling (SEM) and discriminant/logistic regression analyses (D/LR) on the longitudinal data from Study 1 to identify preschool predictors of reading disability. The second aims is to track the high degree of growth in phonological processing abilities that occurs in the later preschool period, determine the factors that influence the rate of growth, and examine the rate and timing of this growth as a predictor of reading disability. We will achieve this aim by using growth curve modeling on data obtained in Study 2 and by applying D/LR analysis on the longitudinal data from Study 2. The third aim is to evaluate the overlap and significance for the development of emergent literacy skills, reading skills, and reading disabilities of behaviors characteristic of Attention Deficit Hyperactivity Disorder. We will achieve this aim using SEM on the longitudinal data obtained in both studies. The fourth aim is to compare the predictive power of different metrics of preschool emergent literacy skills (e.g., growth rate, terminal skill level, initial skill level) for determining later reading skills. We will achieve this aim by using SEM and D/LR on the longitudinal data obtained in Study 2. The fifth and sixth aims are to evaluate the causal relations between preschool emergent literacy skills and both later emergent literacy skills and later reading. We will achieve this aim by using SEM of longitudinal data from both studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROCESSES
DEVELOPMENTAL
COGNITIVE
APPROACHES
TO
MATH
Principal Investigator & Institution: Ewing-Cobbs, Linda K.; Associate Professor; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2003; Project Start 26-SEP-2003; Project End 31-JUL-2008 Summary: Project 1 uses a developmental cognitive approach to understand core mathematical and cognitive processes related to mathematics disability (MD). Early cognitive developmental studies of MD often did not account for possible confounding effects of co-morbid learning disorders, such as reading disability (RD). More recent studies have begun to take other learning disorders into account, but have not investigated math disability in relation to behavioral disorders such as attention-deficit hyperactivity disorder (ADHD) that have substantial overlap with learning disorders. Very few studies are longitudinal, particularly in the early to mid-primary grades, which limits knowledge of factors related to the stability of patterns of mathematical deficits, relationships between acquisition of fact retrieval skills and later development of complex mathematical algorithms, and the rate of growth in different skill domains. Therefore, we propose to examine mathematical processes and their hypothesized
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related cognitive competencies in carefully ascertained community-based samples of typically developing children and children with MD, RD, and MD-RD, in which ADHD is also ascertained. We will examine the speed and accuracy of fact retrieval and speed and accuracy of calculation, strategies used during calculation (e.g, counting, direct retrieval of facts from memory), approximate calculation or estimation of quantities, conceptual number knowledge, speed and accuracy of written multi-digit calculation, and solving complex word problems. We will examine the relationship between these domains of mathematical processing and supporting cognitive competencies, including working memory and executive control processes. Within a longitudinal design spanning third through fifth grades, we propose to identify possible empirically-based subtypes of MD, examine change in patterns of mathematical processes and supporting competencies in the MD subtypes, and ascertain the stability of MD subtypes. In relation to Project 2, we will examine predictors of response to mathematical interventions targeting fact retrieval, multi-digit calculation, estimation, and solving complex word problems. In relation to Projects 3 and 4, we will assess core mathematical processes and supporting cognitive competencies in relation to neuroimaging studies of fact retrieval, calculation, and estimation and will examine functional neuroimaging findings in empirically-derived subtypes of MD. Our approach is innovative in that it integrates careful case ascertainment and model-driven assessment of core mathematical skills and supporting cognitive competencies with studies of functional neuroimaging and intervention in children with MD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DIAGNOSTIC AND NATURAL HISTORY MARKERS IN ALS Principal Investigator & Institution: Mitsumoto, Hiroshi; Professor; Neurology; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 15-JUN-2001; Project End 31-MAY-2004 Summary: Amyotrophic lateral sclerosis (ALS) is one of the most devastating neurological diseases. It affects upper and lower motor neurons (UMN and LMN). The cause is largely unknown, so no effective treatments are available. To date, "no objective and quantitative UMN or LMN markers" are available---one of most serious deficiencies in ALS. Thus, "understanding of the pathogenesis of UMN and LMN involvement" is limited, and no reliable early diagnosis and effective surrogate markers are available. Therefore, we propose (1) to investigate several novel technologies to establish accurate UMN and LMN markers, (2) to investigate whether these markers provide early diagnosis and clinically meaningful natural history data that indicate changes over time with high sensitivity, (3) to identify whether these markers prognosticate ALS disability and survival, and (4) to validate histologically the changes observed with technologyidentified markers. First, test-retest validity and normal data will be established in healthy controls using emerging neuroimaging technologies at two hospital campuses. In patients with suspected/possible ALS or probable/definite ALS, we will investigate quantitative evidence for (1) UMN involvement at the motor cortex area by single-voxel magnetic resonance spectroscopy (MRS) and more accurately at the primary motor cortex by multiple-voxel MRS; (2) fiber tract integrity of descending UMN fiber tracts by MR diffusion tensor imaging; and (3) physiological integrity of the corticospinal tracts using transcranial magnetic stimulation technology. An LMN marker will be studied by motor unit number estimation using multiple point stimulation technology. ALS status will be measured by well- validated quantitative clinical assessments. The patients will be followed every 3 months for 15 months. The potential value of the technologyidentified markers for use as surrogate markers as endpoints in clinical trials will be
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analyzed by statistical modeling. Functional disability and survival also will be correlated with these markers. When autopsy is permitted, technology-identified markers will be validated histologically. To our knowledge, this project will be the first comprehensive approach to investigate ways to develop a reliable and early diagnosis of ALS, to develop surrogate markers in clinical trials, and to improve prognostication in ALS. The knowledge gained from this project not only will expand understanding of the pathogenesis of UMN and LMN involvement in ALS, but also will permit more effective clinical trials of new drugs in the near future and improve diagnosis and treatment for patients with this disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISABILITY BENEFITS AND SERVICE USE Principal Investigator & Institution: Frueh, B Christopher.; Associate Professor; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: The research aim of this proposal is to advance our understanding of the association between disability benefits, service use (medical, mental health, rehabilitation), race, and clinical presentation among trauma victims with severe posttraumatic stress disorder (PTSD) and other associated mental illnesses. It is well accepted that persons with mental illnesses often experience severe occupational impairment and related financial hardships associated with their psychiatric condition. Recent advances in clinical and rehabilitative services, and changes in public opinion and subsequent legislative reform toward welfare and the Work Incentives Improvement Act of 1999, have led policy makers to reconsider multiple aspects of the current disability policies. Unfortunately, rehabilitative efforts have not been shown to significantly increase the work-related income of persons with psychiatric disabilities. Furthermore, we know relatively little about how public disability benefits affect work behavior or use of other services available within various public systems. At present the VA system offers a unique opportunity to study the relationship between clinical symptoms, associated disability, and service use because it is a large, closed system which provides a broad range of medical, mental health, and social services. Furthermore, the clients served by the VA system (i.e., veterans) are of interest in that they represent a population that has high percentages of rural and minority members. Thus, the VA system represents the chance to study a range of variables that are of general interest to policy makers, advocates, and key stakeholders concerned with the welfare of mentally ill persons. In this study we will learn more about the relationship between service use and a number of relevant variables (e.g., race, symptom reporting, disability seeking, employment) by examining archival data, including administrative and medical records, on approximately 450 trauma victims with severe PTSD served within the VA system. These data may have implications for our understanding of service delivery systems for trauma victims with severe PTSD and other associated mental illnesses, including the important interface with associated psychiatric disability and rehabilitation efforts. This proposal is responsive to Health People 2010 and the Bridging Science and Service report recommendation regarding rehabilitation and interventions (recommendation #9). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DISABILITY IN NURSING HOME RESIDENTS WITH DEMENTIA Principal Investigator & Institution: Mcconnell, Eleanor S.; None; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 01-SEP-1998; Project End 31-MAY-2004 Summary: (Adapted from the Investigator's Abstract): A two-phase project aimed at preventing worsening disability in nursing home residents with cognitive impairment. The overall purpose of the project is to increase an understanding of how disability progresses and to determine whether risk factors for worsening disability can be modified by existing nursing home staff, slowing the rate of functional decline in cognitively impaired residents. Specific aims are to: (1) analyze trajectories of decline in functional status in long-stay nursing home residents with cognitive impairment to determine whether modifiable clinical and care factors influence decline; (2) identify subgroups of nursing home residents with cognitive impairment who have atypical patterns of decline, characterized by either frequent fluctuations in ADL status or steeper than average slope of decline, and 3) examine the feasibility and preliminary effects of an intervention designed to reduce risk factors for disability progressing in cognitively impaired long-stay nursing home residents. In the first phase, a secondary analysis of functional decline in long-stay nursing home residents with cognitive impairment will be conducted, using multi-year data from the HCFA-sponsored Nursing Home Case Mix and Quality Demonstration Project. Hypothesis concerning the influences of co-existing chronic diseases and cognitive impairment, sensory and neuromuscular impairments, and limitations in function in changes in self-care ability will be tested, along with hypotheses about care factors that may influence change. Results from the analyses will be used to identify subgroups of residents at high risk of decline and to isolate modifiable risk factors for decline. In the second phase, we will conduct a pilot randomized trial to test the feasibility and efficacy of a multiple risk factor reduction intervention to present worsening ADL function in nursing home residents by comparing outcomes to usual care. In this intervention, existing nursing home staff will be taught new methods for risk factor screening, using a combination of nursing home Minimum Data Set items and other performance-based assessments of residents' transfer skills and walking. Staff will also be taught how to implement risk reduction protocols, including exercise built into daily routines to compensate for or mediate performance deficits. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DISABILITY IN PARKINSON'S DISEASE Principal Investigator & Institution: Bassett, Susan S.; Associate Professor; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 07-SEP-2001; Project End 31-JUL-2006 Summary: Disability affects as much as 17 percent of the adult population in the US and the majority of these individuals suffer both chronic medical conditions and psychiatric disorders. In combination, the impairments that accompany these disorders synergistically intensify any disability. Parkinson's disease (PD), a progressive neurodegenerative disorder, produces marked impairments of motor function and significant disability. However, the majority of PD patients also experience emotional and cognitive impairments, yet little is known about the contribution of these impairments to disability. In addition, disability assessment in PD has focused narrowly on self-care, ignoring other important areas such as work performance. It is unknown, for example, whether withdrawal from the workforce among PD patients is
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more closely tied to emotional and cognitive impairments than to decrements in motor function. The aim of this project is to assess impairments in motor, cognitive and emotional function and the accompanying disabilities, longitudinally, in individuals with PD, to understand how the impairments contribute to disability and how psychiatric disorders produce excess disability in these patients. Specifically we will examine performance on quantitative motor tests and cognitive tests of memory, attention and executive function. Psychiatric symptom occurrence and severity, clinical diagnosis, and temperament will also be examined. Disability assessment will include the areas of physical, social and occupational functioning as well as perceived quality of life, utilizing clinical interview, performance evaluation, vocational testing and informant interview. Participants will include 100 non-demented individuals with PD, 65 years of age or younger. Approximately equal numbers of males and females will be enrolled. All participants will be evaluated yearly, four times during the course of the project. Investigation into the full range of disability found in PD, and an understanding of the contribution all impairments play in increasing disability, will enable us to develop strategies to improve the care of these patients. It will also provide information to guide interventions to decrease the level of disability suffered by those with PD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISABILITY OF ELDERS: US AND ENGLAND COMPARISONS Principal Investigator & Institution: Melzer, David; University of Cambridge Cambridge, England Cambridge, Timing: Fiscal Year 2004; Project Start 01-JAN-2004; Project End 31-DEC-2005 Summary: (provided by applicant): The principal applicant coordinates the physical health and disability module of the English Longitudinal Study of Ageing. Dr Melzer's longer-term research program addresses two key public health questions in aging: 'how much of future disability in older people is avoidable?' and 'how best could population prevention and early detection efforts be targeted in older populations?' This project proposes epidemiological analyses of disability data from two NIA supported nationally representative public datasets: the English Longitudinal Study of Ageing (ELSA) and its sister study, the US Health and Retirement Survey (HRS). The proposed work aims to test the comparability of disability self-reporting across these studies, and establish whether associations between risk factors and disabilities are consistent across the two studies/countries. This international comparison will extend our understanding of risk factors for disability, by studying more diverse risk exposures, and the effects of differing social, economic, and healthcare environments. The results will provide a foundation for a range of multidisciplinary analyses involving disability, and a baseline for tracking trends in disability in ELSA and HRS. Many identical or comparable questions have been included in ELSA from HRS. In addition, gait speed measures in the ELSA study will be used to provide an objective 'calibration' of self-reporting of functional mobility status to the US population, using the NHANESIII dataset. In addressing the validity problems in international comparisons, and in covering unusually large nationally representative samples, this work represents an exciting step forward in the field of international health and disability research in aging populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DISABLEMENT IN AN AGING BI-ETHNIC COHORT Principal Investigator & Institution: Hazuda, Helen P.; Professor of Medicine; Medicine; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229
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Timing: Fiscal Year 2002; Project Start 01-MAY-2000; Project End 31-MAR-2005 Summary: Today, Americans over 65 can expect to spend 10-50% of their remaining lives in a dependent state. Prolong active life expectancy (i.e., decreasing the absolute years of dependency as people survive to older ages) is thus an urgent goal. This is particularly critical for Mexican Americans (MA), who compris3e the most rapidly growing segment of the U.S. elderly population and appear to have markedly higher rates of dependence than European Americans (EA). Prolonging active life expectancy will require systematic and detailed information about stages in the progression from specific diseases to ultimate dependence, and about factors which modify these stages, in order to identify optimal targets for effective interventions to slow or prevent this progression in MA as well as EA elderly. We therefore assembled a unique, aging, biethnic cohort of community- dwelling MA and EA elderly of low, middle, and high socioeconomic status. An epidemiological analysis of this cohort indicated that ethnic differences in impairments, functional limitations, and disability may result primarily from the higher prevalence of diabetes among MA elderly. Further multi-variable, hierarchical analyses, using the Displacement Process Model (DPM) as a framework, enabled us to identify 1) a psychosocial, and lifestyle modifiers to variables within that main pathway. These cross-sectional results suggest relationships that might indicate promising targets for intervention, but distinguishing the valid targets among these will require a longitudinal study to estimate the time course of these relationships within the DPM. This proposed further study is designed: 1) to define optimal targets for intervention in the main disease-to-disability pathways of diabetes and arthritis; and 2) to determine whether psychosocial and lifestyle factors alter the main pathways of these diseases and regardless of disease, whether psychosocial and lifestyle factors influence successive stages in the main DPM pathway, suggesting that these factors themselves are promising targets for function-enhanced intervention. To estimate the time course of relationships in the DPM, we will carry out three follow-up assessments of the cohort at 18-month intervals. Longitudinal growth curve models will be used to fit person-specific curves to these longitudinal data, and estimate the general shapes of time- related changes among the cohort. This new study will provide critical information identifying key points in the disablement process where targeted medical and/or behavioral interventions may be most effective in altering the course of disability. Thus, scientific and public health benefits will be substantial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISABLEMENT PROCESS IN RHEUMATOID ARTHRITIS Principal Investigator & Institution: Escalante, Agustin; Associate Professor; Medicine; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2002; Project Start 01-AUG-1999; Project End 31-MAY-2004 Summary: (adapted from investigator's abstract): The broad objective of this research is to understand disability in rheumatoid arthritis (RA) within the theoretical framework of The Disablement Process Model. This model postulates a main disease-disability pathway in which pathology causes impairments, which lead to functional limitations, which, in turn, cause disability. Risk factors that precede and interventions or exacerbation's that follow the onset of the process of disablement, modify the main pathway. The specific aims of this application are: (1) To define the temporal sequence of events in the development of disability due to RA attributable to altered articular structure; (2) To define the temporal sequence of events leading to disability in RA attributable to pain; (3) To define the temporal sequence of events leading to disability in RA attributable to symptoms of depression; (4) To evaluate the modifying effect of
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medical interventions and co-morbidity. The models and hypotheses of this application are based on cross-sectional analyses on a cohort of 455 persons with RA participating in Dr. Escalante's current ORALE Study (Outcome of Rheumatoid Arthritis Longitudinal Evaluation). The ORALE cohort will be augmented to 760 members by the end of the first year of this application. Four yearly follow-ups are planned after the initial baseline assessment, to be conducted during the first through fourth years of this 5-year application. Main pathway factors that will be assessed include the inflammatory response, serum rheumatoid factor, bone destruction and extra-articular signs and symptoms, corresponding to pathology; articular signs and symptoms, strength, ambulation and manual dexterity, corresponding to impairments; activities of daily living, under functional limitations; and physical disability. Risk factors are age, gender and ethnicity, the HLA-DRB1 genotype, education, occupation, income, functional health literacy and acculturation. Psychosocial modifiers include and social support, learned helplessness, self-efficacy, coping strategies, stress, symptoms of depression, and coexistent medical conditions. Interventions to be measured include anti-rheumatic drugs and joint surgery, the lag between disease onset and initiation of anti-rheumatic therapy, compliance, and rehabilitation interventions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISPARITIES IN INJURIES AND ACCESS TO INJURY PREVENTION Principal Investigator & Institution: Pressley, Joyce C.; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2003; Project Start 10-FEB-2003; Project End 31-JAN-2008 Summary: Injuries, unintentional and intentional, contribute significantly to ethnic disparities in morbidity, disability and life expectancy. In Harlem childhood injuries occur at twice the national rate. Unintentional injuries are the third leading cause of death in Hispanics and the fourth in blacks--preceded only by heart disease, cancer, and cerebrovascular disease (blacks). In addition, unintentional injuries are a leading cause of years of potential life lost (YPLL) (CDC 2002). Yet the leading role of injuries, both in morbidity and mortality in the general population and as a major dimension of racial and ethnic disparities, has not received full recognition. Inadequate attention to ethnic disparities left Healthy People 2010 (DHHS 2000) with insufficient information to set targets for reduction of ethnic disparities in many injury areas. Both intentional and unintentional injuries have been shown to have a modifiable component when wellfocused interventions are implemented in a minority community. Through the efforts of the Co-PI, Dr. Barbara Barlow and others, focused, community-based interventions were put into place that lowered injury rates by 40%-50%. Using funding from the Robert Wood Johnson Foundation, the success of this program has been nationalized. The program now operates sites in 7 of 10 trauma regions covering the mainland United States. As Chief of Surgery at Harlem Hospital, Dr. Barlow has observed the need to expand these efforts to adults and the elderly. The focus of the Injury/Disability Prevention Core is to facilitate the study of racial and ethnic disparities in injuries and injury prevention across all age groups. Specific aims are to: (1) promote research on disparities in access to programs and capabilities to prevent injury and disability among infants, children, adolescents, and elderly to characterize health disparities in injury; (2) expand monitoring of injury surveillance and disparities in health care access to potentially disability-reducing treatments for adult and elderly populations in northern Manhattan; and (3) develop research in collaboration with northern Manhattan organizations to identify potential interventions to reduce injury disparities through primary, secondary, and tertiary prevention of falls, the most prevalent nonfatal injury.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OUTCOMES
DYSVASCULAR
AMPUTEES:
REHABILITATION
USE
AND
Principal Investigator & Institution: Dillingham, Timothy R.; Associate Professor; Phys Med and Rehabilitation; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2003; Project Start 10-AUG-1998; Project End 31-MAY-2005 Summary: (provided by applicant): Amputations resulting from peripheral vascular disease and diabetes (dysvascular causes) represent an important source of permanent impairments and functional limitations for the elderly. We have learned through our work that (i) rates of dysvascular amputations continue to rise in the United States; (ii) a substantial proportion of dysvascular amputees go on to have additional amputations within one year; (iii) utilization of rehabilitation services in the United States is relatively low and characterized by substantial geographic variation; and iv) African Americans are at two- to four-fold greater risks for amputation than white persons. Despite the potential for enhancement of function through appropriate rehabilitation, little is known about the effectiveness of rehabilitation services provided in different care settings for these amputees. The purpose of this competitive renewal is twofold; (i) to prospectively compare the outcomes for a cohort of dysvascular amputees receiving rehabilitative care in three different settings- inpatient rehabilitation units, skilled nursing facilities, and at home, and ii) to determine the cost-effectiveness of post-acute care delivered in these settings at improving outcomes at six months post amputation. Primary data will be obtained from medical records and patient interviews initially after amputation and by telephone follow up 6 months later for a sample of dysvascular amputees undergoing surgery at one of the participating Baltimore hospitals. Multivariate techniques will be utilized to compare outcomes across settings, controlling for patient characteristics, initial disability levels, and other confounders. Cost-effectiveness analyses for alternative rehabilitation settings will be conducted through econometric modeling and simulation techniques. These important outcome and cost-effectiveness results will inform clinicians, consumers, insurers, and health policy makers, regarding the most appropriate rehabilitation care for persons undergoing dysvascular amputations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EARLY HEMICRANIECTOMY TO MANAGE TRAUMATIC BRAIN INJURY Principal Investigator & Institution: Coplin, William M.; Associate Professor; Neurology; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 1999; Project Start 18-JUL-1999; Project End 31-DEC-2004 Summary: Severe blunt traumatic brain injury (TBI) is a major cause of mortality and long-term disability in previously healthy young adults. The current standard of initial surgical care includes evacuation of intracranial hematomas, and, often amputation of swollen confused brain. The rationale for the latter intervention is that further edema in this area of presumed unsalvageable cerebrum will cause intracranial hypertension, impeding blood flow to otherwise more health areas of brain, with resultant infarction. To this end, modern neuro-tensive care expends great effort to control intracranial pressure (ICP) and prevent such secondary injury. While effectively reducing ICP, past non-randomized investigations have employed hemicraniectomy at later times, for refractory ICP, and have lacked standardized surgical and/or medical protocols and
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outcome measures. This randomized pilot study seeks to address the safety and possibly preliminary efficacy of early hemicraniectomy (as the initial surgical intervention) for managing patients with severe TBI. Goals include: 1) reduced therapeutic intensity for ICP over a shorter length of stay (LOS), 2) reduced need for repeat computer tomography (CT) scans and returns to the operating room (OR), and 3) improved neurological outcome. The study will randomly assign, within 24 hours of ictus, 92 TBI patients, Glasgow Coma Scale score less than or equal to 9, with midline shift greater than the size of a surgically removable hematoma. Group I will receive standardized hemicraniectomy; Group II will undergo traditional craniotomy with or without brain amputation, at the discretion of the attending neurosurgeon. I both groups, hematomas greater than or equal to 20 cc will be evacuated, a standardized medical protocol will be followed, and daily monitoring will assess neurological status and ICU therapeutic intensity. The primary outcome measure is the six-month Glasgow Outcome Scale. Secondary outcome measures include the Disability Rating Scale, Functional Independence Measures, and the SF-36 Health Survey o to one year after TBI (to assess quality of live for survivors), the duration and frequency of elevated ICP episodes, ICE Therapeutic Intervention Severity Scores, returns to CT and the OR, and ICU and hospital LOS. We hypothesize that, while both surgical therapies will initially effectively treat intracranial hypertension, the hemicraniectomy group will experience improved neurological outcome, and a reduced intensity of cre to control ICP. These data will prepare us for a full-scale multi-center outcome study of early hemicraniectomy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ECONOMIC IMPACT OF INJURY/ILLNESS IN CAREER ROOFERS Principal Investigator & Institution: Welch, Laura S.; Professor; Medstar Research Institute Hyattsville, Md 20783 Timing: Fiscal Year 2002; Project Start 30-SEP-2001; Project End 31-JAN-2003 Summary: We aim to provide a credible measure of the amount of disability, disability retirement, early retirement, and job change caused by injury, illness, and musculoskeletal disease among roofers. We will use standard well-developed survey instruments and techniques to survey union construction workers as they leave their trade and one year later. We will determine the reason for leaving, the nature of injury or illness if present, functional limitations at the time of leaving the trade and again after one year, and the social and economic consequences of that decision. This study will focus on three groups of roofers: (1) those who leave the trade before retiring, at any time in their careers; (2) and those who take early retirement; and (3) those who apply for disability retirement. We will also interview a comparable group of roofers who continue to work for each of these three groups. Specifically we will: (1) Determine what proportion of roofers leave the union before retirement age or retire early, or apply for disability retirement because of work-related injury, work-related disease, or a chronic medical condition. (2) Determine what proportion of roofers who continue to work in the trade have chronic symptoms from a work-related injury, have a work-related disease, or have a chronic medical condition. (3) Describe the social and economic impact of work-related injury and illness or premature retirement due to a medical condition for each of these groups. (4) Evaluate change in measures of social and economic impact over time in the roofers who drop out of the union and those who retire early or on disability. (5) Assess and describe the impact of work-related conditions and aging on the ability of roofers to remain employed in their trade. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EFFECTS METABOLISM
OF
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Principal Investigator & Institution: Toth, Michael J.; Assistant Professor; Medicine; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2008 Summary: (provided by applicant): Aging is associated with increased risk for heart disease, diabetes and physical disability. In women, the incidence of these age-related conditions increases dramatically after menopause. This has led to the hypothesis that ovarian hormone deficiency contributes to these adverse health outcomes. However, the effect of ovarian hormone deficiency, per se, on risk factors for disease and disability has not been clearly defined. Thus, the primary goal of the proposed studies is to characterize the effect of ovarian hormone deficiency on glucose, insulin, fat and protein metabolism. Our overall hypothesis is that ovarian hormone deficiency alters substrate turnover and utilization in a manner that increases the risk for developing chronic disease and disability. Specifically, alterations in glucose, insulin and fat metabolism increase the risk for developing heart disease and diabetes and changes in protein metabolism reduce lean tissue mass which, in turn, promotes disability. To address our hypothesis, we will measure substrate metabolism using stable isotope tracer methodology in healthy, premenopausal women before and after pharmacological ovarian suppression. Women will be randomized to receive the gonadotropin-releasing hormone agonist leuprolide acetate or placebo. Measurements of substrate metabolism will be performed during both the follicular and luteal phases of the menstrual cycle prior to treatment and 2 months after the initiation of treatment. This experimental paradigm will enable us to investigate the effect of ovarian hormone deficiency, per se, on substrate metabolism without the confounding factors present in prior crosssectional, longitudinal and hormone replacement studies. This application consists of 3 separate experiments that will employ this model of ovarian suppression. Experiment I will investigate the effect of ovarian hormone deficiency on the glucose and insulin response to hyperglycemia. Experiment 2 will examine the role of ovarian hormone deficiency in the regulation of whole-body lipolysis under postabsorptive and epinephrine-stimulated conditions. Experiment 3 will examine the effect of ovarian hormone deficiency on whole-body protein metabolism under postabsorptive and simulated-postprandial conditions. Our findings will have direct relevance to understanding the fundamental role of ovarian hormone deficiency in the physiologic and metabolic changes that occur with menopause. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ENHANCING OUTCOME MEASURES IN A MODEL SYSTEMS DATABASE Principal Investigator & Institution: Bode, Rita K.; Rehabilitation Institute Research Corp Research Corporation Chicago, Il 60611 Timing: Fiscal Year 2002; Project Start 12-APR-2001; Project End 31-MAR-2004 Summary: (provided by applicant): The purpose of this project is to develop reliable and valid measures of impairment, activities, and participation for use in clinical practice and research. Existing instruments that measure these aspects of disablement are collected routinely in a variety of settings, but have not been evaluated rigorously with contemporary measurement methodology. Existing information from the Model Spinal Cord Injury (SCI) Systems national database will be used to evaluate the measurement characteristics of several instruments, increase our understanding of the recovery
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process, and improve the clinical utility of this information. The aims of this methodologic project are to: (1) evaluate the quality of measures that can be derived from a national database, and (2) produce accurate and precise outcome measures that can be used in subsequent research in which hypotheses can be appropriately tested. The research activities will consist of a series of secondary analyses of data for existing instruments that will address the shortcomings of composite raw scores through the use of state-of-the-art measurement methodology. Data for approximately 5000 cases collected by 18 Model SCI Systems sites will be used for the instrument calibration. Instruments measuring the original components of the World Health Organization model (impairment, disability and handicap) are included in the Model SCI System database. Records from the database will be stripped of patient identifiers and, when transferred to the applicant, will be reformatted into ASCII files in preparation for analyses. The Rasch measurement model will be applied in the proposed analysis (Rasch, 1960) using rating scale analysis (Wright & Masters, 1982) conducted with WINSTEPS (Linacre & Wright, 2000), a Rasch computer program. Completion of the project will provide fine-tuned measures for use in clinical trials and practice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EYE DISEASE, DISABILITY AND MORTALITY RISK IN US ADULTS Principal Investigator & Institution: Lee, David J.; Assistant Professor; Epidemiology and Public Health; University of Miami-Medical Box 248293 Coral Gables, Fl 33124 Timing: Fiscal Year 2002; Project Start 01-FEB-2001; Project End 31-JAN-2004 Summary: (Applicant's Abstract) Visual impairment (VI) and disabling eye diseases in adults can lead to serious consequences, including social isolation, cognitive impairment, impaired functional status, increased motor vehicle accident risk, risk of falls and fractures, and mortality. Unfortunately, the epidemiology of vision disorders in adults remains poorly characterized in subgroups such as minorities and those residing in lower socioeconomic strata (SES). The National Health Interview Survey (NHIS) is a household survey of the US civilian population conducted annually by the National Center for Health Statistics (NCHS). From 1986-94, demographic, health, VI and eye disease data have been collected on over 121,000 US adults. Recently, NCHS conducted a mortality follow-up for all individuals participating in the 1986-94 NHIS surveys. Using this uniquely representative and large database the Investigators will: 1) estimate the prevalence and degree of self-reported VI and selected eye diseases in adults by age, gender, ethnicity, SES, and geographic region; 2) compare trends over time in the prevalence of VI and selected eye diseases in different sociodemographic subgroups; 3) estimate the number of adults currently residing in the US with VI and selected eye diseases by these subgroups; 4) project estimated changes in the number of Americans with these conditions to the year 2020; 5) evaluate the health and disability status of adults with and without VI and selected eye diseases and determine if these associations vary in different sociodemographic subgroups; and 6) calculate and compare the overall and cause specific mortality rates for adults with and without VI and selected eye diseases. This study will address three NEI research priorities outlined in Vision Research, "A National Plan 1999-2003": 1) ascertain the prevalence (and incidence) of VI and visual disability in the US and identify subpopulations at heightened risk for VI and disability; 2) determine the number of Americans with eye disease and VI and measure the impact on medical costs and costs to society associated with these conditions; and 3) improve our understanding of the nature and course of glaucoma, incorporating studies of co-morbidity, natural history, and genetics, with special emphasis on Hispanic, Native American, and African-American populations.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FOOT DISORDERS, PAIN AND PHYSICAL DISABILITY IN ELDERS Principal Investigator & Institution: Hannan, Marian T.; Senior Research Associate; Hebrew Rehabilitation Center for Aged 1200 Centre St, Roslindale Boston, Ma 02131 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-MAR-2007 Summary: (provided by applicant): Foot problems are thought to be common in older persons, yet very little population-based information exists on the prevalence of foot disorders, and the influence of foot disorders on physical limitations and functional disability. We propose to examine the role of foot disorders and foot pain in lower extremity limitations and disability in the population based Framingham Study. We will link a comprehensive assessment of foot disorders and foot pain to functional measures, such as performance measures and walking ability. Our aims are: (1) to establish the prevalence of foot disorders and foot pain in men and women across a wide age spectrum in a population-based group, the Original Framingham Cohort and the Framingham Offspring Cohort; (2) to examine whether foot disorders and foot pain are related to lower extremity physical limitations, and further, to examine whether individuals ascribe physical limitations to foot disorders in this cross-sectional study; and (3) to evaluate whether foot disorders are associated with physical disability, and whether the rate of disability in those with foot disorders is similar to those with other lower extremity disorders, such as knee osteoarthritis. Most studies examining foot pain have focused solely on clinical patients instead of community subjects, and few have examined specific limitations attributed to foot pain in the community. In addition to extensive data on confounders, the Framingham cohort has verified medical diagnoses available to evaluate the impact of comorbidities. While foot disorders and foot pain will be evaluated as part of this grant, functional limitations and disability are part of routine evaluations of Framingham cohort members. This study will provide essential information on prevalence estimates of foot disorders and location of foot pain, and how these may relate to functional limitations and disability, perhaps allowing insight into preventive actions. Further, this study will advance current knowledge in a timely and cost-effective manner, requiring no time for patient recruitment and limited further data collection. Finally, this study may provide new public health information of the importance of attribution of functional morbidity in populations and the impact of foot disorders upon lower extremity disability. A greater understanding of foot disorders and pain may lead to better understanding of the prevention of mobility limitations and disability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FUNCTIONAL AND HEALTH CHANGES OF THE ELDERLY Principal Investigator & Institution: Manton, Kenneth G.; Center for Demographic Studies; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 01-JUL-1987; Project End 31-MAR-2003 Summary: This application seeks five years of funding to collect, analyze, and disseminate data for a fifth wave of the National Long-Term Care Survey (NLTCS) intended for 1999. The wave is planned to include 5,971 detailed non-institutionalized interviews and 1,484 detailed institutionalized interviews, along with 11,038 additional screening interviews and 707 non-interviews, amounting to 19,245 subjects in total. All subjects from previous waves identified as still living and residing in the United Sates (estimated at 3,967) will be interviewed to maintain the longitudinal sample originating
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in 1982 and augmented in 1984, 1989, and 1995. New sample members will be drawn from people passing the age-65 boundary between 1994 and 1999, along with people newly screened for chronic disability or newly selected to maintain representativeness of a healthy subsample. A new subsample of 600 persons over age 95 will be drawn from Medicare records. The data collection, as in previous waves, will be accomplished through a subcontract with the U.S. Census Bureau. The new NLTCS wave will maintain comparability of questions measuring chronic disability, Alzheimer's disease and related dementias and care and service utilization, so that trends in disability, active life expectancy, and mortality can be estimated by age and cohort over an 18-yearlong time stretch from the start of 1982 to the end of 1999. Data from all waves will be linked to each other and to Medicare Part A and Part B service use records and mortality records from 1982 through 2000, so that longitudinal analysis of service use and cost can be conducted. Three new areas will be probed in the 1999 wave. First is the relation between nutrition, disability, and cognitive function through a short food frequency assessment. Second is the prevalence of the APO-E genetic polymorphisms recently shown to be associated with risk of Alzheimer's Disease as well as circulatory diseases; this genetic information will be collected for an age-stratified sample of 1,500 people over age 80. Third is the prevalence of polymorphisms of the WRN gene recently implicated in Werner's Syndrome and possibly affecting rates of health changes at extreme ages. The biological samples will be obtained using a non-invasive cheek swab, and the genetic typing will be accomplished through a subcontract with the University of Washington for with Dr. George Martin as Principal Investigator. Planned in-house analyses include the updating of studies of temporal trends in components of disability and dementia, of costs and service utilization, and of active life expectancy up to the year 2000. Educational effects and birth-cohort effects are to be emphasized. The stochastic risk-factor models and Grade of Membership models developed by this group at Duke will be extended and applied. A public use file containing linked data from all waves of the NLTCS along with linked Medicare service use and mortality records will be prepared and electronically disseminated. According to a letter of clarification submitted subsequent to the application by the Principal Investigator and provided to reviewers, an outside users' conference and an early results conference are contemplated (presumably through a supplementary application) to facilitate widespread use of the NLTCS data. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FUNCTIONAL IMPACT OF PENS FOR 65+ CHRONIC LOW BACK PAIN Principal Investigator & Institution: Weiner, Debra K.; Medicine; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-MAY-2007 Summary: (provided by applicant): Chronic low back pain (CLBP) plagues greater than 6 million community dwelling older adults, and causes physical and psychosocial dysfunction as well as increased utilization of health care resources. While the mainstay of treatment for these individuals consists of non-opioid analgesics and physical therapy (PT), frail older adults with unrelieved symptoms have limited therapeutic alternatives. Opioid analgesics and surgical treatment may be inapplicable to those with prohibitive physical or cognitive comorbidities. Many individuals with chronic musculoskeletal pain seek out complementary and alternative treatments, although most have not been subjected to rigorous scientific investigation. Acupuncture is among the most commonly employed of these modalities. The purpose of this investigation is to explore the utility
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of percutaneous electrical nerve stimulation (PENS), a neuroanatomically guided form of electroacupuncture, as a safe non-pharmacologic analgesic alternative for the older adult with CLBP. In order to optimize physical performance and diminish disability, the value of a general conditioning and aerobic exercise (GCAE) program with and without PENS will also be studied. A randomized controlled clinical trial will be performed. Two hundred community dwelling older adults equal to or > age 65 with CLBP will receive either (1) PENS alone, (2) sham PENS alone, (3) PENS + GCAE, or (4) sham PENS + GCAE, twice a week for 6 weeks. All outcome measures will be collected pre-treatment, at the completion of the 6 weeks protocol, and 6 months later. Primary outcome measures include pain intensity (short form McGill Pain Questionnaire) and pain-related disability (Roland Disability Scale). Because chronic pain is a complex, multidimensional experience, important secondary outcome measures will also be collected that assess key aspects of (1) physical function (self-reported and performancebased), (2) psychosocial function (mood, self-efficacy, self-rated health, cognitive coping, fear, sleep), and (3) health care utilization. This study represents the first wellcontrolled, comprehensive examination of an alternative medicine intervention for CLBP in older adults. If effective, this trial could lead to improved quality of life for millions of suffering older Americans, and by diminishing pain intensity and the use of toxic analgesic regimens, lead to substantial cost savings by decreasing health care utilization. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GRANDPARENT FAMILIES IN THE 2000 CENSUS Principal Investigator & Institution: Mutchler, Jan E.; Professor; Gerontology Institute; University of Massachusetts Boston 100 Morrissey Blvd Boston, Ma 02125 Timing: Fiscal Year 2004; Project Start 01-JAN-2004; Project End 31-DEC-2005 Summary: (provided by applicant): The purpose of this study is to conduct a demographic analysis of grandparent households, focusing on differences in prevalence and characteristics of these households by race and ethnicity. As required by the 1996 Welfare Reform Act, the Census Bureau developed questions included in the 2000 Census of Population about grandparents who were responsible for their grandchildren living in the same household, allowing systematic national assessment of this issue for the first time. Based on these data, this project examines grandparent households that include no parents ("skipped-generation" households) as well as the much larger pool of grandparent households that include at least one parent ("three-generation" households). Four specific aims guide the proposed study: (1) To develop national estimates of the prevalence of grandparent households for race and national origin groups. This activity provides for the first time an assessment of the extent to which this behavior is occurring broadly across racial groups or, instead, concentrated in a few racial groups. (2) To profile the key household characteristics and resources within each type of grandparent household. This study examines the resource base and household characteristics of three-generation families, and the variation across race/ethnic groups in those features. In addition to financial resources, characteristics relating to disability status, labor force activity, immigration status and citizenship, and English proficiency are profiled. (3) To evaluate the resource balance of the oldest and middle generations within three-generation households. The resource balance is compared for households in which the grandparent reports responsibility for the child, and those in which the grandparent does not report such responsibility. The study provides evidence on how differences in the characteristics of the parents and of the grandparents (e.g., differences in work status, low income, disability) are related to the demographic features of the
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household and the characterization of responsibility for children. (4) To make available micro data files including data for grandparent families. Dissemination of the data to a wide range of researchers in the academic and policy communities will further advance the understanding of grandparent families. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HEALTH AND CARE TRAJECTORIES OF OLDER DISABLED AMERICANS Principal Investigator & Institution: Freedman, Vicki A.; Polisher Research Institute 1425 Horsham Rd North Wales, Pa 19454 Timing: Fiscal Year 2002; Project Start 01-FEB-1998; Project End 31-JUL-2003 Summary: Currently over 5 million older Americans require care for chronic disability. The cost of providing long-term care to these Americans currently amounts to over one hundred billion dollars per year. In light of impending growth in the number of older disabled Americans and the current deficit-reduction climate, policy makers now face important questions about how to best restrain growth in public spending for long-term care. Because costs are driven by families decisions about the intensity, structure and balance of arrangements over time, policy makers seeking to control costs require a basic understanding of how families choose care arrangements in response to health declines and improvements of older family members. Yet surprisingly few studies have investigated basic questions about the relationship between health and care trajectories of older disabled Americans over time. The goal of this FIRST award is to understand the dynamic process driving long- term care decisions, particularly the ways in which older persons and their families respond over time to changes in the health of older family members. Using a dynamic, interdisciplinary framework, two overarching research questions will be explored: 1) How do older disabled Americans and their families shift care arrangements in response to various health trajectories and what are the critical junctures in the health progression of older disabled Americans when families shift the intensity and structure of care? And 2) How do various health trajectories affect the balance of informal and formal care over time? That is, under what circumstances do changes in health lead to the displacement of formal care over time? That is, under what circumstances do changes in health lead to the displacement of formal for informal care over time and what is the magnitude of that displacement? To address these issues, the project will use multiple waves from two relatively new nationally representative panel survey: the Study of Asset and Health Dynamics of the Oldest Old (AHEAD) and the Medicare Current Beneficiary Survey (MCBS). Answers to these questions will provide critical information on the underlying process by which older disabled persons and their families cope with disability over time. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HEALTH AND SOCIOECONOMIC CONSEQUENCES OF NSBRI Principal Investigator & Institution: Redlich, Carrie A.; Associate Professor of Medicine; Internal Medicine; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: The primary goal of this revised RO1 application is to determine the health and socioeconomic consequences of nonspecific building-related illness (NSBRI) (or sick building syndome) in workers diagnosed with this prevalent disorder. More than half of the U.S. workforce is now employed in indoor nonindustrial environments. Various
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symptoms and illnesses have increasingly been reported in such nonindustrial indoor environments. NSBRI refers to a common nonspecific disorder which is usually associated with a particular building. Although objective physiologic abnormalities are generally not noted, NSBRI can be extremely unpleasant and an important cause of disability and lost work time. Despite this, NSBRI has received scant scientific attention from a clinical and economic perspective. Little progress has been made in establishing: 1) diagnostic criteria, 2) the natural history or clinical course of NSBRI, 3) the social and economic consequences of this common and important occupational health problem, or 4) the predictors of adverse outcomes. Our Specific Aims are: Aim 1 A) Identify and classify NSBRI cases using several different case definitions of NSBRI. Aim 1 B) Determine associations between the different case definitions and the various outcome variables. Aim 2 A) Characterize the natural history of NSBRI following diagnosis. Aim 2 B) Determine which host factors (i.e. age, marital status, initial symptoms) and workplace factors (i.e. job stress, work environment) are associated with disease progression and severity. Aim 3 A) Determine the effect of NSBRI on socioeconomic outcomes (i.e. work-disability, employment status, financial status). Aim 3 B) Determine which host factors and workplace factors are associated with more adverse socioeconomic outcomes. The overall study design will be a retrospective longitudinal follow-up study of 75 patients diagnosed with NSBRI at the YOEMP Clinic from 1994 to 1999. A similar group of 75 musculoskeletal patients matched on age, gender and year of diagnosis will be used as scontrols for the socioeconomic analysis. Phone interviews will assess symptoms, general health, functional status, disability, stress, and socioeconomic status since diagnosis of NSBRI. This study should identify diagnostic criteria, increase our understanding of the natural history and socioeconomic consequences of NSBRI, as well as identify risk factors associated with worse outcomes. This information is critical for the development of interventions to prevent and/or ameliorate the adverse consequences of NSBRI. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HEALTH CONDITIONS OF ELDERLY PUERTO RICANS Principal Investigator & Institution: Palloni, Alberto; Professor; Sociology; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 15-JUN-2000; Project End 31-MAY-2004 Summary: (Adapted from the Applicant's Abstract): The proposed project will collect and analyze information on health conditions, living arrangements, transfers, and access to and use of health care among older adults (aged 60+) in Puerto Rico. We propose an island-wide, cross-sectional sample survey of target individuals and their surviving spouses or partners. The baseline survey will be complemented by (a) a single follow-up to take place two years after the baseline survey; (b) record linkages with Medicare and other insurance providers;(c) record linkage with certificates of decedents who die between in the inter-wave period; and, (d) a sample of targets' siblings for the analysis of paired survival times. The data the investigators propose to collect can be used to addresses the following goals: (i) to describe health conditions of adults 60+ in general, and of those 80+ in particular, with regard to self-reported health conditions, physical and mental impairment, and functional disability; (ii) to assess the effects of socioeconomic conditions and migration histories on health status, physical and mental impairment, functional disability, rates of institutionalization and mortality risks; (iii) to assess relations between self-reported chronic conditions, functional disability, mortality and institutionalization, and background conditions, including migration experience. (iv) to assess relations between individuals' history of illness, behavioral
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risks, and shared environments, on the one hand, and chronic diseases, disability, mortality and institutionalization, on the other; (v) to identify risk profiles based on functional limitations, self-reported conditions, and risky behavior and use them as inputs for short-term forecasting of age-patterns of morbidity, disability, and mortality, (vi) to evaluate elderly's access to and use of health care services, including those supplied outside the formal medical establishment; (vii) to investigate the sources, magnitude and direction of intergenerational support, as well as the activity of kin networks, as a function of elderly' health status; (ix) to establish comparisons with information about Puerto Ricans in the US and other Hispanics and, with proper modeling techniques based on spouse and siblings data, to obtain robust estimates of effects of socioeconomic effects and migration experience. This will help to shed light on the seemingly favorable health conditions of Hispanics living in the US (NRC1997). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HEALTH ECONOMICS & RHEUMATOLOGY INTERNATIONAL CONFERENCE Principal Investigator & Institution: Gabriel, Sherine E.; Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2003 Summary: The past decade has witnessed remarkable advances in the field of Rheumatology with the introduction of several novel treatments for Rheumatoid Arthritis and other rheumatic diseases. Although many of these agents are quite costly, they may have major long-term benefits, especially slowing disease progression and preventing disability. In our current healthcare fiscal environment, proof of benefit alone is no longer sufficient, we must also demonstrate that the expected benefits of a new agent are worth the costs of that agent. This can only be shown by formal economic evaluation, a group of analytic methods that allow us to quantify and compare the benefits (such as prevented disability, improved quality of life, etc) and the costs of medical interventions. Unfortunately, the science of economic evaluation in Rheumatology is not adequately developed to convincingly demonstrate the costefficiency of such therapies. There are a number of reasons for this, including the continuing controversy regarding defining meaningful clinical outcomes, identifying optimal sources of effectiveness and utility estimates, determining the role of mathematical modeling, choosing the appropriate comparator for a particular analysis, and measuring and incorporating compliance and toxicity. The aims of this international, interdisciplinary conference are to review the current state of the science and outline and methodological research agenda to identify the data needed to advance the science of economic evaluation in Rheumatology. This conference will also serve to promote collaboration between clinicians, policy makers, pharmaceutical industry scientists, health economists, and statisticians. We believe that such collaboration will expedite and enhance both the product of the methodological research itself and, subsequently, the transfer of the results into policy and practice. The meeting format will include plenary sessions by invited speakers, followed by small working sessions where attendees will discuss available data and will be charged with proposing recommendations for research agenda to improve the validity and credibility of current approaches. The proceedings of the conference will be published in the Journal of Rheumatology and disseminated through a series of oral presentations in several countries designed to raise awareness of the issue and encourage the research and collaboration needed to successfully complete this research agenda. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IMPACT OF TERMINATING SUBSTANCE ABUSE DISABILITY BENEFIT Principal Investigator & Institution: Orwin, Robert G.; Senior Study Director; Westat, Inc. 1650 Research Blvd Rockville, Md 208503195 Timing: Fiscal Year 2001; Project Start 01-JUN-2000; Project End 31-MAY-2004 Summary: Effective Jan. 1, 1997, the Contract with America Advancement Act (PL 104121) terminated the Social Security Administration's Disability Insurance (DI) and Supplemental Security Income (SSI) benefits for persons diagnosed with drug or alcohol addiction, also known as DA and A recipients. The law ended Medicaid eligibility as well, leading to many chronic substance abuse patients losing Medicaid reimbursement for addiction treatment and general health care needs. The legislation raised two sets of interrelated concerns. The first was for the well-being of the substance abusers who lost their mandate for treatment, insurance for treatment, insurance for general health care, monthly income, and their relationships with their representative payees. The second was for the larger effects on others in society. Several studies have been conducted or are currently in progress that address the issue of how the benefits termination affected recipients. However, no rigorous evaluation of the net impact of the law using actual resource utilization and labor force participation data has yet been attempted. The proposed study fills that gap with a quasi-experimental evaluation of the economic impact of the policy change in Washington State. Using records extracted and recombined from existing datasets, the analytic methodology combines an enhanced interrupted time series analysis with 1) recent developments in the multilevel random regression modeling of longitudinal outcome data, and 2) contemporary economic valuation methods for resource utilization and productivity. Specific aims are: 1. Estimate the net impact of the law on service utilization and labor force participation among the DA and A population as a whole and its component subgroups. Service utilization data will include mental health services, general medical services, substance abuse services, use of the criminal justice system, and cash benefits. Subgroups will include former benefit classification (SSI, DI, or both), urban v. rural, age, gender, education, ethnicity, criminal justice background, previous employment history, substance abuse diagnosis, substance abuse treatment history, psychiatric comorbidity, medical comorbidity, and SSI/DI requalification status. 2. Based on the findings from Aim 1, estimate the economic impact of the benefits termination on federal, state and local government resources, for the population as a whole and subgroups. This will be accomplished through the use of cost data from Washington State and current economic valuation models that assign unit cost estimates to each of the resource utilization and productivity activities that were modeled in Aim 1. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: LIMB LOADING AND WEIGHT TRANSFER DURING STROKE RECOVERY Principal Investigator & Institution: Mercer, Vicki S.; Allied Health Sciences; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2005 Summary: (provided by applicant): Impairments in bearing weight on or "loading" the paretic lower extremity and in transferring weight from one lower extremity to the other are common after stroke. These impairments may make it difficult for stroke survivors to perform daily activities and to fulfill their roles as members of their families and communities. Even mild residual motor impairments may have a major impact on
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quality of life. The long-range goal of this research is to understand how impairments in paretic lower extremity loading and weight transfer abilities relate to functional limitation and disability in various subgroups of individuals with stroke. If problems with loading and weight transfer are found to play a major role in functional limitation and disability, then a second long-term objective will be to identify interventions that are effective in improving these abilities for individuals in each subgroup. The specific aims of this application are to (1) use laboratory measures to identify valid clinical tests of impairments in loading and weight transfer; (2) determine the relationship between measures of loading and weight transfer abilities and measures of functional limitation and disability during recovery from mild to moderate stroke; (3) identify differences in post-stroke trajectories of loading and weight transfer based on initial level of impairment; and (4) relate changes in clinical and laboratory measures of loading and weight transfer to changes in measures of function and disability. Participants with a unilateral hemispheric stroke who have significant lower extremity motor impairment, but are able to stand up from a chair without physical assistance, will be tested at monthly intervals from 1 to 6 months post-stroke. At each test session, loading and weight transfer abilities will be measured in the laboratory using a dual force platform system. A variety of clinical tests of impairment, functional limitation, and disability also will be administered. Descriptive analyses, correlational analyses, multivariate analyses, and hierarchical linear modeling will be used to explore relationships between the impairment measures and the measures of function and disability. Improved understanding of these relationships may help clinicians examine patients in a more efficient manner, provide a more accurate prognosis, and make better decisions about the appropriateness and timing of interventions directed toward improving loading and weight transfer abilities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LINGUISTIC DISABILITY/HANDICAP
CONTEXT
USE
AND
HEARING
Principal Investigator & Institution: Chisolm, Theresa H.; Associate Professor; Communication Scis & Disorders; University of South Florida 4202 E Fowler Ave Tampa, Fl 33620 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 31-JUL-2004 Summary: This project is conceived as an initial step in the development of efficacious aural rehabilitation strategies for individuals with adult-onset hearing impairment. As a result of this impairment individuals experience difficulty communicating, thus there are known reductions on self-perceived hearing-related quality of life. While communication performance and hearing- related quality of life improvements can be obtained through the use of hearing aids, their use is not a panacea. Aural rehabilitation therapy is designed to help individuals for whom hearing aid use alone is not sufficient to overcome the communicative, social, and psychological impact of adult-onset hearing impairment. Thus the goals of aural rehabilitation therapy are twofold: 1) alleviate the communication difficulties (i.e., the hearing disability); and, 2) reduce the psycho-social sequelae (i.e., the hearing handicap) that often accompany the impairment. While aural rehabilitation approaches evaluated to date appear efficacious when group performance is examined, individual subject variability is found in response to treatment. This suggests the need to examine how factors that may be amenable to treatment are related to hearing disability and/or hearing handicap. Training on factors which contribute significantly to hearing disability and/or hearing handicap would warrant further investigation. Thus the present study is designed to examine the relationship between
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one cognitive- linguistic variable that may be amenable to treatment, and the selfperception of hearing disability and/or hearing handicap. This is the ability to use linguistic constraints in the speech recognition process. To examine, in the main experiment, the unique contribution of this factor to hearing disability and/or hearing handicap, the regression model will also include data on known significant audiometric and demographic correlates, as well as data on self-perceived benefit from the use of hearing aids. Prior to initiating the main experiment, however, it is necessary to examine an underlying assumption of the mathematical model, based on probability theory, that will be used to quantify linguistic constraint use. Results will not only have important clinical implications, but will also increase our understanding of the use of probability theory as a model for the speech recognition process. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LONGITUDINAL TWIN STUDY OF READING DISABILITY Principal Investigator & Institution: Wadsworth, Sally J.; Inst of Behavioral Genetics; University of Colorado at Boulder Boulder, Co 80309 Timing: Fiscal Year 2002; Project Start 15-FEB-2002; Project End 31-JAN-2007 Summary: (provided by applicant): The proposed project will initiate the first longitudinal twin study of reading disability and conduct novel analyses of the genetic and environmental etiologies of stability and change in reading difficulties. To accomplish these objectives, an extensive psychometric test battery, as well as behavioral questionnaires and interviews, will be administered to a sample of 50 pairs of identical twins and 50 pairs of fraternal twins in which at least one member of each pair is reading disabled, to their siblings, and to a comparison sample of 50 pairs of identical twins and 50 pairs of fraternal twins with no history of reading deficits, all of whom previously participated in the Colorado Learning Disabilities Research Center CLDRC). Resulting data will be analyzed in conjunction with data previously collected in the CLDRC to provide the first longitudinal assessment of the genetic and environmental etiologies of reading deficits and subtypes of reading disability at two ages, as well as their longitudinal stability and comorbidity with ADHD. These data will also be used to test novel hypotheses about the longitudinal covariation of reading difficulties with measures of other psychopathology, reading, language and perceptual processes and specific cognitive abilities. Univariate and bivariate QTL analyses of reading deficits and ADHD, reading component processes and other psychopathology will also be conducted. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MAJOR DEPRESSION FOLLOWING MINOR INJURY Principal Investigator & Institution: Richmond, Therese S.; None; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (provided by applicant): The cost of injury is considerable, estimated at $260 billion for fiscal year 1995. The primary costs are morbidity costs -- the value of goods and services not produced because of injury. Preliminary findings indicate that psychological distress is a significant predictor of post-injury disability and that symptoms of depression often accompany injury, appearing out of proportion to the severity of physical injury. The purpose of this study is to follow up on these findings, and in particular, to examine the public health impact of the development of major depression following minor injury. The majority of all injuries are minor, defined as
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injuries of sufficient import that individuals seek urgent medical care in an emergency department, but which do not threaten loss of life or limb. The primary aims of this study are to: determine the frequency of major depression (& related mood disorders) following minor physical injury; and determine the extent to which developing major depression (& related mood disorders) contribute to increased disability and reduced quality of life following minor physical injury. The secondary aims are to: compare the effect of developing depression and related psychiatric disorders (anxiety & stressrelated disorders) on outcomes following minor physical injury; and describe the onset and course of developing depression and related psychiatric disorders in the year following minor physical injury. 250 patients presenting to the emergency department at the Hospital of the University of Pennsylvania with minor injury will be enrolled. Minor injury will be defined by the Injury Severity Score for anatomic severity and the triageRevised Trauma Score for physiologic severity. Intake information includes injury data, pre-injury disability and quality of life. A comprehensive, structured psychiatric diagnostic evaluation will be conducted 72 hours after the minor injury has occurred, documenting psychiatric baseline (excluding patients with existing depression at time of injury or major DSM IV Axis I psychotic disorders). Participants will be followed by systematic, longitudinal follow-up evaluations (3, 6, & 12 months) to determine the development of major depression and its effect on post-injury disability and quality of life. The quasi-experimental design, in which each participant serves as his/her own control, will enable an accurate and comprehensive profile of developing major depression (and related mood disorders) following minor injury. Further, this design, using comprehensive psychiatric evaluation, will allow a critical analysis of the influence of major depression and related psychiatric disorders on outcomes following minor injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MANAGEMENT OF CHRONIC PAIN IN REHABILITATION MEDICINE Principal Investigator & Institution: Jensen, Mark P.; Professor; Rehabilitation Medicine; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 25-AUG-1996; Project End 31-MAY-2007 Summary: (provided by applicant): This application requests continuation of the program project entitled "Management of Chronic Pain In Rehabilitation." The overall goal is to conduct multidisciplinary research aimed at understanding the nature, development, course, and appropriate care of chronic pain as a secondary condition in persons with disabilities. The project will continue to focus on using survey research to understand the frequency and severity of pain in persons with disabilities, and to continue testing the efficacy of treatments designed to decrease pain and its impact. Project by Jensen will survey 3,730 adults and children with disabilities to: (1) further our understanding of pain as a secondary condition in persons with disabilities, (2) perform a prospective, longitudinal study to clarify the natural course of pain in adults and children with disabilities, and (3) further develop a biopsychosocial model of chronic pain as it applies to persons with disabilities. Project by Ehde will evaluate the efficacy of cognitive restructuring, relative to an education/attention control condition, in the management of chronic pain in persons with disabilities, and determine the causal impact of pain cognitions (specifically, catastrophizing cognitions) on functioning in persons with disability-related chronic pain. Project by Engel includes a randomized clinical trial and a series of single-subject studies designed to test the efficacy of relaxation training for reducing pain in youth with disability-related pain, and to test
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three hypothesized mechanisms for the efficacy of relaxation training for reducing pain in youth. A Scientific Core will provide scientific direction, project coordination, data collection and management, statistical support, and shared scientific expertise. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MEASUREMENT & PREDICTION OF EVERYDAY FUNCTION DEMENTIA Principal Investigator & Institution: Tomaszewski-Farias, Sarah; Neurology; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 95616 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): This five-year career development plan is designed to further refine the candidate's research skills, enabling her to become an independent and productive researcher focused on the assessment of everyday functional impairments in older adults. The training plan emphasizes three content areas: 1) test development of ecologically valid measures for use with older adults; 2) the integration of structural imaging techniques into neuropsychological research; and 3) research design and statistical analysis. Learning objectives will be met utilizing several training modalities: a) regularly scheduled structured meetings with Sponsors, Mentors, and Consultants; b) formal coursework; c) attendance at regular on-site research colloquia and annual scientific conferences; and d) direct research experience. The aim of this project is to develop a method of conceptualizing and measuring everyday function that is: 1) grounded in neuroanatomy and neuropsychology, 2) sensitive to a wide spectrum of functional change and; 3) useful in understanding how a multitude of factors can contribute to, and/or mediate everyday function. Study participants will include individuals diagnosed with mild cognitive impairment or dementia, and a sample of cognitively normal older adults. The proposed model of the functional changes associated with dementia has been adapted from the classification system set forth by the World Health Organization (WHO), [96] which describe the consequence of disease at three levels: impairment, disability, and handicap. These levels can be hierarchically arranged wherein 'impairments' (observable, externalized neurological manifestations of disease) are precursors to 'disability' (declines in the ability to carry out activities essential to normal life), which in turn is a precursor to 'handicap' (the social consequence of disease). In this project, all three levels of functional change will be assessed, with a particularly emphasis on assessing functional change at the level of impairment in order to increase the sensitivity to early functional changes associated with the preclinical and early stages of dementia. A new scale will be developed to assess functional impairments, which organizes these impairments into neuropsychologically and neuroanatomically-relevant domains. Measures of disability and preliminary assessment of handicap will also be included to examine the relationship between the different levels functional change set forth in the model. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MENTAL DISORDERS, PRIVATE INSURANCE, AND SSDI BENEFITS Principal Investigator & Institution: Salkever, David S.; Professor; Health Policy and Management; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2004 Summary: This project will specify and estimate econometric models of transitions from private, long-term disability (LTD) benefits to Social Security Disability insurance
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(SSDI) benefits by employees who are on LTD as a result of a mental disorder. Using data from individual LTD claims, the probability of transitioning to SSDI benefits will be modeled as function of: 1) individual employee, employer, and disability characteristics; 2) LTD policy provisions; 3) mental health coverage provided by the employer; 4) availability of mental health treatment resources; 5) employers' disability management efforts; and 6) interstate differences in availability of SSDI and other compensation programs. Data on SSDI costs will also be aggregated over individual claims to the employer-year level for estimating models of SSDI costs per employee (covered by LTD insurance) per year. Data for the project will pertain to approximately 1,400 employers and their 500,00 employees covered by LTD insurance. Administrative data, claims data, data from public sources, and survey data on 278 of these 1,400 employers will be analyzed. Econometric methods will include hazard (duration) regressions as well as multiple hazard models (where return to work and transition to SSDI benefits are the competing risks). Estimation of employer-level costs will use the methods for modeling health expenditures recently proposed by Manning and Mullahy. Several approaches for estimation with missing data will also be tested as strategies for combining our employer survey data with information for all 1,400 employers in the study. The empirical estimates obtained in the study will provide information on the possible implications of changes in mental health benefits and changes in benefit and compensation programs for the continuing rapid rise in SSDI costs for beneficiaries with mental disorders. Estimates will be derived of the impacts, on SSDI receipt and costs, or increased managed care/carve-out coverage, of increased geographic availability of mental health specialty care, and of employers' disability management efforts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MULTIPURPOSE ARTHRITIS & MUSCULOSKELETAL DISEASES CENTER Principal Investigator & Institution: Brandt, Kenneth D.; Professor; Medicine; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2000; Project Start 15-SEP-1977; Project End 31-MAR-2004 Summary: The Indiana University Multipurpose Arthritis and Musculoskeletal Diseases Center (IUMAMDC) consists of a Biomedical Research Component, an Epidemiology/Education/Health Services Research (EEHSR) Component and an Administration Unit. Major biomedical research interests include the pathogenesis and treatment of osteoarthritis (OA), the causes of pain and disability in OA, and amyloidosis. Four new Developmental and Feasibility Studies are proposed in this application: one examines the reproducibility of radiographic measurement of joint space width [an issue of great relevance to the design of clinical trials of diseasemodifying OA drugs (DMOADs)]; the second examines the role of arthrogenous muscle inhibition (AMI) as a cause of quadriceps weakness and a risk factor for disability, knee pain and muscle atrophy in subjects with knee OA; the third examines the use and (misuse) of magnetic resonance imaging by primary care physicians evaluating patients with low back pain; the fourth relates to inflammatory arthritis and probes the role of the receptor for platelet activating factor in cellular responses. Our EEHSR component is concerned with training of Fellows, house staff, medical students and arthritis health professionals (AHPs) and includes outreach programs and a variety of interactions with community organizations. Four new EEHSR projects are proposed, 3 of which relate to OA: the first compares the rate of tibiofemoral joint space narrowing among various subsets of subjects representing likely target populations for clinical trials of DMOADs;
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the second, a prospective study of patients with knee OA treated by primary care physicians in a managed care setting, compares outcomes achieved with standard care to those inpatients treated with a comprehensive program of nonpharmocologic and pharmacologic measures, graduated with respect to risk of side effects, cost and convenience. The third project builds on our observation during the current funding period that quadriceps weakness is common in community-based subjects with knee OA even in the absence of joint pain; it examines the effects of lower extremity strength training on the progression of knee pain, functional impairment and radiographic changes in the elderly. The fourth project examines the clinical and economic effects of a psychosocial intervention inpatients with recurrent acute low back pain. To support the research activities of IUMAMDC, 2 Core units are proposed: Biostatistics and Data Acquisition. Overall Center activities are supported by an Administration Unit. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROIMAGING OF THE CEREBRAL NETWORKS ENGAGED IN MATHEMATICAL PROCESSING Principal Investigator & Institution: Gore, John C.; Professor; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2003; Project Start 26-SEP-2003; Project End 31-JUL-2008 Summary: The overall aim of this project is to use state-of-the-art high field (3T) functional magnetic resonance imaging (fMRI) to identify and assess the neural circuits involved in various types of mathematical processing in third grade children studied in Project 1 (Cognition, and to evaluate quantitatively the effects on brain function of specific interventions developed in Project 2 (Intervention). These studies would be performed in well characterized groups of third graders with difficulties only in math (MD), both math and reading (MD-RD), only reading difficulties (RD), and normal controls. In addition, we will use high resolution MR imaging to measure morphological differences, and diffusion tensor imaging to assess structural differences in white matter tracts, among these groups. Previous fMRI studies in adults have demonstrated that different types of mathematical processing engage specific neural regions. The intraparietal area bilaterally has been found to activate in number processing and it has been proposed that this region encodes numerical quantity in a non-verbal semantic fashion. Retrieval of this representation of quantity becomes automatic with normal development. In addition, intraparietal cortex is activated for approximation tasks in which estimates are based on distances between different quantities. It is hypothesized that different mathematical abilities will show different recruitment patterns of these various areas, and that specific disabilities will manifest themselves as abnormal patterns of activation. Based on studies with other types of disabilities, we expect the activation within these regions will correlate with mathematical skill and will therefore show changes with positive effects of interventions. These hypotheses will be tested by imaging children with both normal and impaired mathematical skills, with and without associated reading problems. We will quantitatively describe the patterns of brain activation associated with different levels of performance in exact calculation (fact retrieval) tasks and estimation tasks, in children with mathematical disability (MD), reading disability (RD), co-occurring MD-RD, and normal controls, and correlate fMRI data with behavioral data collected in Project 1 (Cognition). We will also quantitatively evaluate regional changes in brain activation following each of two different types of intervention: treatments that systematically vary fact retrieval and procedural skill instruction, and treatments that systematically vary arithmetic word problem instruction with and without fact retrieval instruction. Our overall aims are to use
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modern imaging tools to identify the recruitment patterns within the brain that correlate with mathematical ability, especially in the absence of other (reading) disabilities; to assess whether differences can be found in these neural substrates between different groups (identified by learning and skill in mathematics and reading); and to quantify the effects of different interventions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OUTCOMES AMPUTATION
FOLLOWING
LIMB
RECONSTRUCTION
VS
Principal Investigator & Institution: Mackenzie, Ellen J.; Professor and Director; Health Policy and Management; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 25-JUL-1993; Project End 31-MAR-2004 Summary: This is a proposal to continue and extend an ongoing prospective study of outcomes following high energy lower extremity trauma. The principal objectives of the Lower Extremity Assessment Project or 'LEAP' study were to (1) compare clinical and functional outcomes for those undergoing amputation versus successful reconstruction, (2) identify early clinical predictors of successful limb salvage and good functional outcomes, and (3) identify characteristics of the patient and his environment that mediate the quality of functional outcomes and quality of well being. The investigators propose to extend the followup to 5 years post-injury. Preliminary results of the 2 year follow-up indicate substantial improvement in physical function over time. However, 2 year outcomes are far from optimal. Only 50 percent of all patients are back to their major role activity; SIP scores are indicative of significant disability. Furthermore, little difference in outcomes was observed among those undergoing amputation versus reconstruction. Without longer term follow-up of these individuals, the investigators state they have an incomplete picture of recovery and expected levels of permanent impairment and disability over all patients, and by treatment. Although patients appear to have achieved a plateau in terms of clinical recovery, there is reason to believe that functional recovery may continue to improve for some patients; for others, function may deteriorate. The 5-year followup will address the following specific aims: (1) to determine the long term (5 year) outcomes and quality of life following high energy lower extremity trauma and to compare outcomes of those undergoing amputation during the initial hospitalization, amputation following discharge from the hospital, and successful reconstruction; (2) to estimate 5 year and lifetime costs associated with amputation versus reconstruction following high energy lower extremity trauma; and (3) to determine the correlates of good outcome at 5 years post injury for both amputation and reconstruction patients. In addition, they propose to extend analysis of the 2-year data to address several important clinical and methodological issues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PAINFUL HIV NEUROPATHY: TREATMENT WITH ALPHA-LIPOIC ACID Principal Investigator & Institution: Mann, John D.; Neurology; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 31-MAR-2005 Summary: (provided by applicant): HIV infection is associated with painful distal peripheral polyneuropathy in up to 35 to 50% of those without AIDS and in more than 70% of those with advanced disease. Pain is located distally in the extremities, is
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symmetrical, spontaneous, moderate to severe and associated with varying degrees of weakness and sensory loss. The pain is described as burning, pressure and shock-like with both constant and intermittent features. The condition is progressive but may be halted with disease remission. Disability is often significant, arising from the fluctuating intensity of the pain and the character of the pain itself. Peripheral nerve axons and sensory, neuron cell bodies in the dorsal root ganglia are the principal targets of the process leading to symptoms. Conventional medical treatment consists of anticonvulsants, tricyclic antidepressants, opiates and adjuvant medications, all of which have significant side effects and limited effectiveness. Alpha-lipoic acid is an eight carbon disulfide, naturally occurring in all cells of the body, which serves as a critical cofactor for key mitochondrial enzymatic reactions leading to energy production. In high concentrations it acts as an antioxidant directly, regenerates other anti-oxidants such as glutathione and vitamins C and E, and promotes glutathione synthesis. Clinical studies in using alpha-lipoic acid for painful diabetic neuropathy have shown significant benefit at daily oral doses that are well tolerated: Diabetic neuropathy shares both clinical and some pathological features with painful HIV neuropathy. The present study is designed to evaluate the effects of using daily oral supplements of alpha-lipoic acid plus standard medical care in the treatment of painful HIV-associated neuropathy over a 6 month period in subjects 18 and older. A control group will receive standard medical care plus placebo for six months. Primary endpoints include pain, use of pain medication and peripheral nerve function. Measures of current mood, depression and quality of life along with serum markers of HIV disease activity and mitochondrial function will be obtained at baseline and study termination for correlation with clinical outcomes. Possible benefits of the study to patients with HIV-associated painful neuropathy include reduction in pain and disability, reduced use of medications and enhanced cellular metabolism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PARTICIPATION OF CHILDREN WITH PHYSICAL DISABILITIES Principal Investigator & Institution: Law, Mary C.; Professor; Mc Master University Hamilton L8s 4L8, Canada Hamilton, Timing: Fiscal Year 2002; Project Start 01-JUN-2000; Project End 31-MAY-2004 Summary: (adapted from investigator's abstract): Childhood physical disability refers to intrinsic biological or acquired conditions (e.g., cerebral palsy, spina bifida, traumatic brain injury, spinal cord injury, amputation) that cause impairments which result in disability and limited participation in day-to-day activities. As children grow and develop, there are many factors within the child, his or her family and the environment that have the potential to influence participation in the everyday activities of childhood. It is difficult to plan interventions to enhance participation without knowledge about which factors are the most important in what is, undoubtedly, a complex set of relationships. The proposed project, from the Neurodevelopmental Clinical Research Unit (NCRU) at McMaster University, is a longitudinal study of children with physical disabilities aged 5- 13 years to determine the child, family and environmental factors that enhance participation in the formal and informal activities of childhood. Innovative methodologies (structural equation modeling and a cross-sequential design) will be used to evaluate the relative contribution of child, family and environmental factors in determining participation of children with long-term, non-progressive physical conditions associated with physical functional limitations in day-to-day activities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PATIENT-ORIENTED GAIT RESEARCH Principal Investigator & Institution: Kerrigan, D Casey D.; Professor & Chair; Spaulding Rehabilitation Hospital 125 Nashua St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 18-MAR-2000; Project End 31-MAR-2002 Summary: (Adapted from Applicant's Description): The objectives of this proposal are to continue and expand the principal investigator's patient- oriented research in the area of walking (gait), and to expand her role as research mentor for physical medicine and rehabilitation (PM&R) resident physicians. The goals of the on-going and planned patient-oriented research are to (1) advance gait analysis using computer simulation techniques, (2) define and validate clinically relevant quantitative gait assessment measures, and (3) evaluate the effects of certain interventions on clinically relevant quantitative gait assessment measures. Specific studies will be accomplished in the Center for Rehabilitation Science which combines state-of-the-art quantitative gait measurement technology with advanced computer modeling and simulation capabilities. Each of the ongoing and planned studies enhances the ability to evaluate and improve gait performance and/or improve or prevent secondary disease and impairment. While these studies are specific in nature, they coordinate with each other to evaluate the complex relationships between impairment, functional limitation, and gait disability. Moreover, the specific projects allow distinct opportunities for highly clinically relevant research for PM&R resident and junior attending physicians. The mentoring plan includes (1) developing an integrated research didactic block into the current curriculum, (2) holding scheduled meetings between the principal investigator and resident physicians pursuing research projects, and (3) formalizing mechanisms to nurture a requirement for PM&R resident physicians to develop and complete a research project during residency. This proposal is expected to allow the principal investigator to continue and expand her patient-oriented gait research in an environment that supports and enhances her position as a role model in research, encouraging beginning clinicians in PM&R to pursue academic careers in patientoriented rehabilitation research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PERSONS WITH MENTAL DISORDERS IN THE LABOR MARKET Principal Investigator & Institution: Baldwin, Marjorie L.; Sch of Health Admin & Policy; Arizona State University P.O. Box 873503 Tempe, Az 852873503 Timing: Fiscal Year 2003; Project Start 01-MAR-2003; Project End 31-JAN-2005 Summary: (provided by investigator): The purpose of this research is to develop and assess amodel of mental illness and work disability, with a specific focus on identifying the types of mental disorders associated with poor work outcomes, and the extent to which persons with mental disorders are subject to discrimination in the labor market. Previous research shows that discrimination contributes to the low wages and employment rates of persons with disabilities, and that the extent of discrimination is weakly correlated with the intensity of prejudice against different types of impairments. Persons with mental disorders may be subject to intense prejudice, but there are no studies of labor market discrimination specifically focused on mental illness. In part, this is because the data have not been available to support such a study. The information is now available on the MEPS and the NHIS Disability Survey, and the two data sets can be linked. The proposed project will use this rich data source to provide the first rigorous economic analysis of the impactof mental disorders on outcomes in the labor market. The specific goals of the project are: (1) To compare the relative wages and
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employment rates of persons with serious mental disorders to persons with physical impairments and non-disabled persons; and to estimate the extent to which the low wages of persons with mental disorders can be attributed to labor market discrimination. (2) To compare the health care and work loss costs of persons with different types of mental disorders and analyze the extent to which expectations regarding expenditures may explain observed wage and employment differentials. (3)To identify job characteristics that enable persons with mental disorders to participate in the labor market (e.g., occupation, health insurance coverage, part-time employment). (4) To analyze the extent to which self-reports of job-related discrimination coincide with measures of discriminatory wage and employment differentials across different types of mental disorders. The proposed project is timely because recent advances in medications for serious mental disorders now enable many persons with these illnesses to participate in the labor market. Yet discrimination may still prevent them from achieving their full potential. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PILOT STUDY--CV DYNAMICS IN FRAGILITY/DISABILITY OF ELDE Principal Investigator & Institution: Chaves, Paulo; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Healthy physiologic function is characterized by the complex interaction of multiple control systems and feedback loops that enable a subject to rapidly adapt to the internal and external stresses of everyday life. This dynamic interplay of multiple regulatory mechanisms is key to the ability to maintain internal equilibrium and good health in older adults. Cumulative declines across multiple physiologic systems and regulatory mechanisms have been hypothesized to be a major pathway to frailty in older adults. The overall goal of this project is to investigate the role of dysregulation of cardiovascular dynamics, as assessed by measures of heart rate (HR) variability and complexity, in frailty and disability, and to explore how such dysregulation may interact with other physiologically-related systems to exacerbate the risk for adverse outcomes. Specifically, we will conduct secondary data analyses using data from 525 women 3 age 65 from the Women's Health and Aging Study I, to test the following hypotheses: (1) Cross-sectionally, reduction in HR variability and complexity are independently associated with: (a) decreased exercise-tolerance, (b) impaired cardioacceleration in response to isometric and isokinetic stressors (c) frailty status, (d) and severity of disability; (2) Longitudinally, reduction in HR variability and complexity are predictive, independent of chronic diseases, of onset and progression of frailty and disability, and mortality; and (3) There are interactions between reduction in HR variability and complexity and impairment in other physiologic parameters of the cardiopulmonary system, particularly hemoglobin, FEV1, and atherosclerosis (measured by the ankle-arm index), vis-a-vis risk of frailty, disability, and mortality. Inferences will ultimately be based on regression models within the generalized linear model framework. Proportional hazards models will be used for time-to-event analysis. Interactions will be assessed through standard regression techniques, and by sequence analysis using "logic regression". Potential practical implications of this study include: (a) the identification of clinically relevant interactions between physiologic systems and threshold associations, which might lead to the development of methods to identify those at risk of frailty, and (b) development of multifactorial interventions targeting
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simultaneous impairments in multiple physiologic systems for prevention of frailty and disability in older adults. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PILOT--EFFECT OF COMORBIDITY ON PROGRESSION OF CANCER RELATED DISABILITY Principal Investigator & Institution: Chrischilles, Elizabeth A.; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2003; Project Start 29-SEP-2003; Project End 31-AUG-2008 Summary: Cancer diagnoses occur within a milieu of pre-existing and evolving comorbidity. In a population-based, three-year longitudinal survey database linked to Medicare claims (the Prevention of Secondary Conditions Study database), we have studied the inter-relationship of pre-existing co-morbidity, evolving co-morbidity (also termed "secondary conditions"), and the trajectory of functional status. The purpose of this pilot project is to determine whether individuals aging with a history of cancer have a greater progression in mobility disablement and to evaluate the extent to which this is explained by pre-existing co-morbidity and the development of secondary conditions. Primary aims focus on the long-term progression of mobility disability and quality of life among cohort members with a history of cancer at baseline, specifically to: 1) determine whether cancer survivors (those with a history of cancer at the baseline survey) are more likely to experience progression of mobility disability and decrement in quality of life than people without cancer, controlling for baseline number of mobility limitations and co-morbidity; 2) determine whether development of secondary impairments explains long-term progression of mobility disability and decline in quality of life after cancer diagnosis; and 3) among people with a history of cancer, describe risk factors for developing secondary impairments, including: cancer characteristics (cancer site, extent of disease, time since diagnosis, and original and current treatment modalities), individual co-morbid conditions, number of co-morbid conditions, baseline medications, mental health summary score, physical health summary score, social support, barriers to health-promoting activities, perceived access to care, and geographic access to care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PITTSBURGH MIND-BODY CENTER SUMMER INSTITUTES Principal Investigator & Institution: Matthews, Karen A.; Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2005 Summary: (provided by applicant): The Pittsburgh Mind-Body Center (PMBC) was established in 1999 to conduct research and training on the effects of beliefs, attitudes, values, and stress on multiple diseases, in accord with the NIH requirements for five newly funded "Centers for Mind/Body Interactions and Health." One of PMBC's specific aims relevant to its training mission is to hold week long Summer Institutes on mindbody interactions and health, with alternate years concentrating on behavioral antecedents of disease and disability, and on psychosocial interventions. To our knowledge, there is no other summer institute on these topics available at a national or international level. PMBC faculty have already conducted two Summer Institutes and gained valuable information and experience for the design and conduct of future Summer Institutes. This application requests three years of funding to partially support the costs of these Institutes and to defray the travel expenses of the attendees that were
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not budgeted as part of the original Center application. The specific goals of the Summer Institutes are to provide information about basic pathways linking behavioral, psychological, and biological connections between environmental factors and physical illness; to evaluate the importance of state-of-the-art psychosocial interventions in preventing disease and disability; and to enhance research skills, including problems solving, design of studies, and communication of ideas. The overall goal is to foster the development of a cadre of new investigators in mind-body science and health. We anticipate that 25 scientists will attend the Summer Institute each year, with 20 from outside Western Pennsylvania. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: POSITIVELY AGING: OPTIMIZING MOBILITY ACROSS LIFE Principal Investigator & Institution: Lichtenstein, Michael J.; Professor; Medicine; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2003; Project Start 29-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): This SEPA application is a Phase I and II application to create, evaluate, and disseminate new teaching materials centered on the inter-related areas of mobility and obesity for the Positively Aging program. The National Institute on Aging (NIA) and the Surgeon General's Office have underscored the importance of physical activity and health maintenance across the life span. This application will utilize information from patient-oriented clinical research related to mobility and obesity as examples to create lessons and activities that effectively teach scientific and mathematical principles dealing with forces and motion at the middle school level. The Positively Aging program is an active ten-year innovative interdisciplinary partnership between the working scientists of the Aging Research and Education Center (AREC) of the UTHSCSA and middle school educators in San Antonio, TX. The Positively Aging program has three long-term goals: 1. to provide innovative, effective teaching materials that center on math and science curricular elements and are based on examples from the Gerontologic Sciences; 2. to help students learn to make critical, life determining decisions for extending and enhancing their own lives; and 3. to help students develop a sensitivity to the needs and concerns of the aging population. For the present application, we designed three specific aims to achieve these long-range goals: 1. To create new instructional materials focused on mobility and obesity that teach students: (A) Scientific and mathematical concepts of forces and motion; B) The associations between mobility, obesity, disease, and disability across the life span; (C) Activities that promote healthy nutritional and activity habits across the life span. 2. To develop a cohesive set of quantitative evaluation strategies to determine whether the new Positively Aging instructional program improve: (A) Knowledge and skills specific to State of Texas and National Standards for math and science curricular objectives; B) Knowledge specific to the associations between mobility, obesity, disease, and disability; (C) Knowledge and skills regarding healthy nutrition and activity habits. 3. To disseminate the new materials through the internet and teacher workshops. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PREPARING THE NEXT GENERATION OF RESEARCHERS IN AGING Principal Investigator & Institution: Sloane, Philip D.; Family Medicine; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008
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Summary: (provided by applicant): Aspiring research scientists frequently fail to develop successful careers due to a lack of focus, insufficient mentoring, and inadequate opportunities for collaboration. The early faculty years are an especially vulnerable period, during which time they could benefit from the guidance of senior faculty, individually-tailored formal instruction, participation in established research programs, critique of works-in-progress, and opportunities for professional networking. The goal of this academic leadership career award (K07) is twofold: (1) to promote the successful development of junior faculty researchers in the health sciences disciplines whose work will shed new light on pressing issues related to the provision of health services to older persons with chronic illness and disability in community and long-term care settings, and, in doing so, (2) to enhance the capacity of the University of North Carolina at Chapel Hill (UNC-CH) to make significant research contributions in these areas. The proposed project will be housed in the Program on Aging, Disability and Long-Term Care of the Cecil G. Sheps Center for Health Services Research - the largest aging research program on campus, which conducts a range of interdisciplinary research and has a strong track record of mentoring. The project will be directed by Philip Sloane, MD, MPH, the program's co-director, who will devote one-quarter time to this effort. Sheryl Zimmerman, PhD, the program's other co-director, will donate ten percent time in areas relevant to her K02 on long-term care. Other program faculty and staff who will assist in this effort include a biostatistician, analyst, project manager, and research assistant. The project steering committee will include directors of aging-oriented programs, centers and institutes on campus. The proposed project will consist of an intensive mentoring and research career development program for four junior faculties per year (Faculty Fellows). Participants will be drawn from the disciplines of medicine, nursing, pharmacy, social work, allied health, dentistry, and public health. Each participant's sponsoring unit will guarantee a minimum of 40 % dedicated research time. Participants will engage in a structured program consisting of: a) career mentoring; b) intensive research mentoring; c) availability of subject cohorts for use in pilot and preliminary studies; d) a monthly seminar series on critical methodological and funding issues in aging; e) biweekly discussions of works-in-progress; f) required research presentations and proposals; and g) a $4,000 annual allowance for networking, professional travel, and research development. Candidate selection will assign priority to traditionally underrepresented minorities, women, and physician-scientists. Fellows will transition out of the program upon obtaining significant independent funding through a research career award, R01, or major foundation research grant. Project success on both individual and programmatic levels will be measured by academic accomplishments of current and former Faculty Fellows. Institutional mechanisms are in place to provide ongoing support for this model of mentoring, if successful, and they will be pursued as a partnership between the Candidate, the Sheps Center, and the University's Vice Chancellor for Research and Graduate Studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PREVENTING DEPRESSION IN MACULAR DEGENERATION Principal Investigator & Institution: Rovner, Barry W.; Psychiatry and Human Behavior; Thomas Jefferson University Office of Research Administration Philadelphia, Pa 191075587 Timing: Fiscal Year 2002; Project Start 06-FEB-2001; Project End 31-JAN-2006 Summary: Applicant's This application describes a randomized controlled clinical trail to evaluate the efficacy of a brief, standardized cognitive psychotherapy, Problem Solving Therapy (PST), to prevent incident depressive disorder (DSM-IV diagnoses) in
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elderly patients with age-related macular degeneration (AMD). AMD is the most common cause of blindness in older adults and limits the ability to read, see familiar faces, and walk independently. Almost 2 million persons (about 5 percent of the U.S. population over age 65) are now affected and their number will triple by the year 2020. We will target patients with neovascular AMD (NV-AMD), a form of AMD that can lead to sudden vision loss, substantial disability, and depression. Because depression is itself disabling and not likely to be recognized nor treated by ophthalmologists, preventing depression is clearly important. We will recruit 230 non-depressed AMD patients from the retinovascular clinic of Wills Eye Hospital with newly diagnosed NV-AMD one eye, who already have AMD in the fellow eye. Because they have recently developed bilateral vision loss they will be at high risk for depression. We will randomize subjects to PST or a usual care control condition in this 6-month clinical trial. The primary outcome measure will be a DSM-IV diagnosis of depression diagnosed by a geriatric psychiatrist masked to treatment assignment. We will evaluate subjects at baseline, month 2 (immediately post-intervention), month 6 (for the primary efficacy analysis) and month 12 (to evaluate sustained effects). Although depressive disorder is the primary outcome, we will also assess the impact of PST on levels of disability and vision-related quality of life. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROGESTERONE TREATMENT OF BLUNT TRAUMATIC BRAIN INJURY Principal Investigator & Institution: Kellermann, Arthur L.; Emergency Medicine; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2002; Project Start 01-AUG-2001; Project End 31-JUL-2004 Summary: Traumatic brain injury (TBI) is a major cause of premature death and disability worldwide. Few effective treatments exist. Based on encouraging results from studies with animals, we hypothesize that early administration of progesterone to victims of moderate to severe TBI reduces secondary brain injury and improves neurological outcomes. Prior to proceeding with a full-scale clinical trial, we propose to conduct a pilot study by identifying and recruiting eligible subjects at a single level I trauma center. Consenting subjects will be randomly assigned to receive either IV infusion of progesterone or an equivalent volume of placebo. The study team, which will be blinded to treatment status, will monitor each subject's clinical progress and assess outcome at one month post-injury. The primary objectives of this pilot study are to: 1) achieve proper dosing of the study drug, 2) gather data on drug safety, and 3) generate preliminary evidence of efficacy. The secondary objective is to identify the most appropriate clinical subgroup(s) for subsequent treatment in a multi-center trial. To identify the correct dosage and infusion rate to achieve a steady state serum progesterone concentration (SSSPC) level of 450 nmole/L + 100 in our subjects, we will statistically examine the SSSPCs of the first ten subjects randomized to progesterone. To test the safety of the progesterone infusion, we will monitor patients for several unlikely, but potential complications of progesterone administration. To assess the potential efficacy of the progesterone for TBI, we will compare treatment groups with respect to duration of coma, death at one month post-injury, and most important, neurological outcome at one month post-injury. Three measures of neurological outcome will be used: the Glasgow Outcome Score, the Disability Rating Scale, and the Galveston Orientation and Amnesia Test. Once these objectives are accomplished, we will apply the lessons learned in this pilot study to mount a multi-center, randomized, double blind, placebo-controlled clinical trial of intravenous progesterone for treatment
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of traumatic brain injury. If the therapeutic benefits observed in animals are replicated in humans, administration of intravenous progesterone should produce several benefits, including: a) decreased duration of coma; b) decreased mortality; and c) improved neurological function. If these hypotheses are verified, this it will represent a major advance in the treatment of traumatic brain injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PST DYSFUNCTION
IN
GERIATRIC
DEPRESSION
WITH
EXECUTIVE
Principal Investigator & Institution: Alexopoulos, George S.; Professor and Vice Chair; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-MAY-2007 Summary: (provided by applicant): This study proposes to compare the efficacy of Problem Solving Therapy (PST) to that of Supportive Therapy (ST) in non-demented elderly patients with major depression and cognitive impairment. Among them, we will focus on patients with major depression and executive dysfunction because this combination of symptoms (as defined in our preliminary studies) is prevalent, debilitating, and responds poorly to treatment with antidepressant agents. Therefore, we find it compelling to identify an effective treatment for these patients, who would otherwise remain depressed, debilitated, and demoralized during the last years of their lives. We selected PST because it can address depression as well as deficits in problem solving skills that impact on the patients' ability to negotiate their environment and contribute to their depression and disability. Moreover we now have empirical evidence suggesting that PST can reduce depressive symptoms and disability in cognitively unimpaired depressed elderly patients as well as elderly patients with major depression and executive dysfunction. The subjects will be 240 (120 from each Center) elderly (>64 years) patients with non-psychotic, unipolar major depression and executive dysfunction and will be randomly assigned to receive 12 sessions of PST or ST. The study is designed to test the hypotheses that the PST is more effective than ST in reducing depressive symptoms and disability. Furthermore, we hypothesize that these effects are mediated by improvement in generation of alternative solutions, decision making, and solution implementation. While we are aware of the methodological problems and confounds posed by studying a "sick and old population", we bring to this project two groups with complementary expertise in treatment studies and psychotherapy research, and experience in directing multicenter studies. Moreover, the project will be supported by the structures of the Cornell Intervention Research Center (IRC), whose principal objective is to develop treatment interventions targeting specific clinical and biological characteristics of geriatric depression. Accordingly, we are well positioned to meet the challenges inherent in this difficult but important area of research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PREVENTION
PSYCHOSIS:
EARLY
DETECTION,
INTERVENTION
AND
Principal Investigator & Institution: Mcfarlane, William R.; Chief; Maine Medical Center 22 Bramhall St Portland, Me 04102 Timing: Fiscal Year 2003; Project Start 01-MAR-2003; Project End 31-JAN-2008 Summary: (provided by applicant): The primary aim of this application is to conduct a randomized, controlled clinical trial of a specialized mental health service delivery
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system specifically developed for prodromal psychotic disorders. The intervention is Family-aided Assertive Community Treatment (FACT). The proposed study will be part of a larger program, Portland Identification and Early Referral (PIER), under foundation and Center for Mental Health Center sponsorship, that has established a populationbased system of early detection for Greater Portland, Maine. Previous and present effort has educated and trained the community-at-large and all health, education and other professionals, with the result that referrals are occurring at the expected frequency. The principle strategy is to intervene early, prior to onset, in the course of the onset of psychotic disorders to arrest the development of psychotic symptoms and functional disability. The test treatment is a specialized combination of psychoeducational multifamily group and assertive community treatment. In pilot studies FACT has led to very low rates of conversion to psychosis and very high rates of engagement and retention in treatment, thereby decreasing the burden on the family and the community. The goal of the treatment is prevention of psychosis and disability. This study will assess experimentally the clinical effectiveness of this new type of mental health service. Other domains of outcome include cognitive dysfunction and functional disability. The project will support an EDIPFACT team of clinical staff with the ability to: a. foster detection of prodromal disorders in the Greater Portland community by general practitioners, guidance counselors, mental health professionals and the general public; b. accurately assess individuals at high risk for psychosis; c. reliably deliver an evidencebased psychosocial and, if indicated, pharmacological treatment package using standardized methodology. The research study will test, in a randomized controlled trial, the symptomatic and functional outcome of treatment in 96 subjects ages 12 to 35 identified by that system. It will allow the analysis of key social factors contributing to psychosis and their interaction with the treatment conditions and each other. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: QUALITY IMPROVEMENT FOR DEPRESSION Principal Investigator & Institution: Ford, Daniel E.; Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 30-SEP-1994; Project End 31-MAR-2004 Summary: Policy makers do not know how to alter the structure and process of primary care to provide treatment which will improve and sustain improvement in the functional impairment associated with major depression, the fourth leading cause of disability worldwide. To address this problem, we propose an R-10 to fund Quality Improvement for Depression (QID). The specific aims of QID are: (1) to provide integrated analyses of the long term impact of four distinct but related primary care interventions to improve depression treatment during the acute, continuation, and maintenance phase of care; and (2) to estimate the effects of high quality primary care depression treatment on long term disability. In the early stages of QID collaboration, funded investigators of four separately conceived quality improvement interventions planned and implemented a coordinated strategy for recruitment, intervention, and data collection in 108 primary care clinics in network and staff model HMOs, IPAs, PPOs, and mixed model settings. In addition to common baseline organizational and provider data, QID investigators are collecting over 80 common variables from 1,980 patients with major depression at each of three waves across the first year. This application seeks support to conduct effectiveness analyses in the combined database after standardizing patient follow-up during the second year across the four projects. This effort is needed to understand the "big picture" of how four dissemination interventions which are feasible to integrate across a variety of practice settings and populations, impact the
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quality and outcome of care, with sufficient power to determine whether they improve outcomes over a duration meaningful to policy makers. The analyses will inform policy debates about effective mental health treatment by providing generalizable estimates of the effect of antidepressant medication and psychotherapy on disability over the long term. To address these policy questions through the QID is more efficient than funding another large new project and more scientifically rigorous than drawing conclusions from heterogeneous studies whose differing methodologies complicate meta- analytic methods and conclusions. In addition to serving as a competing continuation for the Depression Guidelines Cooperative Agreement, QID serves as an important model of how mental health effectiveness research can be efficiently conducted by intensive collaboration of independently funded projects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: QUALITY OF LIFE IN OLDER BREAST CANCER SURVIVORS Principal Investigator & Institution: Haley, William E.; Professor and Chair; Gerontology; University of South Florida 4202 E Fowler Ave Tampa, Fl 33620 Timing: Fiscal Year 2002; Project Start 15-JUL-2002; Project End 31-DEC-2003 Summary: Increasing numbers of older women are surviving cancer after successful medical treatment, with the potential for both positive and negative long- term outcomes. Women surviving breast cancer face unique problems and concerns, including the physical and psychological sequelae of cancer treatments and fears concerning cancer recurrence. Psychosocial cancer research has primarily focused on younger women, despite the fact that older women are at the highest risk for cancer and often have multiple chronic illnesses and other factors putting them at risk for complications. The proposed project will be among the first studies to examine the longterm impact of surviving cancer among older adults, and will provide valuable information that can be used to design cancer intervention programs for older adults that target their special needs and concerns. It will be a collaborative effort between the Department of Gerontology at the University of South Florida and the Senior Adult Oncology Program (SAOP) at the Moffitt Cancer Center and Research Institute, one of the few programs nationally specializing in cancer care for older persons. The proposed project will study the impact of breast cancer on disability and quality of life in older women, with the overall goal of providing information of value to older women, their families, and health care professionals. Participants will be drawn from a database of 298 women with breast cancer seen by the SAOP from 1994-2001. Cancer survivors will be administered a battery of tests to assess disability, quality of life, and psychological growth, and will be compared to a non-cancer control group taken from over 250 older women in the Charlotte County Healthy Aging Study. Specific aims are to (1) develop a description of outcomes among older adult breast cancer survivors, including quality of life, functional impairment, and independence and how these vary over length of survival; (2) identify predictors of change in depression, functional impairment and independent living status from initial patient information; and (3) examine survivor perceptions of cancer-related services and their suitability for older adults. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RACE AND OUTCOMES IN WORK-RELATED BACK INJURIES Principal Investigator & Institution: Tait, Raymond C.; Psychiatry; St. Louis University St. Louis, Mo 63110 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2005
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Summary: Occupational low back injury, a significant economic and healthcare problem in the U.S., has proven difficult to manage consistently and cost-effectively. Recent studies have shown medical management of low back pain to be highly variable. With respect to Workers' Compensation, apparent disparities in assessment and treatment associated with race have also been identified. While this research demonstrated potentially inequitable treatment of injured minorities with low back injuries, the representativeness of the results and their implications for post-settlement outcomes (i.e., clinical adjustment and employability) remain unknown. This historical cohort study is designed to identify potential race-related disparities in occupational healthcare, define the scope of the problem, and to assess the impact of such disparities on post-settlement adjustment. The study will examine a cohort of African Americans and White workers who incurred disabling low back injuries in the State of Missouri and whose disability claims were settled during the year 2001. Records of the Missouri Division of Workers' Compensation (MODWC) will be used to identify those claims from three Missouri population centers (St. Louis City, St. Louis County, Jackson County), where the majority of African Americans in Missouri reside. MODWC records will provide data relevant to medical costs, temporary total disability costs, permanent disability costs, and other injury-related matters for all claimants with work-related low back injuries leading to missed work time. Computer Assisted Telephone Interviewing methods will be used to assess post-settlement adjustment. Regression models will be used to assess the relationship of race and legal representation, alone and in interaction, with Workers' Compensation outcomes and post-settlement adjustment of claimants. The historical cohort design will address three weaknesses in the present state of knowledge. First, it addresses potential associations between race, treatment, and disability outcomes, an area that has been neglected. Second, it addresses relations among the above constructs and the post-settlement adjustment of claimants. Moreover, because of the sample size and the design, we will be able to separate the effects of potentially confounding variables (e.g., job type, socioeconomic status), both alone and in interaction with race. Finally, by dint of the procedures needed to recruit participants, the study will establish a cohort of injured workers whose adjustment can be monitored not only at the time of this study, but potentially beyond that time frame. If the cohort is examined at a later point in time, it will be possible to track true long-term outcomes of occupational healthcare. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: READING ENHANCEMENT FOR PATIENTS WITH VISUAL FIELD LOSS Principal Investigator & Institution: Sandberg, Michael A.; Ophthalmology; Harvard University (Medical School) Medical School Campus Boston, Ma 02115 Timing: Fiscal Year 2003; Project Start 01-AUG-2001; Project End 31-DEC-2004 Summary: (Applicant's Abstract) According to The National Advisory Eye Council, a program goal is to "Develop assistive devices. and rehabilitation strategies to minimize the impact of visual impairment in everyday life, and reduce disability and societal limitations among visually impaired persons" (Vision Research-A National Plan: 19992003, National Eye Institute). In accordance with this guideline, the proposed pilot study will measure and attempt to correct the reading disability of patients who retain only a small central island of vision due to advanced retinal degeneration or glaucoma, or only the left or right visual field due to stroke. These patients, who number in the thousands in the United States, are handicapped for reading standard, stationary text because they lack adequate parafoveal visual cues for smoothly shifting fixation from word to word
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and from line to line, and because some have reduced visual acuity as well. We plan to evaluate 150 patients with different forms of retinal degeneration or glaucoma and 30 patients with stroke. This program will quantify their reading speeds to standard, stationary text and relate reading speed to conventional measures of vision to develop a quantitative clinical frame of reference for their reading disability. We will explore whether their reading speeds to stationary text can be improved by tailoring the letter spacing, letter size, page width, and contrast polarity to their disease type and stage. Testing will also involve measuring their reading speed to text presented serially to the same location of the visual field, a format that minimizes the need for eye movements, and that should, therefore, little depend upon the absence of parafoveal cues; this format has been reported to result in up to four-fold faster reading by normal subjects. Since software is available for presenting text serially to the same location, either on-line or off-line, and since palmheld wireless devices are commercially available, a serial mode of presentation could be a practical, mobile solution for patients with these types of visual field loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RESEARCH TRAINING IN DISABILITY & DISABLING DISORDERS Principal Investigator & Institution: Gill, Thomas M.; Associate Professor; Internal Medicine; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2003; Project Start 15-JAN-2003; Project End 31-DEC-2007 Summary: (provided by applicant): The specific aims of this Midcareer Investigator Award in Patient-oriented Research are: (1) to further establish the candidate's independent patient-oriented research program in the epidemiology and prevention of disability among community-living older persons; and (2) to establish a formal mentorship program for junior investigators, across disciplines, who are pursuing patient-oriented aging research related to disability and disabling disorders. This includes functional assessment in general as well as the functional consequences of highly prevalent disease-specific conditions such as arthritis, heart disease, diabetes, stroke, cancer, depression, and dementia. The candidate's ultimate objective is to build a premier program in patient-oriented research related to disability and disabling disorders. During the past ten years, the candidate has established a highly successful and independent patient-oriented research program addressing fundamental issues related to the epidemiology and prevention of disability. A K24 Award will permit the candidate to further advance the scientific knowledge base of this serious and pervasive problem in geriatric medicine by affording him the protected time to complete the patient-oriented research projects proposed in this application. This program of research, in turn, will provide the platform for the candidate's greatly expanded mentorship program, which will include didactic training, hands-on research mentorship, and a research infrastructure (data analytic and research assistant support). The candidate plans to accept two to three junior investigators into the program during each of the first two years. Subsequently, the number of accepted candidates per year will vary to achieve the ultimate goal of having 5 to 6 active trainees at any one time. The Yale environment provides the ideal setting, replete with interdisciplinary research and training programs, interdisciplinary expertise and collaboration, and resources (e.g., methodological consultation, biostatistical support, access to study populations and databases) to foster the candidate, the proposed research projects, and the mentorship program. In summary, the candidate's accomplishments in patient-oriented research, his ability and commitment to mentoring junior investigators, and the research and training
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strengths of Yale combine to provide an ideal context for successfully carrying out the specific aims of this proposal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RISK FACTORS FOR PHYSICAL DISABILITY IN AGING WOMEN Principal Investigator & Institution: Fried, Linda P.; Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 10-JUN-1994; Project End 31-MAY-2005 Summary: This proposal seeks renewal of a prospective, observational cohort study of the natural history of, and risk factors for, the onset of physical disability in older women, in order to complete the observation of the evolution of function in the cohort in 3 additional examinations 18 months apart. This would permit completion of the initial specific aims and addressing additional related questions that have developed from our findings. Meeting these objectives will provide new bases for screening for those at high risk of disability and for early interventions to prevent the onset of disability. The goals of this renewal are to: 1) complete determination of the characteristics and natural history of preclinical disability in two major, distinct and parallel casual pathways to physical disability: one caused by diseases that affect mobility and exercise tolerance, and the second caused by decrements in cognition. We will determine the measures of preclinical disability that predict progression to disability in each pathway and are, thus, markers of high risk; 2) define who does, or does not, implement modifications that characterize preclinical disability. This could provide insight into adaptations that slow the decline in function in those who do not employ them; 3) determine the predictors and modifiers of decline in function over time, and of remaining high functioning; and 4) develop practical clinical nomograms for screening for those at risk of disability in each pathway, and overall. The study participants are a populationbased sample of 436 community-dwelling women who were 70 to 79 years of age and high functioning in 1994-5 at the time of recruitment. They completed one follow-up examination since then, and a second follow-up examination is currently being completed, each 18 months apart. Examinations are performed in the Functional Status Laboratory within the Outpatient General Clinical Research Center, and include ascertainment of both functional outcomes and chronic diseases and other hypothesized risk factors, as well as measurement of change over time. As this cohort has, to date, primarily developed early changes in mobility function, we propose 3 additional examinations, 18 months apart, to observe the progression of mobility preclinical and clinical mobility disability to the development of difficulty in tasks essential to independent living. We also have evidence of early changes in cognitive function in the cohort and indications of potential preclinical indicators of resulting functional decline; further follow-up would determine the prognostic import of these finding and gain insight into opportunities for amelioration of such functional losses. It would also confirm our hypothesis that there are 2 parallel pathways to disablement: via cognitive decline and via mobility and exercise tolerance losses. Completing the follow-up of this cohort in the next funding period will permit understanding the preclinical phase of disablement due to chronic, progressive disease and cognitive impairment, the process and risk factors for progression to task disability and dependency. In selected instances, data from the complementary Women's Health and Aging Study I, a study of the 1/3 most disabled older women in the community, will be combined with this cohort to enhance the power and precision of our analyses. The resulting insights should provide new opportunities for screening and prevention of physcial disability in older womenthe population subgroup at highest risk for disability at older ages.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ROLE OF CATASTROPHIZING IN ADJUSTMENT TO PAIN Principal Investigator & Institution: Ehde, Dawn M.; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 04-JUN-2002; Project End 31-MAY-2007 Description (provided by applicant): The broad, long-term objectives of this subproject are to reduce the pain and suffering in persons with chronic pain as a secondary condition to a disability and to further test and refine a biopsychosocial model of chronic pain as it applies to persons with disabilities. The proposed study has two specific aims: (1) to evaluate the effects of a cognitive restructuring intervention on pain in a sample of adults with disabilities in a randomized clinical trial; and (2) to study the mechanisms of the effects of cognitive restructuring by determining whether treatmentrelated changes in cognitions mediate the effects of cognitive restructuring on pain. These aims will be accomplished through a longitudinal study in which persons with chronic pain as a secondary condition to a disability (N 240) will be randomly assigned to one of two experimental conditions. In the first condition, a cognitive-restructuring intervention, subjects will be instructed in cognitive strategies designed to eliminate catastrophizing and other negative thinking about pain. The second condition will be an education control intervention in which subjects will receive education about chronic pain. Measures of pain intensity, psychological functioning, pain interference with activities, participation, and medical services utilization will be collected at several time points throughout the course of the study (pre-treatment, posttreatment, follow-up). Findings from this study will increase our understanding of the efficacy of cognitive restructuring interventions as well as the causal role of catastrophizing in adjustment to chronic pain. The study will provide an important empirical test of one hypothesis derived from a biopsychosocial model of chronic pain: that cognitions influence pain experience and adjustment to chronic pain. Ultimately, these findings may also lead to the development and refinement of treatment strategies that will reduce suffering and improve functioning in persons with chronic pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SES COMMUNITY
AND
AGE-RELATED
DISABILITY
IN
A
BIRACIAL
Principal Investigator & Institution: Mendes De Leon, Carlos F.; Associate Professor; Rush-Presbyterian-St Lukes Medical Ctr Chicago, Il 60612 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 31-JUL-2005 Summary: (Taken from the Investigators' Abstract) The goal of the proposed project is to conduct an epidemiologic study to examine the biological and environmental mechanisms by which relative socioeconomic deprivation leads to disability in older people. Age-related disability is generally considered to be the most important measure of overall health status in the elderly, and a major cause of poor quality of life at that age. There are significant disparities in disability among persons with different socioeconomic positions, yet the reasons for these disparities are poorly understood. The study will test whether these disparities in disability are due to a combination of greater biological risk and adverse neighborhood conditions. These mechanisms are hypothesized to increase risk for disability through their negative effect on participation in everyday social and physical activity. The investigators propose to also test racial differences in disability, and examine the degree to which they are a result of
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socioeconomic deprivation or other factors. Finally, they will develop, implement, and evaluate outreach and educational programs aimed at increasing awareness about factors by which socioeconomic deprivation can lead to disability. The proposed project will take advantage of an ongoing study on risk factors for Alzheimer's Disease in a geographically defined, biracial community in the Southside of Chicago. This study will hopefully contribute detailed biological and sociodemographic data on a cohort of more than 8,000 elderly African Americans and Whites, as well as add a detailed assessment of the physical and social qualities of the neighborhoods and annual ascertainment of disability to supplement the existing data. The aging of the population adds urgency to a better understanding of the factors that prevent potential increases in disparities in age-related disability among the socially disadvantaged. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SHARED IMPAIRMENTS FOR GERIATRIC SYNDROMES & DISABILITY Principal Investigator & Institution: Tinetti, Mary E.; Professor; Internal Medicine; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 15-FEB-2000; Project End 31-JAN-2003 Summary: (adapted from Investigator's abstract) As proposed by several investigators, a substantial decrease in disability among older persons might be achieved by identifying, and then focusing preventive efforts at, modifiable impairments that have been shown to adversely effect a range of geriatric disability-related outcomes. The necessary first step is to identify such impairments. The primary aim of this project is, therefore, to determine whether impairments in four potentially modifiable domains, namely affect , sensory (vision and hearing), upper extremity ability, and lower extremity ability are associated with decline in mobility and social/productive activities and with the onset of falls, incontinence, and disability in self-care ADLs among three cohorts of community-living older persons over three years. The secondary aim is to determine if the relationship between these four impairment domains and the outcomes is modified by cognitive status and/or social supports. The three cohorts include: 1) Project Safety, a probability sample of 1,103 persons greater than or equal to 72 years of age; 2) MacArthur, a sample of 1,189 "above average" persons aged 70-90 at initiation; and 3) PEP-a stratified random sample of 750 members of a large general group practice. Baseline data available on the three cohorts include: 1) measures of the four targeted impairments: depressive symptoms, sensory (vision + hearing), upper extremity ability, and lower extremity ability; 2) potential modifying variables-cognitive status, emotional and instrumental social support; and 3) other covariates-demographic, psychosocial, and health variables. Outcomes ascertained over three years of follow-up include: 1) decline in mobility; 2) decline in social-productive activities; 3) onset of self-care disability; 4) occurrence of more than two falls; and 5) onset of weekly incontinence. Analyses will be structured to determine whether the targeted impairments are independently and additively related to the outcomes, and whether the relationships between the targeted impairments and the outcomes are modified by cognitive status or social supports. The goal is to determine whether there exists the epidemiologic evidence to suggest that these four, potentially modifiable, impairments should serve as targets in a shared impairment intervention strategy aimed at reducing the risk of geriatric syndromes and disability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SOCIAL ROLE DISABILITY AND MENTAL-PHYSICAL COMORBIDITY Principal Investigator & Institution: Von Korff, Michael R.; Senior Investigator; Center for Health Studies Seattle, Wa 98101 Timing: Fiscal Year 2004; Project Start 01-JAN-2004; Project End 31-DEC-2007 Summary: (provided by applicant): An historic shift of the world population into age groups with increased prevalence of chronic physical diseases, mental disorders and disability is taking place. Chronic physical conditions and mental disorders are both leading causes of disability. Treatable mental disorders and chronic physical conditions often co-occur, but national data concerning their co-morbidity are not available. The extent and nature of disability among persons with specific mental disorders co-morbid with major chronic physical conditions is largely unknown in the population-at-large. There is growing evidence that treating co-morbid mental disorders improves functional outcomes among persons with chronic physical diseases. Unfortunately, efforts to respond to the growing epidemic of chronic disease, mental disorders and related disability are not guided by reliable population-based data. Epidemiological data are urgently needed to guide research, clinical practice, health care organization and public policy in responding to this challenge. In response to PA-02-047 (Research on Co-morbid Mental and Other Physical Disorders), our goal is to address this knowledge gap by determining the extent and nature of disability among persons with mental disorders that are co-morbid with major chronic physical conditions. We will employ data from 28 coordinated national population surveys (N=196,000) participating in the WHO World Mental Health (WMH) initiative. We will study how mood, anxiety, substance use and impulse control disorders influence disability among persons with cardiovascular disease, diabetes, respiratory disorders, arthritis,and chronic pain conditions. The specific aims of this program of research are: Aim 1: Estimate prevalence rates of treatable mental disorders among representative cases with major chronic physical disorders that are leading causes of disability; Aim 2: Advance disability research methods by calibrating WMH disability measures for use in national and international health surveys and health outcomes research; Aim3: Establish the specific contributions of mental disorders to global and specific role disabilities (including work role disability) among persons with major chronic physical disorders; and Aim 4: Determine the effects of physical-mental co-morbidity and social role disability on broader measures of disease burden including health utilities, family burden and stigma. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SPIRAL OF DEPRESSION AND DISABILITY IN LATE LIFE Principal Investigator & Institution: Bruce, Martha L.; Professor; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 05-AUG-1998; Project End 31-JUL-2003 Summary: (Adapted from applicant's abstract): This application for a NIMH Independent Scientist Award(K02) requests support for the candidate's career goal of identifying strategies which can effectively intervene on the potential spiral of depression and functional disability in older adults. The K02 career development aims are: a) to foster collaborative study of these issues with an interdisciplinary set of scientists with clinical, biological, and psychosocial orientations, and b) to develop personal expertise in: i) theory and assessment of functional disability, and ii) methodology for assessing the feasibility and effectiveness of intervention strategies for reducing the causal effects of disability and depression on each other. The specific K02
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research aims are to further the understanding of the relationship between depression and functional disability in elderly adults by testing hypotheses in data from both naturalistically treated and controlled treatment samples of elderly adults about: a) specific attributes of depression and disability that contribute to the risk of each condition over time, and b) the effect of systematic treatment interventions for depression on changes in functional disability in relationship to changes in depressive status. Depression and disability are both highly prevalent in advanced age and both associated with immense personal suffering, burden on family and expensive health care. Longitudinal population-based and clinical-based studies demonstrate that depression and disability affect each other's onset and course. The K02 award offers an opportunity to introduce the concept of heterogeneity to this research, both in terms of the severity and other clinical features of depression but also in terms of the assessment of functional disability. Disaggregating these phenomena and specifying attributes of depression and disability associated with the downward course of both promises two sets of scientific contributions. First, this research will identify specific mechanisms relating depression to functional disability in older adults. Second, it will identify potential avenues for effective intervention into these relationships in high risk populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STUDY OF OSTEOPOROTIC FRACTURES Principal Investigator & Institution: Cauley, Jane A.; Professor; Epidemiology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-FEB-1986; Project End 31-JUL-2006 Summary: (provided by applicant): The Study of Osteoporotic Fractures (SOF) is a multi-center longitudinal study in a cohort of 9,704 older women. SOF has comprehensive data about risk factors for osteoporosis and other diseases, along with an archive of serum, buffy coat and urine specimens. Data from SOF have served for: (1) developing osteoporosis guidelines, (2) estimating the cost-effectiveness of screening for osteoporosis, and (3) planning trials of osteoporosis therapies. They propose to renew SOF to sustain this unique resource and to pursue several new hypotheses. Osteoporosis is a chronic disease and prevention of fractures must be considered over the very longterm, not just the 3-5 year duration of most studies in the field. As the study of osteoporosis and aging with the longest (nearly 15 years) follow-up, SOF will provide the foundation for describing ways to identify people at greatest risk of osteoporosis and fractures decades in advance. They envision a new generation of clinical guidelines based on long-term prediction of risk of fractures and disability. Because they have enriched the cohort with African-American women, SOF will also provide unique information on risk factors for osteoporosis and non-spine fractures in older African American women. SOF was the first study to show a link between low BMD and risk of stroke and this has helped to fuel the interest and new investigations about the links between arterial calcification and osteoporosis. If they demonstrate, and can begin to explain, the link between these two diseases, this may lead to screening tools and treatments that simultaneously decrease the risk of both of these disabling conditions. Preliminary results from SOF suggest that impaired sleep may be a major cause of fractures, disability and decline in cognition in older women. If the next phase of SOF confirms these relationships using more objective measures of insomnia and other sleep disorders, then this might change current clinical policies and practices toward more aggressive screening and better coverage for treatment of sleep disorders. Finally, the value of SOF could be magnified by recruiting other scientists to work on SOF data and
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samples. They propose to make the database easily accessible to investigators outside of SOF and assist them in making productive use of a database that represents one of the most comprehensive prospective sources of information about the health of older women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE ROLE OF METALS IN OSTEOARTHRITIS Principal Investigator & Institution: Jordan, Joanne M.; Associate Professor; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 31-DEC-2007 Summary: Symptomatic osteoarthritis (OA) of the knee and hip is common, the leading cause of disability and diminished quality of life among those 65 years of age and older, and responsible for a large proportion of the costs associated with joint replacement surgery and other direct and indirect health costs(I-10). As the population in the United States ages, this problem can only be expected to increase(9). Despite the high personal and societal costs of knee and hip OA, few modifiable risk factors for its occurrence or progression have been identified (11; 12). Heavy metals are ubiquitous, and exposure through drinking water, contaminated food, pesticides, and other means, is widespread in our society(13-18). This proposal introduces chronic metal exposures as novel, potentially modifiable risk factors for thc incidence and progression of knee and hip OA and its consequences. The study population is the Johnston County Osteoarthritis Project, an ongoing longitudinal study of OA in African-Americans and Caucasians in a rural county of North Carolina. The research plan adds the collection of additional biological specimens, namely whole blood and toenails, to the already funded examinations of the cohort to establish a resource for current and future examinations of multiple metals in OA and OA-related outcomes. Whole blood will be analyzed for lead at the Centers for Disease Control and Prevention, and toenails will be analyzed for mercury and selenium by instrtmaental neutron activation analysis at the University of Missouri-Columbia Research Reactor Center. Multiple logistic regression will be used to test associations between these metals and incidence and progression of radiographic knee and hip OA, knee and hip symptoms, and disability. By dovetailing this proposal with the funded cohort, costs are minimized, and efficiency and utility maximized. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TREATMENT OF DEPRESSION IN PARKINSON'S DISEASE Principal Investigator & Institution: Menza, Matthew A.; Psychiatry; Univ of Med/Dent Nj-R W Johnson Med Sch Robert Wood Johnson Medical Sch Piscataway, Nj 08854 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2006 Summary: (provided by the applicant): Depression is the most common neuropsychiatric disorder found in patients with Parkinson's Disease (PD). It causes immense personal suffering, and is associated with increased disability and caregiver burden. Despite the adverse consequences of depression in patients with PD, there are virtually no empirical data to guide clinical treatment. In the absence of data, the SSRIs are apparently used as the first-line treatment, despite concerns about efficacy, safety, and tolerability in this population. This proposal is for a pilot study to establish the feasibility of, and generate sufficient data to plan, a larger clinical trial that will be able to inform clinical treatment of these patients. This pilot trial will (AIM 1) examine the feasibility of a larger trial, and establish (AIM 2) the effect size for short-term efficacy of anti-depressants, compared to placebo, in this population. It will also (AIM 3) evaluate
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the effect of long-term depression treatment on quality-of-life. This will be done in the context of a placebo-controlled, double-blind, parallel group, flexible dose trial of an SSRI (Paroxetine), a tri-cyclic (Nortriptyline) and placebo in acute (8 weeks) and longterm treatment (6 months). A total of 75 patients with PD (without significant motor fluctuations or Dementia) and depression (major depression or Dysthymia) will be randomized to each of the three arms in a balanced design. The feasibility issues that will be explored include recruitment, retention, drug tolerability, and the ability to maintain the blind. The outcomes that will be explored for the acute phase include changes in the Hamilton Depression Rating Scale (HAM-D) score, and the percent of patients who are responders (>50% improvement in the HAM-D, or < 10 on the HAMD). The outcome variables explored for the long-term phase include the Parkinson's Disease Questionnaire and the Medical Outcome Study Short Form. Secondary analyses will involve the exploration of anxiety, motor disability, sleep, cognition, and individual or clusters of symptoms that are responsive to treatment in order to facilitate planning a subsequent, full-scale clinical trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: UNDERSTANDING/PREVENTING MATH PROBLEM/SOLVING DISABILITY Principal Investigator & Institution: Fuchs, Lynn S.; Professor; Special Education; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2003; Project Start 25-SEP-2003; Project End 31-JUL-2008 Summary: (provided by applicant): The overall purpose of this project is to increase the understanding and decrease the prevalence of disability in mathematical problem solving (MPS; word problems requiring more than one step and/or presented realistically with relatively long narratives and/or irrelevant information). On the one hand, research on MPS has been confined largely to middle- and high-school students without significant difficulties. On the other hand, research on mathematics disability in younger children has focused primarily on arithmetic, with some attention to arithmetic word problems (linguistically simple one-step problems requiring adding/subtracting basic facts). Arithmetic word problems do not, however, represent the kinds of math problems incorporated in school curricula beyond the earliest grades or those required in life. So, the generalizability of findings to math disability as it occurs in and out of school is tenuous. This creates the need for the explicit study of MPS disability (MPSD) at 3rd grade, when students are first expected to solve multi-step problems with longer narratives and/or irrelevant information. Another reason to increase the breadth of math disability study is that, given the demands of MPS, the profiles associated with deficient arithmetic or arithmetic word problems may differ from those associated with deficient MPS. Consequently, a focus on MPS is required to understand and prevent math disability as it develops in schools and pertains to real-world competence. This project employs randomized controlled trials to test the efficacy of classroom-level and tutoring treatments designed to decrease the prevalence of MPSD, with the contribution of an innovative component tested annually for classroom-level and tutoring treatment. Within the context of those trials, the prevalence and diagnostic stability of MPSD is estimated as it occurs with or without reading disability (RD), with or without using an IQ-achievement discrepancy, and with or without prevention. The demographic, academic, attention, and cognitive profiles associated with the development of MPSD with or without RD and with or without IQ-achievement discrepancy are explored, and students are followed longitudinally to understand how classroom and tutoring prevention efforts at 3rd grade, when complex MPS develops, affect outcomes as
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curricular difficulty intensifies through the 5th grade. Four specific aims are therefore proposed: (1) investigating the demographic, academic, attention, and cognitive profiles associated with the development of MPSD with or without RD and with or without IQachievement discrepancy; (2) estimating the prevalence and stability of MPSD with or without RD, with or without IQ discrepancy, and with or without prevention; (3) building effective classroom-level prevention for MPSD; and (4) identifying effective preventive tutoring for students at risk for poor MPSD outcomes with and without risk for RD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: WOMEN WITH PHYSICAL DISABILITIES' EXPERIENCES OF ABUSE Principal Investigator & Institution: Phillips, Dena S.; None; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: Women with physical disabilities are at risk for abuse in multiple and complex ways. This population experiences abuse from many sources, including but not limited to intimate partners, care givers, and health care providers. In addition, the nature of the abuse women with physical disabilities experience is, at times, disability specific. Despite the significant health risks associated with woman abuse, the vulnerable position of women with disabilities in society, and the fact that many women with physical disabilities are medically fragile, there is a paucity of information available about the complex abuse experience of this group of women. To address this gap in the literature and promote the overall health and safety of women with physical disabilities, the specific aims of the proposed study are: (1) to describe women with physical disabilities' lived experiences of abuse in the context of society; (2) to describe women with physical disabilities' concerns and background meanings with regard to the influence of abuse on their emotional, social and physical well-being; and (3) to recommend abuse assessment and intervention strategies to prevent and end the problem of abuse as it occurs among women with physical disabilities. To achieve these aims the proposed study will employ a critical hermeneutic design. This approach allows for the context and meaning of everyday life experiences to emerge. Thirty women with physical disabilities from diverse ethnic backgrounds who have experienced abuse will be asked to participate in two unstructured individual interview. The initial interview will gather a life history, along with the details of abuse experiences and the meaning of these experiences to each participant. Second interviews will follow-up on emerging themes, gaps, and areas of apparent contradiction. Analysis of data will occur both within and across narratives to ensure that both commonalities and differences within the sample are examined. NU*DIST, a qualitative data management software program, will be used during the analysis phase of the proposed study. The long-term goal of this program of research is to promote the health and safety of women with physical disabilities by increasing awareness and promoting a contextual understanding of their abuse experiences. It is anticipated that this understanding will facilitate the development of clinically relevant, intervention strategies specifically targeted for use with this vulnerable population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: WORK FUNCTION/STRUCTURE
OUTCOME
IN
SCHIZOPHRENIA--BRAIN
Principal Investigator & Institution: Gold, James M.; Associate Professor; Psychiatry; University of Maryland Balt Prof School Baltimore, Md 21201
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Timing: Fiscal Year 2002; Project Start 20-AUG-1998; Project End 31-MAY-2004 Summary: (Applicant's abstract): The persistent vocational disability associated with schizophrenia is an enormous problem for patients, their families, and systems of public financial support. Clinical and demographic variables account for little of the variance in vocational outcome. To address this issue, we are proposing a study design which has not been utilized in previous investigations: a neuropsychological, cognitive liability marker, social skills and MRI studies of patients who have demonstrated good vocational performance contrasted with appropriate poor vocational outcome patients and normal controls. Good vocational performance requires patients to have held paid, competitive employment, for 24 or more hours a week, for at least 75% of the last two years. The contrast of patients differing in vocational outcome should highlight the cognitive functions and social skills which are required for successful occupational functioning, and the brain morphological features are associated with outcome. Pilot data suggest that patients with good and poor vocational outcome differ in neuropsychological performance and in qualitative aspects of brain morphology, while sharing hippocampal volume reduction and impairments on liability markers. Thus, some abnormalities are evident in both groups, while others may be markers of disability. Identification of disability markers could provide an empirical foundation necessary to develop rational treatment approaches to vocational disability in schizophrenia. The study of good outcome patients also offers the opportunity to examine abnormalities which are associated with the illness, independent of functional disability. Abnormalities present in both good and poor outcome groups are arguably fundamental features of the illness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “disability” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for disability in the PubMed Central database: •
A transcription map of the 6p22.3 reading disability locus identifying candidate genes. by Londin ER, Meng H, Gruen JR.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=166143
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Changes in the prevalence of chronic disability in the United States black and nonblack population above age 65 from 1982 to 1999. by Manton KG, Gu X.; 2001 May 22; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=33472
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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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Choosing marginal or random-effects models for longitudinal binary responses: application to self-reported disability among older persons. by Carriere I, Bouyer J.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=140021
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Chronic disability trends in elderly United States populations: 1982 --1994. by Manton KG, Corder L, Stallard E.; 1997 Mar 18; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=20133
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Cohort study of birthweight, mortality, and disability. by Power C, Li L.; 2000 Mar 25; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27324
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Correlation of the score for subjective pain with physical disability, clinical and radiographic scores in recent onset rheumatoid arthritis. by Sarzi-Puttini P, Fiorini T, Panni B, Turiel M, Cazzola M, Atzeni F.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=117789
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Cross sectional survey of cervical cancer screening in women with learning disability. by Stein K, Allen N.; 1999 Mar 6; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27770
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Cross-national agreement on disability weights: the European Disability Weights Project. by Schwarzinger M, Stouthard ME, Burstrom K, Nord E.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=317384
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D is for drug addiction --- and disability. by Berger PB.; 2001 May 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=81106
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Disability in young adults following major trauma: 5 year follow up of survivors. by Evans SA, Airey MC, Chell SM, Connelly JB, Rigby AS, Tennant A.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149229
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Disability in young people and adults one year after head injury: prospective cohort study. by Thornhill S, Teasdale GM, Murray GD, McEwen J, Roy CW, Penny KI.; 2000 Jun 17; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27407
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Disability tax credit eligibility expanded. by [No authors listed]; 2001 Mar 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=80892
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Effects of thrombolysis for acute stroke in patients with pre-existing disability. by Foell RB, Silver B, Merino JG, Wong EH, Demaerschalk BM, Poncha F, Tamayo A, Hachinski V.; 2003 Aug 5; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=167119
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Erythropoietin prevents motor neuron apoptosis and neurologic disability in experimental spinal cord ischemic injury. by Celik M, Gokmen N, Erbayraktar S, Akhisaroglu M, Konakc S, Ulukus C, Genc S, Genc K, Sagiroglu E, Cerami A, Brines M.; 2002 Feb 19; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=122352
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FRAXA and FRAXE: Evidence against segregation distortion and for an effect of intermediate alleles on learning disability. by Teague JW, Morton NE, Dennis NR, Curtis G, McKechnie N, Macpherson JN, Murray A, Pound MC, Sharrock AJ, Youings SA, Jacobs PA.; 1998 Jan 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=18487
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Hip disability and osteoarthritis outcome score (HOOS) -- validity and responsiveness in total hip replacement. by Nilsdotter AK, Lohmander LS, Klassbo M, Roos EM.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=161815
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Library services for people with disabilities: results of a survey. by Nelson PP.; 1996 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=226160
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Living with a Disability. by Wise CS.; 1954 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=199721
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Pain and disability reported in the year following a distal radius fracture: A cohort study. by MacDermid JC, Roth JH, Richards RS.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=270028
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Population based intervention to change back pain beliefs and disability: three part evaluation. by Buchbinder R, Jolley D, Wyatt M.; 2001 Jun 23; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=33390
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Predictors of positive health in disability pensioners: a population-based questionnaire study using Positive Odds Ratio. by Ejlertsson G, Eden L, Leden I.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=128811
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Processing of Speech Signals for Physical and Sensory Disabilities. by Levitt H.; 1995 Oct 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=40725
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Profile of disability in elderly people: estimates from a longitudinal population study. by [No authors listed]; 1999 Apr 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27843
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Rheumatology: 13. Minimizing disability in patients with low-back pain. by Wing PC.; 2001 May 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=81075
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Social Security Claims of Psychiatric Disability: Elements of Case Adjudication and the Role of Primary Care Physicians. by Leo RJ, Del Regno P.; 2001 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=181194
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The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. by Gummesson C, Atroshi I, Ekdahl C.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=165599
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The reduction in disability among the elderly. by Cutler DM.; 2001 Jun 5; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=34389
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The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with disability, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “disability” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for disability (hyperlinks lead to article summaries): •
A community-based intervention for siblings and parents of children with chronic illness or disability: the ISEE study. Author(s): Williams PD, Williams AR, Graff JC, Hanson S, Stanton A, Hafeman C, Liebergen A, Leuenberg K, Setter RK, Ridder L, Curry H, Barnard M, Sanders S. Source: The Journal of Pediatrics. 2003 September; 143(3): 386-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14517525&dopt=Abstract
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A comparison of anxiety and depression in sex offenders with intellectual disability and a control group with intellectual disability. Author(s): Lindsay WR, Lees MS. Source: Sexual Abuse : a Journal of Research and Treatment. 2003 October; 15(4): 339-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14571538&dopt=Abstract
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A comparison of assistive technology and personal care in alleviating disability and unmet need. Author(s): Agree EM, Freedman VA. Source: The Gerontologist. 2003 June; 43(3): 335-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12810897&dopt=Abstract
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A comparison of correlates of self-rated health and functional disability of older persons in the Far East: Japan and Korea. Author(s): Lee Y, Shinkai S. Source: Archives of Gerontology and Geriatrics. 2003 July-August; 37(1): 63-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12849074&dopt=Abstract
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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A cytogenetic study in 120 Turkish children with intellectual disability and characteristics of fragile X syndrome. Author(s): Demirhan O, Tastemir D, Diler RS, Firat S, Avci A. Source: Yonsei Medical Journal. 2003 August 30; 44(4): 583-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12950112&dopt=Abstract
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'A lifestyle coat-hanger': a phenomenological study of the meanings of artwork for women coping with chronic illness and disability. Author(s): Reynolds F, Prior S. Source: Disability and Rehabilitation. 2003 July 22; 25(14): 785-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959359&dopt=Abstract
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A new approach to the qualitative evaluation of functional disability in dementia. Author(s): Kurz X, Scuvee-Moreau J, Rive B, Dresse A. Source: International Journal of Geriatric Psychiatry. 2003 November; 18(11): 1050-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14618558&dopt=Abstract
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A new strategy for learning disability care. Author(s): Goodare L. Source: Nurs Times. 2003 October 28-November 3; 99(43): 42-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14626046&dopt=Abstract
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A novel accelerometer tilt switch device for switch actuation in the patient with profound disability. Author(s): Perring S, Summers A, Jones EL, Bowen FJ, Hart K. Source: Archives of Physical Medicine and Rehabilitation. 2003 June; 84(6): 921-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12808551&dopt=Abstract
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A population-based study of the effects of birth weight on early developmental delay or disability in children. Author(s): Thompson JR, Carter RL, Edwards AR, Roth J, Ariet M, Ross NL, Resnick MB. Source: American Journal of Perinatology. 2003 August; 20(6): 321-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14528402&dopt=Abstract
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A sensitivity analysis for nonrandomly missing categorical data arising from a national health disability survey. Author(s): Baker SG, Ko CW, Graubard BI. Source: Biostatistics (Oxford, England). 2003 January; 4(1): 41-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12925329&dopt=Abstract
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Acceptance of disability and sense of coherence in individuals with Ehlers-Danlos syndrome. Author(s): Berglund B, Mattiasson AC, Nordstrom G. Source: Journal of Clinical Nursing. 2003 September; 12(5): 770-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919224&dopt=Abstract
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Acute hospital discharges of patients with major disability: a review of patients admitted to a young disabled unit. Author(s): O'Connor RJ, Delargy MA. Source: Ir Med J. 2003 July-August; 96(7): 209-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14518584&dopt=Abstract
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ADA: isolated bouts of depression do not qualify as a disability. Author(s): Prieto-Gonzalez M. Source: The Journal of Law, Medicine & Ethics : a Journal of the American Society of Law, Medicine & Ethics. 2003 Spring; 31(1): 165-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12762116&dopt=Abstract
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Adaptation to disability in chronic obstructive pulmonary disease: neglected relationships to older adults' perceptions of independence. Author(s): Falter LB, Gignac MA, Cott C. Source: Disability and Rehabilitation. 2003 July 22; 25(14): 795-806. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959360&dopt=Abstract
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Age and disability affect dietary intake. Author(s): Bartali B, Salvini S, Turrini A, Lauretani F, Russo CR, Corsi AM, Bandinelli S, D'Amicis A, Palli D, Guralnik JM, Ferrucci L. Source: The Journal of Nutrition. 2003 September; 133(9): 2868-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12949379&dopt=Abstract
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Ageing and intellectual disability in Israel: a study to compare community residence with living at home. Author(s): Lifshitz H, Merrick J. Source: Health & Social Care in the Community. 2003 July; 11(4): 364-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14629208&dopt=Abstract
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Aging, disability, and disabled older people in India. Author(s): Prakash IJ. Source: Journal of Aging & Social Policy. 2003; 15(2-3): 85-108. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14696691&dopt=Abstract
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An evaluation of community learning disability nurse teams in two London boroughs. Author(s): Messent PR. Source: British Journal of Community Nursing. 2003 September; 8(9): 411-3, 416-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14508429&dopt=Abstract
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An examination of the pattern of challenging behaviour referrals to a community learning disability nursing service. Author(s): McKenzie K, Paxton D, Matheson E, Murray GC. Source: Health Bull (Edinb). 1999 July; 57(4): 262-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12811887&dopt=Abstract
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An integrative conceptual framework of disability. New directions for research. Author(s): Tate DG, Pledger C. Source: The American Psychologist. 2003 April; 58(4): 289-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866395&dopt=Abstract
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An unexpected and severe neurological disorder with permanent disability acquired during short-course treatment with metronidazole. Author(s): Rustscheff S, Hulten S. Source: Scandinavian Journal of Infectious Diseases. 2003; 35(4): 279-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12839161&dopt=Abstract
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Anger management training: the effects of a structured programme on the selfreported anger experience of forensic inpatients with learning disability. Author(s): Burns M, Bird D, Leach C, Higgins K. Source: Journal of Psychiatric and Mental Health Nursing. 2003 October; 10(5): 569-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12956636&dopt=Abstract
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Anorexia nervosa: the cost of long-term disability. Author(s): Su JC, Birmingham CL. Source: Eat Weight Disord. 2003 March; 8(1): 76-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12762629&dopt=Abstract
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Anxiety and depression influence the relation between disability status and quality of life in multiple sclerosis. Author(s): Janssens AC, van Doorn PA, de Boer JB, Kalkers NF, van der Meche FG, Passchier J, Hintzen RQ. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2003 August; 9(4): 397403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12926846&dopt=Abstract
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Applying the International Classification of Functioning, Disability and Health (ICF) to measure childhood disability. Author(s): Simeonsson RJ, Leonardi M, Lollar D, Bjorck-Akesson E, Hollenweger J, Martinuzzi A. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 602-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959334&dopt=Abstract
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Arithmetic difficulties in children with visuospatial learning disability (VLD). Author(s): Venneri A, Cornoldi C, Garuti M. Source: Neuropsychology, Development, and Cognition. Section C, Child Neuropsychology : a Journal on Normal and Abnormal Development in Childhood and Adolescence. 2003 September; 9(3): 175-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13680407&dopt=Abstract
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Arthritis and the role of the physician in nonmalignant pain and disability. Author(s): Miller CE. Source: Journal of Health & Social Policy. 2002; 16(1-2): 33-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12809376&dopt=Abstract
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Arthritis self-management education programs: a meta-analysis of the effect on pain and disability. Author(s): Warsi A, LaValley MP, Wang PS, Avorn J, Solomon DH. Source: Arthritis and Rheumatism. 2003 August; 48(8): 2207-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12905474&dopt=Abstract
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Assessing comparability of dressing disability in different countries by response conversion. Author(s): van Buuren S, Eyres S, Tennant A, Hopman-Rock M. Source: European Journal of Public Health. 2003 September; 13(3 Suppl): 15-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14533743&dopt=Abstract
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Assessment of disability, social and economic situations of people affected by leprosy in Shandong Province, People's Republic of China. Author(s): Shumin C, Diangchang L, Bing L, Lin Z, Xioulu Y. Source: Lepr Rev. 2003 September; 74(3): 215-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14577466&dopt=Abstract
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Association between measures of morbidity and locomotor disability: diagnosis alone is not enough. Author(s): Adamson J, Hunt K, Ebrahim S. Source: Social Science & Medicine (1982). 2003 October; 57(8): 1355-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12927466&dopt=Abstract
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Attitudes of health care trainees about genetics and disability: issues of access, health care communication, and decision making. Author(s): Ormond KE, Gill CJ, Semik P, Kirschner KL. Source: Journal of Genetic Counseling. 2003 August; 12(4): 333-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14682357&dopt=Abstract
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Attitudes towards disability amongst Pakistani and Bangladeshi parents of disabled children in the UK: considerations for service providers and the disability movement. Author(s): Bywaters P, Ali Z, Fazil Q, Wallace LM, Singh G. Source: Health & Social Care in the Community. 2003 November; 11(6): 502-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14629581&dopt=Abstract
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Autism spectrum disorders in children with active epilepsy and learning disability: comorbidity, pre- and perinatal background, and seizure characteristics. Author(s): Steffenburg S, Steffenburg U, Gillberg C. Source: Developmental Medicine and Child Neurology. 2003 November; 45(11): 724-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14580127&dopt=Abstract
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BC introduces changes to disability assistance. Author(s): Quandt T. Source: Can Hiv Aids Policy Law Rev. 2002 July; 7(1): 40-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14765493&dopt=Abstract
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Beating disability, embracing motherhood. Author(s): Baker S. Source: Pract Midwife. 2003 July-August; 6(7): 16-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12886835&dopt=Abstract
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Beyond the disability: recognizing mental health issues among persons with intellectual and developmental disabilities. Author(s): Ailey SH. Source: Nurs Clin North Am. 2003 June; 38(2): 313-29. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12914310&dopt=Abstract
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Bioethics in the United Kingdom: genetic screening, disability rights, and the erosion of trust. Author(s): Herissone-Kelly P. Source: Cambridge Quarterly of Healthcare Ethics : Cq : the International Journal of Healthcare Ethics Committees. 2003 Summer; 12(3): 235-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12889326&dopt=Abstract
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Bone and joint diseases around the world. Arthritis--the greatest health, disability, and civil rights challenge: a UK and international perspective. Author(s): Betteridge N. Source: J Rheumatol Suppl. 2003 August; 67: 36-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12926651&dopt=Abstract
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Can disability studies and psychology join hands? Author(s): Olkin R, Pledger C. Source: The American Psychologist. 2003 April; 58(4): 296-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866396&dopt=Abstract
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Cardiorespiratory fitness and risk of disability pension: a prospective population based study in Finnish men. Author(s): Karpansalo M, Lakka TA, Manninen P, Kauhanen J, Rauramaa R, Salonen JT. Source: Occupational and Environmental Medicine. 2003 October; 60(10): 765-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14504365&dopt=Abstract
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Caregiving burden of families looking after persons with intellectual disability and behavioural or psychiatric problems. Author(s): Maes B, Broekman TG, Dosen A, Nauts J. Source: Journal of Intellectual Disability Research : Jidr. 2003 September; 47(Pt 6): 447-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919195&dopt=Abstract
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Changes in function and disability after resistance training: does velocity matter?: a pilot study. Author(s): Sayers SP, Bean J, Cuoco A, LeBrasseur NK, Jette A, Fielding RA. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 2003 August; 82(8): 605-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12872017&dopt=Abstract
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Child disability and mothers' tubal sterilization. Author(s): Park JM, Hogan DP, Goldscheider FK. Source: Perspectives on Sexual and Reproductive Health. 2003 May-June; 35(3): 138-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866787&dopt=Abstract
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Chronic pain-related disability and use of analgesia and health services in a Sydney community. Author(s): Blyth FM, March LM, Cousins MJ. Source: The Medical Journal of Australia. 2003 July 21; 179(2): 84-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12864718&dopt=Abstract
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Clara: a phenomenology of disability. Author(s): Padilla R. Source: Am J Occup Ther. 2003 July-August; 57(4): 413-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12911083&dopt=Abstract
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Classification of communication disabilities in children: contribution of the International Classification on Functioning, Disability and Health. Author(s): Simeonsson RJ. Source: International Journal of Audiology. 2003 July; 42 Suppl 1: S2-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12918604&dopt=Abstract
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Comparing disability survey questions in five countries: a study using ICF to guide comparisons. Author(s): Swanson G, Carrothers L, Mulhorn KA. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 665-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959341&dopt=Abstract
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Comparing the self-concepts of Hong Kong Chinese adults with visible and not visible physical disability. Author(s): Tam SF, Chan MH, Lam HW, Lam LH. Source: The Journal of Psychology. 2003 July; 137(4): 363-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943186&dopt=Abstract
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Comparison between impairment and disability scales in immune-mediated polyneuropathies. Author(s): Merkies IS, Schmitz PI, Van Der Meche FG, Van Doorn PA. Source: Muscle & Nerve. 2003 July; 28(1): 93-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12811779&dopt=Abstract
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Comparison of different speech coding strategies using a disability-based inventory and speech perception tests in quiet and in noise. Author(s): Beynon AJ, Snik AF, van den Broek P. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 May; 24(3): 392-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806290&dopt=Abstract
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Comparison of the Community Integration Questionnaire, the Craig Handicap Assessment and Reporting Technique, and the Disability Rating Scale in traumatic brain injury. Author(s): Zhang L, Abreu BC, Gonzales V, Seale G, Masel B, Ottenbacher KJ. Source: The Journal of Head Trauma Rehabilitation. 2002 December; 17(6): 497-509. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12802241&dopt=Abstract
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Concordance of four methods of disability assessment using performance in the home as the criterion method. Author(s): Rogers JC, Holm MB, Beach S, Schulz R, Cipriani J, Fox A, Starz TW. Source: Arthritis and Rheumatism. 2003 October 15; 49(5): 640-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14558049&dopt=Abstract
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Consensus statement: Menstrual and contraceptive management in women with an intellectual disability. Author(s): Atkinson E, Bennett MJ, Dudley J, Grover S, Matthews K, Moore P, Quinlivan J, Walters T; Australian Society of Paediatric and Adolescent Gynaecology Working Party. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 2003 April; 43(2): 109-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14712963&dopt=Abstract
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Continuum of intellectual disability: demographic evidence for the “forgotten generation”. Author(s): Fujiura GT. Source: Mental Retardation. 2003 December; 41(6): 420-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14588060&dopt=Abstract
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Cross-sectional and longitudinal associations of low-back pain and related disability with psychological distress among patients enrolled in the UCLA Low-Back Pain Study. Author(s): Hurwitz EL, Morgenstern H, Yu F. Source: Journal of Clinical Epidemiology. 2003 May; 56(5): 463-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12812821&dopt=Abstract
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Daring men to be caring men: the dilemma of disability for male caregivers. Author(s): Anderson ML. Source: Axone. 2001 March; 22(3): 18-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14625969&dopt=Abstract
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Declining trends in work-related morbidity and disability, 1993-1998: a comparison of survey estimates and compensation insurance claims. Author(s): Mustard C, Cole D, Shannon H, Pole J, Sullivan T, Allingham R. Source: American Journal of Public Health. 2003 August; 93(8): 1283-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12893615&dopt=Abstract
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Depression: its trajectory and correlates in mothers rearing children with intellectual disability. Author(s): Glidden LM, Schoolcraft SA. Source: Journal of Intellectual Disability Research : Jidr. 2003 May-June; 47(Pt 4-5): 25063. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787157&dopt=Abstract
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Depressive symptoms in intellectual disability: does gender play a role? Author(s): Lunsky Y. Source: Journal of Intellectual Disability Research : Jidr. 2003 September; 47(Pt 6): 417-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919192&dopt=Abstract
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Determinants of stability and changes in self-reported work disability among older working-age populations. Author(s): Choi NG. Source: Journal of Aging & Social Policy. 2003; 15(1): 11-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12822692&dopt=Abstract
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Diagnosis of Helicobacter pylori infection in adults with intellectual disability. Author(s): Wallace RA, Schluter PJ, Forgan-Smith R, Wood R, Webb PM. Source: Journal of Clinical Microbiology. 2003 October; 41(10): 4700-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14532206&dopt=Abstract
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Differences and similarities between mothers' and fathers' experiences of parenting a child with a disability. Author(s): Pelchat D, Lefebvre H, Perreault M. Source: Journal of Child Health Care : for Professionals Working with Children in the Hospital and Community. 2003 December; 7(4): 231-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14636429&dopt=Abstract
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Different ways of being aware of a psychiatric disability: a multifunctional narrative approach to insight into mental disorder. Author(s): Roe D, Kravetz S. Source: The Journal of Nervous and Mental Disease. 2003 July; 191(7): 417-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12891087&dopt=Abstract
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Disability and borderline personality symptoms. Author(s): Sansone RA, Hruschka J, Vasudevan A, Miller SN. Source: Psychosomatics. 2003 September-October; 44(5): 442. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12954928&dopt=Abstract
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Disability and chronic pain after open mesh and laparoscopic inguinal hernia repair. Author(s): Bozuk M, Schuster R, Stewart D, Hicks K, Greaney G, Waxman K. Source: The American Surgeon. 2003 October; 69(10): 839-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14570359&dopt=Abstract
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Disability and rehabilitation research. Opportunities for participation, collaboration, and extramural funding for psychologists. Author(s): Melia RP, Pledger C, Wilson R. Source: The American Psychologist. 2003 April; 58(4): 285-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866394&dopt=Abstract
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Disability and the future of Medicare. Author(s): Cutler DM. Source: The New England Journal of Medicine. 2003 September 11; 349(11): 1084-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12968093&dopt=Abstract
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Disability in adults with hip and knee arthroplasty: a French national community based survey. Author(s): Boutron I, Poiraudeau S, Ravaud JF, Baron G, Revel M, Nizard R, Dougados M, Ravaud P. Source: Annals of the Rheumatic Diseases. 2003 August; 62(8): 748-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860730&dopt=Abstract
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Disability in depression and back pain: evaluation of the World Health Organization Disability Assessment Schedule (WHO DAS II) in a primary care setting. Author(s): Chwastiak LA, Von Korff M. Source: Journal of Clinical Epidemiology. 2003 June; 56(6): 507-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12873644&dopt=Abstract
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Disability in older Australians: projections for 2006-2031. Author(s): Giles LC, Cameron ID, Crotty M. Source: The Medical Journal of Australia. 2003 August 4; 179(3): 130-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12885280&dopt=Abstract
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Disability in the family: a life span perspective. Author(s): Banks ME. Source: Cultural Diversity & Ethnic Minority Psychology. 2003 November; 9(4): 367-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14609368&dopt=Abstract
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Disability management: the Insurance Corporation of British Columbia experience. Author(s): Harder H, Potts L. Source: Pain Res Manag. 2003 Summer; 8(2): 95-100. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12879140&dopt=Abstract
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Disability needs change as dentists age. Author(s): Kawamura GS. Source: Hawaii Dent J. 2003 September-October; 34(5): 15. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14649004&dopt=Abstract
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Disability payments, drug use and representative payees: an analysis of the relationships. Author(s): Swartz JA, Hsieh CM, Baumohl J. Source: Addiction (Abingdon, England). 2003 July; 98(7): 965-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12814502&dopt=Abstract
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Disability project steering group. Author(s): Tynan A. Source: The Veterinary Record. 2003 June 14; 152(24): 756. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833942&dopt=Abstract
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Disability revisited. Author(s): Holmes EB. Source: American Family Physician. 2003 July 1; 68(1): 175, 179-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12887124&dopt=Abstract
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Disability rites: the cultural shift following impairment. Author(s): Harrison TC, Kahn DL. Source: Family & Community Health. 2004 January-March; 27(1): 86-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14724505&dopt=Abstract
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Disability, sexuality and access to services. Author(s): Cooper E. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2003 July; 29(3): 123. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894783&dopt=Abstract
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Discourse on disability and rehabilitation issues. Opportunities for psychology. Author(s): Pledger C. Source: The American Psychologist. 2003 April; 58(4): 279-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866393&dopt=Abstract
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DSM-IV disorders in children with borderline to moderate intellectual disability. I: prevalence and impact. Author(s): Dekker MC, Koot HM. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 August; 42(8): 915-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12874493&dopt=Abstract
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DSM-IV disorders in children with borderline to moderate intellectual disability. II: child and family predictors. Author(s): Dekker MC, Koot HM. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 August; 42(8): 923-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12874494&dopt=Abstract
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Educating lay carers of people with learning disability in epilepsy awareness and in the use of rectal diazepam: a suggested teaching protocol for use by healthcare personnel. Author(s): Sterrick M, Foley J. Source: Health Bull (Edinb). 1999 May; 57(3): 198-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12811896&dopt=Abstract
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Effect of valued activity disability, social comparisons, and satisfaction with ability on depressive symptoms in rheumatoid arthritis. Author(s): Neugebauer A, Katz PP, Pasch LA. Source: Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association. 2003 May; 22(3): 253-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790252&dopt=Abstract
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Effect on disability outcomes of a depression relapse prevention program. Author(s): Von Korff M, Katon W, Rutter C, Ludman E, Simon G, Lin E, Bush T. Source: Psychosomatic Medicine. 2003 November-December; 65(6): 938-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14645770&dopt=Abstract
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Effects of a perindopril-based blood pressure-lowering regimen on disability and dependency in 6105 patients with cerebrovascular disease: a randomized controlled trial. Author(s): Fransen M, Anderson C, Chalmers J, Chapman N, Davis S, MacMahon S, Neal B, Sega R, Terent A, Tzourio C, Woodward M; PROGRESS. Source: Stroke; a Journal of Cerebral Circulation. 2003 October; 34(10): 2333-8. Epub 2003 September 04. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12958329&dopt=Abstract
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Effects of a short outpatient rehabilitation treatment on disability of multiple sclerosis patients--a randomised controlled trial. Author(s): Patti F, Ciancio MR, Cacopardo M, Reggio E, Fiorilla T, Palermo F, Reggio A, Thompson AJ. Source: Journal of Neurology. 2003 July; 250(7): 861-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12883930&dopt=Abstract
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Effects of glatiramer acetate on relapse rate and accumulated disability in multiple sclerosis: meta-analysis of three double-blind, randomized, placebo-controlled clinical trials. Author(s): Boneschi FM, Rovaris M, Johnson KP, Miller A, Wolinsky JS, Ladkani D, Shifroni G, Comi G, Filippi M. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2003 August; 9(4): 34955. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12926839&dopt=Abstract
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Effects of thrombolysis for acute stroke in patients with pre-existing disability. Author(s): Foell RB, Silver B, Merino JG, Wong EH, Demaerschalk BM, Poncha F, Tamayo A, Hachinski V. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 August 5; 169(3): 193-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12900476&dopt=Abstract
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Establishing minimal clinically important differences for scores on the pediatric evaluation of disability inventory for inpatient rehabilitation. Author(s): Iyer LV, Haley SM, Watkins MP, Dumas HM. Source: Physical Therapy. 2003 October; 83(10): 888-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14519060&dopt=Abstract
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Estimation of the misclassification rate of self-reported visual disability. Author(s): Djafari F, Gresset JA, Boisjoly HM, Boivin JF, Labelle P, Boucher MC, Amyot M, Cliche L, Charest M. Source: Canadian Journal of Public Health. Revue Canadienne De Sante Publique. 2003 September-October; 94(5): 367-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14577747&dopt=Abstract
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Evaluating a Medicaid home and community-based physical disability waiver. Author(s): Fox MH, Kim KM. Source: Family & Community Health. 2004 January-March; 27(1): 37-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14724501&dopt=Abstract
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Evaluation of an intervention system for parents of children with intellectual disability and challenging behaviour. Author(s): Hudson AM, Matthews JM, Gavidia-Payne ST, Cameron CA, Mildon RL, Radler GA, Nankervis KL. Source: Journal of Intellectual Disability Research : Jidr. 2003 May-June; 47(Pt 4-5): 23849. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787156&dopt=Abstract
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Evaluation of functional disability using the health assessment questionnaire in Japanese patients with systemic sclerosis. Author(s): Kuwana M, Sato S, Kikuchi K, Kawaguchi Y, Fujisaku A, Misaki Y, Hatamochi A, Kondo H, Takehara K. Source: The Journal of Rheumatology. 2003 June; 30(6): 1253-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12784399&dopt=Abstract
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Evaluation of management of road trauma survivors with brain injury and neurologic disability in Victoria. Author(s): McDermott FT, Rosenfeld JV, Laidlaw JD, Cordner SM, Tremayne AB; Consultative Committee on Road Traffic Fatalities in Victoria. Source: The Journal of Trauma. 2004 January; 56(1): 137-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14749581&dopt=Abstract
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Explaining the parental stress of fathers and mothers caring for a child with intellectual disability: a Double ABCX Model. Author(s): Saloviita T, Italinna M, Leinonen E. Source: Journal of Intellectual Disability Research : Jidr. 2003 May-June; 47(Pt 4-5): 30012. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787162&dopt=Abstract
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Factors associated with body function and disability in patients with ankylosing spondylitis: a cross-sectional study. Author(s): Falkenbach A, Franke A, van der Linden S. Source: The Journal of Rheumatology. 2003 October; 30(10): 2186-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14528516&dopt=Abstract
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Factors associated with migraine-related quality of life and disability in adolescents: a preliminary investigation. Author(s): Tkachuk GA, Cottrell CK, Gibson JS, O'Donnell FJ, Holroyd KA. Source: Headache. 2003 October; 43(9): 950-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14511271&dopt=Abstract
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Fathers of children with Down's syndrome versus other types of intellectual disability: perceptions, stress and involvement. Author(s): Ricci LA, Hodapp RM. Source: Journal of Intellectual Disability Research : Jidr. 2003 May-June; 47(Pt 4-5): 27384. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787159&dopt=Abstract
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Fear of movement/(re)injury, disability and participation in acute low back pain. Author(s): Swinkels-Meewisse IE, Roelofs J, Verbeek AL, Oostendorp RA, Vlaeyen JW. Source: Pain. 2003 September; 105(1-2): 371-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14499456&dopt=Abstract
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Five clinical tests to assess balance following ball exercises and treadmill training in adult persons with intellectual disability. Author(s): Carmeli E, Bar-Chad S, Lotan M, Merrick J, Coleman R. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2003 August; 58(8): 767-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12902538&dopt=Abstract
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Functional self-efficacy and pain-related disability among older veterans with chronic pain in a primary care setting. Author(s): Barry LC, Guo Z, Kerns RD, Duong BD, Reid MC. Source: Pain. 2003 July; 104(1-2): 131-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12855322&dopt=Abstract
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Functioning and disability associated with mental disorders: the evolution since ICIDH. Author(s): Kennedy C. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 611-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959335&dopt=Abstract
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Gender differences in disability and health-related quality of life in patients with Parkinson's disease treated with stereotactic surgery. Author(s): Hariz GM, Lindberg M, Hariz MI, Bergenheim AT. Source: Acta Neurologica Scandinavica. 2003 July; 108(1): 28-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807390&dopt=Abstract
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Greek versions of the Oswestry and Roland-Morris Disability Questionnaires. Author(s): Boscainos PJ, Sapkas G, Stilianessi E, Prouskas K, Papadakis SA. Source: Clinical Orthopaedics and Related Research. 2003 June; (411): 40-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782858&dopt=Abstract
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Habitual walking and its correlation to better physical function: implications for prevention of physical disability in older persons. Author(s): Wong CH, Wong SF, Pang WS, Azizah MY, Dass MJ. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2003 June; 58(6): 555-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807928&dopt=Abstract
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Hematopoietic stem cell transplantation for progressive multiple sclerosis: failure of a total body irradiation-based conditioning regimen to prevent disease progression in patients with high disability scores. Author(s): Burt RK, Cohen BA, Russell E, Spero K, Joshi A, Oyama Y, Karpus WJ, Luo K, Jovanovic B, Traynor A, Karlin K, Stefoski D, Burns WH. Source: Blood. 2003 October 1; 102(7): 2373-8. Epub 2003 July 03. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842989&dopt=Abstract
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Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement. Author(s): Nilsdotter AK, Lohmander LS, Klassbo M, Roos EM. Source: Bmc Musculoskeletal Disorders [electronic Resource]. 2003 May 30; 4(1): 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777182&dopt=Abstract
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Impact of functional restoration after anterior cervical fusion on chronic disability in work-related neck pain. Author(s): Mayer TG, Anagnostis C, Gatchel RJ, Evans T. Source: The Spine Journal : Official Journal of the North American Spine Society. 2002 July-August; 2(4): 267-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14589478&dopt=Abstract
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Impact of initial aggressive drug treatment with a combination of disease-modifying antirheumatic drugs on the development of work disability in early rheumatoid arthritis: a five-year randomized followup trial. Author(s): Puolakka K, Kautiainen H, Mottonen T, Hannonen P, Korpela M, Julkunen H, Luukkainen R, Vuori K, Paimela L, Blafield H, Hakala M, Leirisalo-Repo M. Source: Arthritis and Rheumatism. 2004 January; 50(1): 55-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14730599&dopt=Abstract
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Impulsiveness as a factor in sexual offending by people with mild intellectual disability. Author(s): Parry CJ, Lindsay WR. Source: Journal of Intellectual Disability Research : Jidr. 2003 September; 47(Pt 6): 483-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919199&dopt=Abstract
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Increasing disability awareness of future spinal cord injury physicians. Author(s): Sabharwal S, Fiedler IG. Source: J Spinal Cord Med. 2003 Spring; 26(1): 45-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830969&dopt=Abstract
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Influence of macrostructure of society on the life situation of families with a child with intellectual disability: Sweden as an example. Author(s): Olsson MB, Hwang PC. Source: Journal of Intellectual Disability Research : Jidr. 2003 May-June; 47(Pt 4-5): 32841. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787164&dopt=Abstract
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Interprofessional practice and learning disability nursing. Author(s): McCray J. Source: British Journal of Nursing (Mark Allen Publishing). 2003 December 11-2004 January 7; 12(22): 1335-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14688655&dopt=Abstract
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Investigation of quality of life, mood, pain, disability, and disease status in primary systemic vasculitis. Author(s): Koutantji M, Harrold E, Lane SE, Pearce S, Watts RA, Scott DG. Source: Arthritis and Rheumatism. 2003 December 15; 49(6): 826-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14673970&dopt=Abstract
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Is reading disability likely to interfere with glaucoma screening of adults using frequency-doubling technology perimetry? Author(s): Edwards JD, De Leon-Ortega J, Bearden WH, Rumble ME, Girkin CA. Source: American Journal of Ophthalmology. 2003 June; 135(6): 816-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12788121&dopt=Abstract
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Leading interprofessional practice: a conceptual framework to support practitioners in the field of learning disability. Author(s): McCray J. Source: Journal of Nursing Management. 2003 November; 11(6): 387-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14641720&dopt=Abstract
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Learning disability. Author(s): Gillberg C, Soderstrom H. Source: Lancet. 2003 September 6; 362(9386): 811-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13678878&dopt=Abstract
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Let's end disability as we know it. Author(s): Luchins DJ. Source: Psychiatric Services (Washington, D.C.). 2003 July; 54(7): 931. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12851426&dopt=Abstract
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Linking osteoarthritis-specific health-status measures to the International Classification of Functioning, Disability, and Health (ICF). Author(s): Weigl M, Cieza A, Harder M, Geyh S, Amann E, Kostanjsek N, Stucki G. Source: Osteoarthritis and Cartilage / Oars, Osteoarthritis Research Society. 2003 July; 11(7): 519-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12814615&dopt=Abstract
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Long-term disability among aviators in Japan Air Self-Defense Force: analysis of 260 cases. Author(s): Nakanishi K, Ohrui N, Nakata Y, Hanada R, Kobayashi M, Ohashi K. Source: Aviation, Space, and Environmental Medicine. 2003 September; 74(9): 966-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14503675&dopt=Abstract
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Long-term injury related disability in Ghana. Author(s): Mock CN, Boland E, Acheampong F, Adjei S. Source: Disability and Rehabilitation. 2003 July 8; 25(13): 732-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12791558&dopt=Abstract
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Management of physical disability. Author(s): Bax MC. Source: Developmental Medicine and Child Neurology. 2003 July; 45(7): 435. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12828395&dopt=Abstract
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Meaning of life for adolescents with a physical disability in Korea. Author(s): Kim SJ, Kang KA. Source: Journal of Advanced Nursing. 2003 July; 43(2): 145-55; Discussion 155-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834372&dopt=Abstract
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Measuring chronic health condition and disability as distinct concepts in national surveys of school-aged children in Canada: a comprehensive review with recommendations based on the ICD-10 and ICF. Author(s): McDougall J, Miller LT. Source: Disability and Rehabilitation. 2003 August 19; 25(16): 922-39. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12857580&dopt=Abstract
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Measuring functional change in children with acquired brain injury (ABI): comparison of generic and ABI-specific scales using the Pediatric Evaluation of Disability Inventory (PEDI). Author(s): Kothari DH, Haley SM, Gill-Body KM, Dumas HM. Source: Physical Therapy. 2003 September; 83(9): 776-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12940765&dopt=Abstract
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Measuring functional status and disability in older adults. Author(s): Allaire SH. Source: Jama : the Journal of the American Medical Association. 2003 June 25; 289(24): 3239; Author Reply 3239-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824202&dopt=Abstract
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Measuring health in a vacuum: examining the disability weight of the DALY. Author(s): Reidpath DD, Allotey PA, Kouame A, Cummins RA. Source: Health Policy and Planning. 2003 December; 18(4): 351-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14654511&dopt=Abstract
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Measuring participation according to the International Classification of Functioning, Disability and Health (ICF). Author(s): Perenboom RJ, Chorus AM. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 577-87. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959331&dopt=Abstract
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Medicaid eligibility of former Supplemental Security Income recipients with drug abuse or alcoholism disability. Author(s): Hanrahan P, Luchins DJ, Cloninger L, Swartz J. Source: American Journal of Public Health. 2004 January; 94(1): 46-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14713695&dopt=Abstract
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Medical services for persons with intellectual disability in Israel. Author(s): Merrick J, Kandel I. Source: Public Health Rev. 2003; 31(1): 45-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14656043&dopt=Abstract
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Mental disability and death by dehydration. Author(s): Marker RL. Source: Natl Cathol Bioeth Q. 2002 Spring; 2(1): 125-36. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12854572&dopt=Abstract
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Mental health services use among school-aged children with disabilities: the role of sociodemographics, functional limitations, family burdens, and care coordination. Author(s): Witt WP, Kasper JD, Riley AW. Source: Health Services Research. 2003 December; 38(6 Pt 1): 1441-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14727782&dopt=Abstract
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Migraine headache disability and health-related quality-of-life: a population-based case-control study from England. Author(s): Lipton RB, Liberman JN, Kolodner KB, Bigal ME, Dowson A, Stewart WF. Source: Cephalalgia : an International Journal of Headache. 2003 July; 23(6): 441-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807523&dopt=Abstract
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Missed opportunities and unlimited possibilities: teaching disability content in schools of social work. Author(s): Gourdine RM, Sanders T. Source: Journal of Health & Social Policy. 2002; 16(1-2): 207-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12809389&dopt=Abstract
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Moderating effects of psychosocial attributes on the association between risk factors and disability in later life. Author(s): Jang Y, Haley WE, Mortimer JA, Small BJ. Source: Aging & Mental Health. 2003 May; 7(3): 163-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775395&dopt=Abstract
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Mothers of children and adolescents with intellectual disability: social and economic situation, mental health status, and the self-assessed social and psychological impact of the child's difficulties. Author(s): Emerson E. Source: Journal of Intellectual Disability Research : Jidr. 2003 May-June; 47(Pt 4-5): 38599. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787168&dopt=Abstract
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Motivated but fearful: welfare reform, disability, and race. Author(s): Crewe SE. Source: Journal of Health & Social Policy. 2002; 16(1-2): 55-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12809378&dopt=Abstract
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Neural systems for compensation and persistence: young adult outcome of childhood reading disability. Author(s): Shaywitz SE, Shaywitz BA, Fulbright RK, Skudlarski P, Mencl WE, Constable RT, Pugh KR, Holahan JM, Marchione KE, Fletcher JM, Lyon GR, Gore JC. Source: Biological Psychiatry. 2003 July 1; 54(1): 25-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842305&dopt=Abstract
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Nurses' role in the developments in learning disability care. Author(s): Parrish A, Styring L. Source: British Journal of Nursing (Mark Allen Publishing). 2003 September 25-October 8; 12(17): 1043-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14512861&dopt=Abstract
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Observing the onset of disability in older adults. Author(s): Reynolds SL, Silverstein M. Source: Social Science & Medicine (1982). 2003 November; 57(10): 1875-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14499512&dopt=Abstract
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Occupational disability after hospitalization for the treatment of an injury of the anterior cruciate ligament. Author(s): Dunn WR, Lincoln AE, Hinton RY, Smith GS, Amoroso PJ. Source: The Journal of Bone and Joint Surgery. American Volume. 2003 September; 85A(9): 1656-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12954822&dopt=Abstract
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Occupational therapy in the promotion of health and the prevention of disease and disability statement. Author(s): Brownson CA, Scaffa ME. Source: Am J Occup Ther. 2001 November-December; 55(6): 656-60. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959230&dopt=Abstract
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On the application of the ICIDH and ICF in developing countries: evidence from the United Nations Disability Statistics Database (DISTAT). Author(s): Mbogoni M. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 644-58. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959339&dopt=Abstract
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On the cause of disability glare and its dependence on glare angle, age and ocular pigmentation. Author(s): Vos JJ. Source: Clinical & Experimental Optometry : Journal of the Australian Optometrical Association. 2003 November; 86(6): 363-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14632612&dopt=Abstract
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Outcome evaluation of the hand and wrist according to the International Classification of Functioning, Disability, and Health. Author(s): Barbier O, Penta M, Thonnard JL. Source: Hand Clin. 2003 August; 19(3): 371-8, Vii. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12945633&dopt=Abstract
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Outcome of hand trauma: the hand injury severity scoring system (HISS) and subsequent impairment and disability. Author(s): Mink van der Molen AB, Ettema AM, Hovius SE. Source: Journal of Hand Surgery (Edinburgh, Lothian). 2003 August; 28(4): 295-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12849937&dopt=Abstract
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Outcomes of digital X-ray mini-panel examinations for patients having mental retardation and developmental disability. Author(s): Farman AG, Horsley B, Warr E, Ianke JL, Hood H. Source: Dento Maxillo Facial Radiology. 2003 January; 32(1): 15-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12820848&dopt=Abstract
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Patients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: implications for clinical practice. Author(s): Pettey AA, Balkrishnan R, Rapp SR, Fleischer AB, Feldman SR. Source: Journal of the American Academy of Dermatology. 2003 August; 49(2): 271-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894076&dopt=Abstract
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Patients', doctors', and caregivers' assessment of disability using the UPDRS-ADL section: are these ratings interchangeable? Author(s): Martinez-Martin P, Benito-Leon J, Alonso F, Catalan MJ, Pondal M, Tobias A, Zamarbide I. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2003 September; 18(9): 985-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14502665&dopt=Abstract
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Patterns of health care and disability for Medicare beneficiaries under 65. Author(s): Riley GF, Lubitz JD, Zhang N. Source: Inquiry. 2003 Spring; 40(1): 71-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12836909&dopt=Abstract
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Pitfalls in the assessment of disability in individuals with low-grade gliomas. Author(s): Pahlson A, Ek L, Ahlstrom G, Smits A. Source: Journal of Neuro-Oncology. 2003 November; 65(2): 149-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14686735&dopt=Abstract
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Pompe disease and physical disability. Author(s): Haley SM, Fragala MA, Skrinar AM. Source: Developmental Medicine and Child Neurology. 2003 September; 45(9): 618-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12948329&dopt=Abstract
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Positive effects of mime therapy on sequelae of facial paralysis: stiffness, lip mobility, and social and physical aspects of facial disability. Author(s): Beurskens CH, Heymans PG. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 July; 24(4): 677-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12851564&dopt=Abstract
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Positive supports for people who experience behavioral and cognitive disability after brain injury: a review. Author(s): Ylvisaker M, Jacobs HE, Feeney T. Source: The Journal of Head Trauma Rehabilitation. 2003 January-February; 18(1): 7-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12802235&dopt=Abstract
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Prediction of prolonged work disability in occupational low-back pain based on nurse case management data. Author(s): Okurowski L, Pransky G, Webster B, Shaw WS, Verma S. Source: Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine. 2003 July; 45(7): 763-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12855916&dopt=Abstract
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Predictive factors of 5-year health assessment questionnaire disability in early rheumatoid arthritis. Author(s): Combe B, Cantagrel A, Goupille P, Bozonnat MC, Sibilia J, Eliaou JF, Meyer O, Sany J, Dubois A, Daures JP, Dougados M. Source: The Journal of Rheumatology. 2003 November; 30(11): 2344-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14677175&dopt=Abstract
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Prevalence of epilepsy and associated health service utilization and mortality among patients with intellectual disability. Author(s): Morgan CL, Baxter H, Kerr MP. Source: Am J Ment Retard. 2003 September; 108(5): 293-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12901705&dopt=Abstract
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Prevention in severe learning disability: lessons from a follow-up study of young adults with a history of childhood learning disability. Author(s): O'Brien G. Source: Dev Med Child Neurol Suppl. 2003 August; 95: 35-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12898990&dopt=Abstract
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Primary health care for adults with intellectual disability. Author(s): Eastgate G, Lennox NG. Source: Aust Fam Physician. 2003 May; 32(5): 330-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12772365&dopt=Abstract
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Professional composition of community learning disability teams in Scotland: implications for service provision. Author(s): McKenzie K, Paxton D, Matheson E, Murray GC. Source: Health Bull (Edinb). 2000 May; 58(3): 192-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813824&dopt=Abstract
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Prognostic effect of prior disability episodes among nondisabled community-living older persons. Author(s): Gill TM, Kurland BF. Source: American Journal of Epidemiology. 2003 December 1; 158(11): 1090-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14630605&dopt=Abstract
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Prognostic factors for radiographic progression, radiographic damage, and disability in juvenile idiopathic arthritis. Author(s): Magni-Manzoni S, Rossi F, Pistorio A, Temporini F, Viola S, Beluffi G, Martini A, Ravelli A. Source: Arthritis and Rheumatism. 2003 December; 48(12): 3509-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14674002&dopt=Abstract
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Progressive resistance strength training for physical disability in older people. Author(s): Latham N, Anderson C, Bennett D, Stretton C. Source: Cochrane Database Syst Rev. 2003; (2): Cd002759. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804434&dopt=Abstract
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Promoting health and preventing disability in older adults: lessons from intervention studies carried out through an academic-community partnership. Author(s): Phelan EA, Cheadle A, Schwartz SJ, Snyder S, Williams B, Wagner EH, LoGerfo JP. Source: Family & Community Health. 2003 July-September; 26(3): 214-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12829943&dopt=Abstract
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Psychiatric disability among tortured Bhutanese refugees in Nepal. Author(s): Thapa SB, Van Ommeren M, Sharma B, de Jong JT, Hauff E. Source: The American Journal of Psychiatry. 2003 November; 160(11): 2032-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14594752&dopt=Abstract
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Psychopathology in people with epilepsy and intellectual disability. Author(s): Besag FM. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 November; 74(11): 1464. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14617698&dopt=Abstract
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Psychopathology in people with epilepsy and intellectual disability; an investigation of potential explanatory variables. Author(s): Espie CA, Watkins J, Curtice L, Espie A, Duncan R, Ryan JA, Brodie MJ, Mantala K, Sterrick M. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 November; 74(11): 1485-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14617702&dopt=Abstract
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Psychotropic drug use among people with intellectual disability before and after deinstitutionalization. Author(s): Nottestad JA, Linaker OM. Source: Journal of Intellectual Disability Research : Jidr. 2003 September; 47(Pt 6): 464-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919197&dopt=Abstract
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Quality here, there and everywhere: the application of a multi-dimensional learning tool to learning disability health services. Author(s): McKenzie K, White D, Murray G, Paxton D. Source: Health Bull (Edinb). 1999 March; 57(2): 134-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12811904&dopt=Abstract
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Quality of life and disability in primary chronic daily headaches. Author(s): D'Amico D, Usai S, Grazzi L, Rigamonti A, Solari A, Leone M, Bussone G. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2003 May; 24 Suppl 2: S97-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12811603&dopt=Abstract
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Re: Surgical removal of metastatic phylodes tumor: this should be strongly considered for the solitary lesion as long as cosmetic and functional disability is not excessive. Author(s): Buchanan EB. Source: The American Surgeon. 2003 July; 69(7): 633. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12889632&dopt=Abstract
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Recent developments in health insurance, life insurance, and disability insurance case law. Author(s): Hasman JJ, Chittenden WA 3rd, Doolin EG, Wall JF. Source: Tort Trial Insur Pract Law J. 2003 Winter; 38(2): 405-45. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807115&dopt=Abstract
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Reduction in long-term functional disability in rheumatoid arthritis from 1977 to 1998:a longitudinal study of 3035 patients. Author(s): Krishnan E, Fries JF. Source: The American Journal of Medicine. 2003 October 1; 115(5): 371-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14553872&dopt=Abstract
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Reference to ICIDH in French surveys on disability. Author(s): Roussel P, Barral C. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 659-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959340&dopt=Abstract
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Rehabilitation: disability ethics versus Peter Singer. Author(s): McPherson GW, Sobsey D. Source: Archives of Physical Medicine and Rehabilitation. 2003 August; 84(8): 1246-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12917869&dopt=Abstract
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Relationship of knee joint proprioception to pain and disability in individuals with knee osteoarthritis. Author(s): Bennell KL, Hinman RS, Metcalf BR, Crossley KM, Buchbinder R, Smith M, McColl G. Source: Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society. 2003 September; 21(5): 792-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919865&dopt=Abstract
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Reliability and validity of the (modified) Amsterdam Inventory for Auditory Disability and Handicap. Author(s): Meijer AG, Wit HP, TenVergert EM, Albers FW, Muller Kobold JE. Source: International Journal of Audiology. 2003 June; 42(4): 220-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790347&dopt=Abstract
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Reliability of the Dutch Pediatric Evaluation of Disability Inventory (PEDI). Author(s): Wassenberg-Severijnen JE, Custers JW, Hox JJ, Vermeer A, Helders PJ. Source: Clinical Rehabilitation. 2003 July; 17(4): 457-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785255&dopt=Abstract
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Response to “abortion and assent” by Rosamond Rhodes (CQ Vol 8, No 4) and “abortion, disability, assent, and consent” by Matti Hayry (CQ Vol 10, No 1). Assent and selective abortion: a response to Rhodes and Hayry. Author(s): Vehmas S. Source: Cambridge Quarterly of Healthcare Ethics : Cq : the International Journal of Healthcare Ethics Committees. 2001 Fall; 10(4): 433-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14533410&dopt=Abstract
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Returning to work after disability; what you should know. Interview by John S. James. Author(s): Ciasullo E. Source: Aids Treat News. 2003 October 31; (395): 5-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14666912&dopt=Abstract
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Rib fracture pain and disability: can we do better? Author(s): Kerr-Valentic MA, Arthur M, Mullins RJ, Pearson TE, Mayberry JC. Source: The Journal of Trauma. 2003 June; 54(6): 1058-63; Discussion 1063-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12813323&dopt=Abstract
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Risperidone and olanzapine in adults with intellectual disability: a clinical naturalistic study. Author(s): Bokszanska A, Martin G, Vanstraelen M, Holt G, Bouras N, Taylor D. Source: International Clinical Psychopharmacology. 2003 September; 18(5): 285-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12920389&dopt=Abstract
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Role of subvoxel free fluid on diffusion parameters in brain tissue with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and its correlation with physical disability: histogram analysis of standard and fluidattenuated MR diffusion. Author(s): Dichgans M, Putz B, Boos D, Auer DP. Source: Ajnr. American Journal of Neuroradiology. 2003 June-July; 24(6): 1083-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12812930&dopt=Abstract
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Screening for disability in a community: the 'ten questions' screen for children, in Bondo, Kenya. Author(s): Muga E. Source: Afr Health Sci. 2003 April; 3(1): 33-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12789086&dopt=Abstract
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Self-image, adolescence, and disability. Author(s): Adamson L. Source: Am J Occup Ther. 2003 September-October; 57(5): 578-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14527122&dopt=Abstract
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Self-reported disability and its association with performance-based limitation in elderly men: a comparison of three European countries. Author(s): van den Brink CL, Tijhuis M, Kalmijn S, Klazinga NS, Nissinen A, Giampaoli S, Kivinen P, Kromhout D, van den Bos GA. Source: Journal of the American Geriatrics Society. 2003 June; 51(6): 782-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12757564&dopt=Abstract
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Sexual esteem, sexual satisfaction, and sexual behavior among people with physical disability. Author(s): McCabe MP, Taleporos G. Source: Archives of Sexual Behavior. 2003 August; 32(4): 359-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856897&dopt=Abstract
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Sexual satisfaction and risk of disability in older women. Author(s): Onder G, Penninx BW, Guralnik JM, Jones H, Fried LP, Pahor M, Williamson JD. Source: The Journal of Clinical Psychiatry. 2003 October; 64(10): 1177-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14658965&dopt=Abstract
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Short-term disability, long term disability, Social Security Disability Insurance, and Family Medical Leave Act--relationship to case management practice. Author(s): Haag AB, Kalina CM, Tourigian R. Source: Aaohn Journal : Official Journal of the American Association of Occupational Health Nurses. 2003 October; 51(10): 414-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14596379&dopt=Abstract
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Shoulder pain and disability in daily life, following supraomohyoid neck dissection: a pilot study. Author(s): van Wilgen CP, Dijkstra PU, Nauta JM, Vermey A, Roodenburg JL. Source: Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery. 2003 June; 31(3): 183-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12818606&dopt=Abstract
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Socioeconomic position, occupational exposures, and gender: the relation with locomotor disability in early old age. Author(s): Adamson J, Hunt K, Ebrahim S. Source: Journal of Epidemiology and Community Health. 2003 June; 57(6): 453-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775793&dopt=Abstract
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Spinal cord atrophy and disability in multiple sclerosis over four years. Author(s): Horsfield MA, Filippi M. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 August; 74(8): 1014-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12876224&dopt=Abstract
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Spinal cord atrophy and disability in multiple sclerosis over four years: application of a reproducible automated technique in monitoring disease progression in a cohort of the interferon beta-1a (Rebif) treatment trial. Author(s): Lin X, Tench CR, Turner B, Blumhardt LD, Constantinescu CS. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 August; 74(8): 1090-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12876240&dopt=Abstract
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Staff reactions to self-injurious behaviours in learning disability services: attributions, emotional responses and helping. Author(s): Jones C, Hastings RP. Source: The British Journal of Clinical Psychology / the British Psychological Society. 2003 June; 42(Pt 2): 189-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12828807&dopt=Abstract
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Statistical mapping analysis of lesion location and neurological disability in multiple sclerosis: application to 452 patient data sets. Author(s): Charil A, Zijdenbos AP, Taylor J, Boelman C, Worsley KJ, Evans AC, Dagher A. Source: Neuroimage. 2003 July; 19(3): 532-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880785&dopt=Abstract
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Straddling the pathway from paediatrician to mainstream health care: transition issues experienced in disability care. Author(s): O'Connell B, Bailey S, Pearce J. Source: The Australian Journal of Rural Health. 2003 April; 11(2): 57-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12780495&dopt=Abstract
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Strengthening acute stroke trials through optimal use of disability end points. Author(s): Young FB, Lees KR, Weir CJ; Glycine Antagonist in Neuroprotection International Trial Steering Committee and Investigators. Source: Stroke; a Journal of Cerebral Circulation. 2003 November; 34(11): 2676-80. Epub 2003 October 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14563964&dopt=Abstract
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Stress management and workplace disability in the US, Europe and Japan. Author(s): Jones DL, Tanigawa T, Weiss SM. Source: Journal of Occupational Health. 2003 January; 45(1): 1-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14605422&dopt=Abstract
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Stress, social support and well-being of Arab mothers of children with intellectual disability who are served by welfare services in northern Israel. Author(s): Duvdevany I, Abboud S. Source: Journal of Intellectual Disability Research : Jidr. 2003 May-June; 47(Pt 4-5): 26472. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787158&dopt=Abstract
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Termination of pregnancy for reason of foetal disability: are there grounds for a special exception in law? Author(s): Sheldon S, Wilkinson S. Source: Medical Law Review. 2001 Summer; 9(2): 85-109. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12778928&dopt=Abstract
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Terrorism and the international classification of functioning, disability and health: a speculative case study based on the terrorist attacks on New York and Washington. Author(s): Seltser R, Dicowden MA, Hendershot GE. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 635-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959338&dopt=Abstract
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The association of disability, sociodemographic background, and social network type in later life. Author(s): Litwin H. Source: Journal of Aging and Health. 2003 May; 15(2): 391-408. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795280&dopt=Abstract
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The epidemiology of agriculture-related osteoarthritis and its impact on occupational disability. Author(s): Kirkhorn S, Greenlee RT, Reeser JC. Source: Wmj. 2003; 102(7): 38-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14711023&dopt=Abstract
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The experience of disability and quality of life in social anxiety disorder. Author(s): Hambrick JP, Turk CL, Heimberg RG, Schneier FR, Liebowitz MR. Source: Depression and Anxiety. 2003; 18(1): 46-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12900952&dopt=Abstract
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The experiences of people with developmental disability in Emergency Departments and hospital wards. Author(s): Iacono T, Davis R. Source: Research in Developmental Disabilities. 2003 July-August; 24(4): 247-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12873658&dopt=Abstract
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The ICF: Applications of the WHO model of functioning, disability and health to brain injury rehabilitation. Author(s): Bilbao A, Kennedy C, Chatterji S, Ustun B, Barquero JL, Barth JT. Source: Neurorehabilitation. 2003; 18(3): 239-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14530589&dopt=Abstract
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The impact of treatment confidence on pain and related disability among patients with low-back pain: results from the University of California, Los Angeles, low-back pain study. Author(s): Goldstein MS, Morgenstern H, Hurwitz EL, Yu F. Source: The Spine Journal : Official Journal of the North American Spine Society. 2002 November-December; 2(6): 391-9; Discussion 399-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14589256&dopt=Abstract
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The influence of pain and pain-related fear and disability beliefs on walking velocity in chronic low back pain. Author(s): Al-Obaidi SM, Al-Zoabi B, Al-Shuwaie N, Al-Zaabie N, Nelson RM. Source: International Journal of Rehabilitation Research. Internationale Zeitschrift Fur Rehabilitationsforschung. Revue Internationale De Recherches De Readaptation. 2003 June; 26(2): 101-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12799603&dopt=Abstract
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The International Classification of Functioning, Disability and Health: a new tool for understanding disability and health. Author(s): Ustun TB, Chatterji S, Bickenbach J, Kostanjsek N, Schneider M. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 565-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959329&dopt=Abstract
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The International Disability Rights Movement and the ICF. Author(s): Hurst R. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 572-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959330&dopt=Abstract
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The long way from the International Classification of Impairments, Disabilities and Handicaps (ICIDH) to the International Classification of Functioning, Disability and Health (ICF). Author(s): de Kleijn-de Vrankrijker MW. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 561-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959328&dopt=Abstract
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The multidimensional scale of independent functioning: a new instrument for measuring functional disability in psychiatric populations. Author(s): Jaeger J, Berns SM, Czobor P. Source: Schizophrenia Bulletin. 2003; 29(1): 153-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12908671&dopt=Abstract
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The prevalence and predictors of respiratory-related work limitation and occupational disability in an international study. Author(s): Blanc PD, Burney P, Janson C, Toren K. Source: Chest. 2003 September; 124(3): 1153-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12970050&dopt=Abstract
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The relationship of brain and cervical cord volume to disability in clinical subtypes of multiple sclerosis: a three-dimensional MRI study. Author(s): Lin X, Blumhardt LD, Constantinescu CS. Source: Acta Neurologica Scandinavica. 2003 December; 108(6): 401-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14616292&dopt=Abstract
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The role of coping in maintaining the psychological well-being of mothers of adults with intellectual disability and mental illness. Author(s): Kim HW, Greenberg JS, Seltzer MM, Krauss MW. Source: Journal of Intellectual Disability Research : Jidr. 2003 May-June; 47(Pt 4-5): 31327. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787163&dopt=Abstract
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The role of environment in the International Classification of Functioning, Disability and Health (ICF). Author(s): Schneidert M, Hurst R, Miller J, Ustun B. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 588-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959332&dopt=Abstract
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The sibling experience of living with childhood chronic illness and disability. Author(s): Van Riper M. Source: Annu Rev Nurs Res. 2003; 21: 279-302. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12858700&dopt=Abstract
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The SIP68: an abbreviated sickness impact profile for disability outcomes research. Author(s): Nanda U, McLendon PM, Andresen EM, Armbrecht E. Source: Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation. 2003 August; 12(5): 583-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13677503&dopt=Abstract
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The subjective dimension of functioning and disability: what is it and what is it for? Author(s): Ueda S, Okawa Y. Source: Disability and Rehabilitation. 2003 June 3-17; 25(11-12): 596-601. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959333&dopt=Abstract
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The transition from relapsing-remitting MS to irreversible disability: clinical evaluation. Author(s): Trojano M, Paolicelli D, Bellacosa A, Cataldo S. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2003 December; 24 Suppl 5: S268-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14652786&dopt=Abstract
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The Wisconsin Arthritis Program--a new partnership to reduce the leading cause of disability. Author(s): Chudy NE, Thomas V, Mehrotra C, Rumm PD. Source: Wmj. 2003; 102(7): 9-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14711017&dopt=Abstract
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Time, gender, and regional trends in the application for service-related post-traumatic stress disorder disability benefits, 1980-1998. Author(s): Murdoch M, Nelson DB, Fortier L. Source: Military Medicine. 2003 August; 168(8): 662-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943044&dopt=Abstract
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Toyota v. Williams: determining disability under the ADA. Author(s): Anfang SA. Source: J Am Acad Psychiatry Law. 2003; 31(1): 97-100. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12817849&dopt=Abstract
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Trajectories of disability among the oldest old. Author(s): Romoren TI, Blekeseaune M. Source: Journal of Aging and Health. 2003 August; 15(3): 548-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12914020&dopt=Abstract
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Treatment of chronic low back pain with etoricoxib, a new cyclo-oxygenase-2 selective inhibitor: improvement in pain and disability--a randomized, placebocontrolled, 3-month trial. Author(s): Birbara CA, Puopolo AD, Munoz DR, Sheldon EA, Mangione A, Bohidar NR, Geba GP; Etoricoxib Protocol 042 Study Group. Source: The Journal of Pain : Official Journal of the American Pain Society. 2003 August; 4(6): 307-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14622687&dopt=Abstract
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Use of the Migraine Disability Assessment Questionnaire in children and adolescents with headache: an Italian pilot study. Author(s): D'Amico D, Grazzi L, Usai S, Andrasik F, Leone M, Rigamonti A, Bussone G. Source: Headache. 2003 July-August; 43(7): 767-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12890131&dopt=Abstract
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Validation of the Japanese version of the Roland-Morris Disability Questionnaire. Author(s): Suzukamo Y, Fukuhara S, Kikuchi S, Konno S, Roland M, Iwamoto Y, Nakamura T; Committee on Science Project, Japanese Orthopaedic Association. Source: Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association. 2003; 8(4): 543-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12898308&dopt=Abstract
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Validity of clinical and patient ratings of tremor disability among older adults. Author(s): Lundervold DA, Pahwa R, Ament PA, Corbin DE. Source: Parkinsonism & Related Disorders. 2003 October; 10(1): 15-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14499201&dopt=Abstract
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Visual performance in specific syndromes associated with intellectual disability. Author(s): Van Splunder J, Stilma JS, Evenhuis HM. Source: Eur J Ophthalmol. 2003 July; 13(6): 566-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12948316&dopt=Abstract
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Vitamin D and disability. Author(s): Gloth FM 3rd. Source: Journal of the American Geriatrics Society. 2003 June; 51(6): 891. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12757591&dopt=Abstract
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Volumetric quantitation by MRI in primary progressive multiple sclerosis: volumes of plaques and atrophy correlated with neurological disability. Author(s): Ukkonen M, Dastidar P, Heinonen T, Laasonen E, Elovaara I. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2003 November; 10(6): 663-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14641511&dopt=Abstract
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Women aging with childhood onset disability. A holistic approach using the life course paradigm. Author(s): Harrison T. Source: Journal of Holistic Nursing : Official Journal of the American Holistic Nurses' Association. 2003 September; 21(3): 242-59. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14528849&dopt=Abstract
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Women are more disabled in basic activities of daily living than men only in very advanced ages: a study on disability, morbidity, and mortality from the Kungsholmen Project. Author(s): von Strauss E, Aguero-Torres H, Kareholt I, Winblad B, Fratiglioni L. Source: Journal of Clinical Epidemiology. 2003 July; 56(7): 669-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12921936&dopt=Abstract
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Workplace accommodations for people with disabilities: National Health Interview Survey Disability Supplement, 1994-1995. Author(s): Zwerling C, Whitten PS, Sprince NL, Davis CS, Wallace RB, Blanck P, Heeringa SG. Source: Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine. 2003 May; 45(5): 517-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12762076&dopt=Abstract
Academic Periodicals covering Disability Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to disability. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
Dissertations on Disability ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to disability. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “disability” (or a synonym) in their titles. The following covers recent dissertations found when using this search procedure: •
An Assessment of the Socio-Sexual Knowledge of Institutionalized Persons with Mental Retardation (Developmental Disability) by Davis, Reginald, PhD from The University of Michigan, 1986, 223 pages http://wwwlib.umi.com/dissertations/fullcit/8612501
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A Comparison of Oral Reading Miscues of Poor Readers Assigned to Learning Disability Classes with Those Assigned to Remedial Reading Classes. by Carder, Mary Elizabeth, EDD from University of Northern Colorado, 1974, 145 pages http://wwwlib.umi.com/dissertations/fullcit/7511081
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A Comparison of the Perceptions of Health Care Administrators and Physically Disabled Adults Concerning the Factors That Contribute to the Psychological Well Being of Adults Who Have a Physical Disability; and Structure of Organizational Characteristics R by Kennedy, Douglas Ayers, EDD from Temple University, 1988, 223 pages http://wwwlib.umi.com/dissertations/fullcit/8902970
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An Analysis of the Generalization Effects of Four Tutoring Procedures on the Oral Reading Responses of Eight Learning Disability Children. by Delquadri, Joseph C., PhD from University of Kansas, 1978, 75 pages http://wwwlib.umi.com/dissertations/fullcit/7910547
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An Investigation of the Reliability and Validity of the 'Enderle-Severson Transition Rating Scale' (Adult Transition, Learning Disabilities, Emotional Disturbance, Mental Retardation) by Severson, Susan Janine, EDD from The University of North Dakota, 1993, 127 pages http://wwwlib.umi.com/dissertations/fullcit/9408439
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Attitudes of Typical Students, Parents and Teachers Concerning Children with Apparent Physical and Mental Disabilities by Johnson, Ronald Truxton, Jr., EDD from Northern Arizona University, 1998, 176 pages http://wwwlib.umi.com/dissertations/fullcit/9826753
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Coping with Arthritis: A Descriptive Study of Adaptation to Chronic Illness (RoleAdjustment, Qualitative Research, Decision-making, Social Identity, Disability) by Shea, Carole A., PhD from Rutgers the State University of New Jersey - New Brunswick, 1986, 436 pages http://wwwlib.umi.com/dissertations/fullcit/8620079
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Developing a Wholistic-Integral Approach to the Institutional Management of Chronic Disability by Offhouse, Charlotte Dorothy, PhD from California Institute of Integral Studies, 1985, 338 pages http://wwwlib.umi.com/dissertations/fullcit/8512011
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Do Illness Perception and Coping Influence Disability in Chronic Fatigue Syndrome? by Cohen, Yoav, PhD from Fairleigh Dickinson University, 2003, 183 pages http://wwwlib.umi.com/dissertations/fullcit/3082846
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Exceptional Children and Everyday Jobs: the Effect of Caring for a Child Who Has a Chronic Illness or a Disability on Parents' Work Hours by Rolf, Karen Ann, PhD from The University of Chicago, 2003, 160 pages http://wwwlib.umi.com/dissertations/fullcit/3077072
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Gender Differences in Long-Term Postschool Outcomes for Youth with Mild Mental Retardation, Learning Disabilities and No Disabilities: Myth or Reality? by Levine, Phyllis, PhD from University of Washington, 1993, 201 pages http://wwwlib.umi.com/dissertations/fullcit/9401447
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In Sickness and in Health: the Effects of Disability on the Psychological Well-Being of Married Couples at Midlife by Rogers, Michelle L., PhD from Brown University, 2002, 185 pages http://wwwlib.umi.com/dissertations/fullcit/3050960
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Interrater Agreement on the Meaning of Mental Illness (Perception, Attitudes, Disability) by Traunig, Gerald Wesley, PhD from The University of Connecticut, 1984, 87 pages http://wwwlib.umi.com/dissertations/fullcit/8425763
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Living with Disability: the Early Pioneers. A Life History Account of the Experience of Individuals with Spinal Cord Injury before 1967 Who Lived in the Community in Ontario (Rehabilitation) by Tremblay, Mary Katharine, PhD from State University of New York at Buffalo, 1993, 522 pages http://wwwlib.umi.com/dissertations/fullcit/9330121
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Lupus: Managing a Complex Chronic Disability by LaBrie, Vida Yvonne, PhD from University of California, San Francisco, 1987, 185 pages http://wwwlib.umi.com/dissertations/fullcit/8708450
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Parent Perceptions of Children with and without a Chronic Illness or Disability: Attributions Regarding Competencies and Needs by Pfaffinger, Kathleen Marie, PhD from University of Minnesota, 1993, 196 pages http://wwwlib.umi.com/dissertations/fullcit/9413044
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Parental Perceptions of Mental Retardation As a Disability: A Case Study of Cali, Colombia by Cuadros, Jose Hermann, EDD from Columbia University Teachers College, 2002, 176 pages http://wwwlib.umi.com/dissertations/fullcit/3067328
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Patterns of Psychoactive Drug Use among College Students with Physical Disabilities (Drug Use) by Moore, Dennis Craig, EDD from Indiana University, 1989, 107 pages http://wwwlib.umi.com/dissertations/fullcit/9024454
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Performing Disability: Representations of Disability and Illness in Contemporary American Performance by Davies, Telory Williamson, PhD from Stanford University, 2003, 218 pages http://wwwlib.umi.com/dissertations/fullcit/3090575
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Planning for Adult Futures: Parents' Self Report of Future Planning and Its Relationship to Family Functioning and Stress with Sons and Daughters Who Are Disabled (Physical Disability, Mental Retardation, Launching) by Brotherson, Mary Jane, PhD from University of Kansas, 1985, 225 pages http://wwwlib.umi.com/dissertations/fullcit/8529066
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Psycho-Educational Labeling Theory: The Biasing Effects of Mental Health Type Labels in the Teacher Assessment of Disability with the Hypothetical Student. by Hawkins, Stephen Sydney, PhD from The University of Michigan, 1977, 126 pages http://wwwlib.umi.com/dissertations/fullcit/7718024
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Sex Differences in Reports of Illness and Disability: A Test of the 'Fixed Role Obligations' Hypothesis by Marcus, Alfred Charles, PhD from University of California, Los Angeles, 1981, 124 pages http://wwwlib.umi.com/dissertations/fullcit/8121005
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Social Competence and Pressure Sores in Spinal Cord Injury (Adjustment to Disability, Assertion, Rehabilitation) by Hundley, Jo Ann, PhD from The University of North Carolina at Chapel Hill, 1985, 97 pages http://wwwlib.umi.com/dissertations/fullcit/8605605
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Social Interaction between Adults with Mental Disabilities and Their Community Members by Owen, Marya Stephanie, PhD from University of Alberta (Canada), 1997, 127 pages http://wwwlib.umi.com/dissertations/fullcit/NQ23050
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Successful Vocational Rehabilitation for Persons with Significant Mental Disabilities: a Logistic Regression Analysis by Spence, Maria A. Stancil; PhD from The Ohio State University, 2000, 103 pages http://wwwlib.umi.com/dissertations/fullcit/9971639
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The Association of Functional Disability, Personality, Social Support and Subjective Well-Being in Older Adult Couples by Robb, Claire, PhD from University of South Florida, 2003, 102 pages http://wwwlib.umi.com/dissertations/fullcit/3080006
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The Development of Medical Standards for the Assessment of Back Disability in a Nursing Population by Turner, John Charles, PhD from The University of Tennessee, 1989, 229 pages http://wwwlib.umi.com/dissertations/fullcit/9021063
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The Economic Well-Being of Men with Disabilities: A Dynamic Cross-national View by Daly, Mary Colleen, PhD from Syracuse University, 1994, 257 pages http://wwwlib.umi.com/dissertations/fullcit/9433972
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The Effect of Pre-Disability Poor Health on the Earnings and Relative Economic WellBeing of Men with Disabilities: An Evaluation of the Social Security Disability Insurance Benefit Structure by Livermore, Gina Ann, PhD from The University of Wisconsin - Madison, 1995, 224 pages http://wwwlib.umi.com/dissertations/fullcit/9508913
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The Effects of Chronic Versus Acute Health Problems, Social, and Psychological Factors on Reports of Illness, Disability, and Doctor Visits for Symptoms (California) by Telesky, Carol Williams, PhD from University of California, Los Angeles, 1987, 481 pages http://wwwlib.umi.com/dissertations/fullcit/8719995
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The Effects of Judicial Intervention on the Development of Deinstitutionalization Policy for Persons with Mental Disabilities by Rogers, Modestine, PhD from George Mason University, 1993, 250 pages http://wwwlib.umi.com/dissertations/fullcit/9316564
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The Effects of the Americans with Disabilities Act on Economic Well-Being of Men with Disabilities by Moon, Sangho, PhD from The University of Wisconsin - Madison, 2001, 206 pages http://wwwlib.umi.com/dissertations/fullcit/3049392
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The Equality-Disability Nexus: The History and Law of Mental Handicap in Canada by Rioux, Marcia Hampton, PhD from University of California, Berkeley, 1993, 263 pages http://wwwlib.umi.com/dissertations/fullcit/9408099
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The Impact of Reading on Oral Language Skills of Saudi Arabian Children with Language Learning Disability by Atyah, Heba Mohammed; PhD from Howard University, 2000, 166 pages http://wwwlib.umi.com/dissertations/fullcit/9964984
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The Injury Experience and Training History of the Competitive Athlete with a Disability by Ferrara, Michael S., PhD from The Pennsylvania State University, 1990, 178 pages http://wwwlib.umi.com/dissertations/fullcit/9104873
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The Moral Identity of Traumatic Brain Injury Survivors (medical Ethics, Disability) by Thobaben, James R., PhD from Emory University, 1994, 528 pages http://wwwlib.umi.com/dissertations/fullcit/9425890
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'To Get Back into Society the Way I Was': A Sociological Analysis of Physical Disability and Impairment (Dialectics, Deafness, Chronic Pain) by Seidel, John Vail, PhD from University of Colorado at Boulder, 1984, 419 pages http://wwwlib.umi.com/dissertations/fullcit/8422650
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Willingness to Accept Risk of Treatment Toxicity in Older Cancer Patients: The Effects of Comorbid Conditions, Functional Disability, Risk Propensity, and Risk Perception by Chen, Hongbin, PhD from University of South Florida, 2002, 109 pages http://wwwlib.umi.com/dissertations/fullcit/3071296
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CHAPTER 2. NUTRITION AND DISABILITY Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and disability.
Finding Nutrition Studies on Disability The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. Once you have entered the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “disability” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following is a typical result when searching for recently indexed consumer information on disability: •
Dietary measures to decrease disability in elderly women. Author(s): University of California at Davis School of Medicine, Davis, CA Source: Meredith, C.N. Nutrition-and-the-M.D (USA). (January 1993). volume 19(1) page 1-3.
Additional consumer oriented references include: •
Comorbidities and impairments explaining the association between diabetes and lower extremity disability: The Women's Health and Aging Study. Author(s): Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland 20892, USA.
[email protected] Source: Volpato, Stefano Blaum, Caroline Resnick, Helaine Ferrucci, Luigi Fried, Linda P Guralnik, Jack M Diabetes-Care. 2002 April; 25(4): 678-83 0149-5992
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Compression of disability: evidence from the National Long-Term Care Survey. Author(s): Center for Demographic Statistics, Duke University, Durham, NC 27706, USA. Source: Corder, L S Nutr-Revolume 1996 January; 54(1 Pt 2): S9-16 0029-6643
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Diabetes and physical disability among older U.S. adults. Author(s): Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
[email protected] Source: Gregg, E W Beckles, G L Williamson, D F Leveille, S G Langlois, J A Engelgau, M M Narayan, K M Diabetes-Care. 2000 September; 23(9): 1272-7 0149-5992
The following information is typical of that found when using the “Full IBIDS Database” to search for “disability” (or a synonym): •
A randomized open-label study of gabapentin and lamotrigine in adults with learning disability and resistant epilepsy. Author(s): Department of Neurosciences, York District Hospital, York YO3 7HE, UK. Source: Crawford, P Brown, S Kerr, M Seizure. 2001 March; 10(2): 107-15 1059-1311
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Benign versus secondary-progressive multiple sclerosis: the potential role of proton MR spectroscopy in defining the nature of disability. Author(s): Department of Neuroradiology, Scientific Institute San Raffaele Hospital, University of Milan, Italy. Source: Falini, A Calabrese, G Filippi, M Origgi, D Lipari, S Colombo, B Comi, G Scotti, G AJNR-Am-J-Neuroradiol. 1998 February; 19(2): 223-9 0195-6108
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Chronic morphine reduces pain-related disability in a rodent model of chronic, inflammatory pain. Author(s): CytoTherapeutics Incorporated, Lincoln, Rhode Island, USA.
[email protected] Source: Lindner, M D Plone, M A Francis, J M Cain, C K Exp-Clin-Psychopharmacol. 1999 August; 7(3): 187-97 1064-1297
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Combination of selegiline and controlled release levodopa in the treatment of fluctuations of clinical disability in parkinsonian patients. Author(s): Instituto de Neurologia, Facultad de Medicina, Montevideo, Uruguay.
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Source: Chouza, C Aljanati, R Scaramelli, A De Medina, O Caamano, J L Buzo, R Fernandez, A Romero, S Acta-Neurol-Scand-Suppl. 1989; 126127-37 0065-1427 •
Deprenyl's effect at slowing progression of parkinsonian disability: the DATATOP study. The Parkinson Study Group. Author(s): Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan 48235. Source: LeWitt, P A Acta-Neurol-Scand-Suppl. 1991; 13679-86 0065-1427
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Depression and chronic diabetic foot disability. A case report of suicide. Author(s): Department of Orthopaedics and Podiatry, Loyola University Medical Center, 2160 South First Avenue, Maxwood, IL 60153, USA. Source: Walsh, S M Sage, R A Clin-Podiatr-Med-Surg. 2002 October; 19(4): 493-508 08918422
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Ginseng root prevents learning disability and neuronal loss in gerbils with 5-minute forebrain ischemia. Author(s): Department of Anatomy, Ehime University School of Medicine, Japan. Source: Wen, T C Yoshimura, H Matsuda, S Lim, J H Sakanaka, M Acta-Neuropathol(Berl). 1996; 91(1): 15-22 0001-6322
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Improvement of disability and akinesia of patients with Parkinson's disease by intravenous iron substitution. Source: Birkmayer, J G Birkmayer, W Ann-Clin-Lab-Sci. 1987 Jan-February; 17(1): 32-5 0091-7370
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Parkinsonism in multiple system atrophy: natural history, severity (UPDRS-III), and disability assessment compared with Parkinson's disease. Author(s): Federation de Neurologie, Epidemiologie et Biostatistiques Centre HospitaloUniversitaire de Bordeaux, Bordeaux, France.
[email protected] Source: Tison, F Yekhlef, F Chrysostome, V Balestre, E Quinn, N P Poewe, W Wenning, G K Mov-Disord. 2002 July; 17(4): 701-9 0885-3185
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Physical 'disability' in Bantu languages: understanding the relativity of classification and meaning. Author(s): Institute on Disability and Human Development, University of Illinois at Chicago, USA. Source: Devlieger, P J Int-J-Rehabil-Res. 1998 March; 21(1): 51-62 0342-5282
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Pubertal growth and sexual maturation for adolescents with chronic illness or disability. Author(s): Department of Ambulatory Pediatrics, A. Alfred Taubman Health Center, University of Michigan, Ann Arbor. Source: Rosen, D S Pediatrician. 1991; 18(2): 105-20 0300-1245
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Relation between vitamin D, physical performance, and disability in elderly persons. Author(s): Cattedra di Geriatria, Universita di Verona, Verona, Italy.
[email protected] Source: Zamboni, Mauro Zoico, Elena Tosoni, Paolo Zivelonghi, Alessandra Bortolani, Arianna Maggi, Stefania Di Francesco, Vincenzo Bosello, Ottavio J-Gerontol-A-Biol-SciMed-Sci. 2002 January; 57(1): M7-11 1079-5006
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Report from the United Nations: Malnutrition and disability. Source: Norman, Ruth E. Environ-Nutr-Newsl. New York : Environmental Nutrition, Inc. July 1983. volume 6 (7) page S-1--S-2. 0195-4024
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Selegiline in the treatment of daily fluctuations in disability of parkinsonian patients with long-term levodopa treatment. Author(s): Department of Neurology, University of Turku, Finland. Source: Heinonen, E H Rinne, U K Tuominen, J Acta-Neurol-Scand-Suppl. 1989; 1261138 0065-1427
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Severe disability in rheumatoid arthritis: assessment following comprehensive rehabilitation. Source: McCarthy, G Egan, S FitzGerald, O Bresnihan, B Ir-J-Med-Sci. 1989 September; 158(9): 225-7 0021-1265
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Sleep-wake schedule disorder disability: a lifelong untreatable pathology of the circadian time structure. Author(s): Institute for Fatigue and Sleep Medicine, Sheba Medical Center, TelHashomer, Israel.
[email protected] Source: Dagan, Y Abadi, J Chronobiol-Int. 2001 November; 18(6): 1019-27 0742-0528
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The coenzyme nicotinamide adenine dinucleotide (NADH) improves the disability of parkinsonian patients. Author(s): Birkmayer-Institut fur Parkinsontherapie, Vienna, Austria. Source: Birkmayer, W Birkmayer, G J Vrecko, K Mlekusch, W Paletta, B Ott, E J-NeuralTransm-Park-Dis-Dement-Sect. 1989; 1(4): 297-302 0936-3076
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The hand-foot impairment score as a tool for evaluating prevention of disability activities in leprosy: an exploration in patients treated with corticosteroids. Author(s): Department of Public Health, Erasmus University Rotterdam, The Netherlands. Source: Broekhuis, S M Meima, A Koelewijn, L F Richardus, J H Benbow, C Saunderson, P R Lepr-Revolume 2000 September; 71(3): 344-54 0305-7518
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The management of epilepsy in a hospital for people with a learning disability. Author(s): Senior Registrar in Psychiatry of Learning Disability, Monyhull Hospital, Monyhull Hall Road, Kings Norton, Birmingham, B30 3QB, UK. Source: Carvill, S Clarke, D Cassidy, G Seizure. 1999 May; 8(3): 175-80 1059-1311
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMD®Health: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to disability; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Vitamins Pantothenic Acid and Pantethine Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin E Source: Prima Communications, Inc.www.personalhealthzone.com
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Minerals Iron Source: Prima Communications, Inc.www.personalhealthzone.com
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Food and Diet Low-Fat Diet Source: Healthnotes, Inc.; www.healthnotes.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND DISABILITY Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to disability. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to disability and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “disability” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to disability: •
“This is a Spiritual Experience”: perspectives of Latter-Day Saint families living with a child with disabilities. Author(s): Marshall ES, Olsen SF, Mandleco BL, Dyches TT, Allred KW, Sansom N. Source: Qualitative Health Research. 2003 January; 13(1): 57-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12564263&dopt=Abstract
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A qualitative study of the transition to adulthood for youth with physical disabilities. Author(s): Stewart DA, Law MC, Rosenbaum P, Willms DG. Source: Physical & Occupational Therapy in Pediatrics. 2001; 21(4): 3-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12043171&dopt=Abstract
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A review of the literature: interventions to maximize capacity to consent and reduce anxiety of women with learning disabilities preparing for a cervical smear test. Author(s): Broughton S.
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Source: Health Services Management Research : an Official Journal of the Association of University Programs in Health Administration / Hsmc, Aupha. 2002 August; 15(3): 17385. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12184837&dopt=Abstract •
American Academy of Pediatrics: Counseling families who choose complementary and alternative medicine for their child with chronic illness or disability. Committee on Children With Disabilities. Author(s): Committee on Children with Disabilities. Source: Pediatrics. 2001 March; 107(3): 598-601. Erratum In: Pediatrics 2001 August; 108(2): 507. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11230608&dopt=Abstract
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An exploration of helping processes in an online self-help group focusing on issues of disability. Author(s): Finn J. Source: Health & Social Work. 1999 August; 24(3): 220-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10505283&dopt=Abstract
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Assessment of disability with the World Health Organisation Disability Assessment Schedule II in patients with ankylosing spondylitis. Author(s): van Tubergen A, Landewe R, Heuft-Dorenbosch L, Spoorenberg A, van der Heijde D, van der Tempel H, van der Linden S. Source: Annals of the Rheumatic Diseases. 2003 February; 62(2): 140-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12525383&dopt=Abstract
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Balance training to maintain mobility and prevent disability. Author(s): Judge JO. Source: American Journal of Preventive Medicine. 2003 October; 25(3 Suppl 2): 150-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14552939&dopt=Abstract
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Barriers to nutrition as a health promotion practice for women with disabilities. Author(s): Hall L, Colantonio A, Yoshida K. Source: International Journal of Rehabilitation Research. Internationale Zeitschrift Fur Rehabilitationsforschung. Revue Internationale De Recherches De Readaptation. 2003 September; 26(3): 245-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14501578&dopt=Abstract
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Beliefs about feeding practices and nutrition for children with disabilities among families in Dharavi, Mumbai. Author(s): Yousafzai AK, Pagedar S, Wirz S, Filteau S.
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Source: International Journal of Rehabilitation Research. Internationale Zeitschrift Fur Rehabilitationsforschung. Revue Internationale De Recherches De Readaptation. 2003 March; 26(1): 33-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12601265&dopt=Abstract •
Beyond the disability: recognizing mental health issues among persons with intellectual and developmental disabilities. Author(s): Ailey SH. Source: Nurs Clin North Am. 2003 June; 38(2): 313-29. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12914310&dopt=Abstract
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Biomedicine, genetics and disability: reflections on nursing and a philosophy of holism. Author(s): Newell C. Source: Nursing Ethics. 2000 May; 7(3): 227-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10986946&dopt=Abstract
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Changes in spiritual beliefs after traumatic disability. Author(s): McColl MA, Bickenbach J, Johnston J, Nishihama S, Schumaker M, Smith K, Smith M, Yealland B. Source: Archives of Physical Medicine and Rehabilitation. 2000 June; 81(6): 817-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10857530&dopt=Abstract
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Cortical activation during Braille reading is influenced by early visual experience in subjects with severe visual disability: a correlational fMRI study. Author(s): Melzer P, Morgan VL, Pickens DR, Price RR, Wall RS, Ebner FF. Source: Human Brain Mapping. 2001 November; 14(3): 186-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11559962&dopt=Abstract
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Cross-sectional and longitudinal associations of low-back pain and related disability with psychological distress among patients enrolled in the UCLA Low-Back Pain Study. Author(s): Hurwitz EL, Morgenstern H, Yu F. Source: Journal of Clinical Epidemiology. 2003 May; 56(5): 463-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12812821&dopt=Abstract
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Disability and rehabilitation: a context for understanding the American Indian experience. Author(s): Marshall CA, Largo HR Jr. Source: Lancet. 1999 August 28; 354(9180): 758-60. Erratum In: Lancet 2000 February 12; 355(9203): 580. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10475205&dopt=Abstract
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Disability in an eastern religious context: historical perspectives. Author(s): Miles M. Source: Disability & Society. 1995; 10(1): 49-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11640073&dopt=Abstract
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Disability, facilitated sex and the role of the nurse. Author(s): Earle S. Source: Journal of Advanced Nursing. 2001 November; 36(3): 433-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11686758&dopt=Abstract
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Disability, spiritual beliefs and the church: the experiences of adults with disabilities and family members. Author(s): Treloar LL. Source: Journal of Advanced Nursing. 2002 December; 40(5): 594-603. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12437609&dopt=Abstract
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Evidence-based prescribing in adults with learning disability and epilepsy. Author(s): Kerr M, Bowley C. Source: Epilepsia. 2001; 42 Suppl 1: 44-5; Discussion 50-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11422357&dopt=Abstract
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Exteroceptive suppression periods and pericranial muscle tenderness in chronic tension-type headache: effects of psychopathology, chronicity and disability. Author(s): Lipchik GL, Holroyd KA, O'Donnell FJ, Cordingley GE, Waller S, Labus J, Davis MK, French DJ. Source: Cephalalgia : an International Journal of Headache. 2000 September; 20(7): 63846. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11128821&dopt=Abstract
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Integrating end of life care into services for people with an intellectual disability. Author(s): Botsford AL. Source: Social Work in Health Care. 2000; 31(1): 35-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10989873&dopt=Abstract
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Intellectual disability and the myth of the changeling myth. Author(s): Goodey CF, Stainton T. Source: Journal of the History of the Behavioral Sciences. 2001 Summer; 37(3): 223-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11466710&dopt=Abstract
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Is asperger syndrome/high-functioning autism necessarily a disability? Author(s): Baron-Cohen S.
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Source: Development and Psychopathology. 2000 Summer; 12(3): 489-500. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11014749&dopt=Abstract •
Korean red ginseng saponins with low ratios of protopanaxadiol and protopanaxatriol saponin improve scopolamine-induced learning disability and spatial working memory in mice. Author(s): Jin SH, Park JK, Nam KY, Park SN, Jung NP. Source: Journal of Ethnopharmacology. 1999 August; 66(2): 123-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10433468&dopt=Abstract
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Learning disability nursing--holistic care at its best. Author(s): Jones S. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 1999 September 15-21; 13(52): 61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10693515&dopt=Abstract
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Lessons from joy living with disability. Author(s): Treloar LL. Source: J Christ Nurs. 1998 Spring; 15(2): 9-13. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11904944&dopt=Abstract
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Long-term sequelae in children treated for brain tumors: impairments, disability, and handicap. Author(s): Macedoni-Luksic M, Jereb B, Todorovski L. Source: Pediatric Hematology and Oncology. 2003 March; 20(2): 89-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12554520&dopt=Abstract
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Massage is better than acupuncture (and in the short term better than self care) in reducing pain and disability in patients with chronic lower back pain. Author(s): Hurley D. Source: The Australian Journal of Physiotherapy. 2001; 47(4): 299. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11774827&dopt=Abstract
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Metabolic recovery following human traumatic brain injury based on FDG-PET: time course and relationship to neurological disability. Author(s): Bergsneider M, Hovda DA, McArthur DL, Etchepare M, Huang SC, Sehati N, Satz P, Phelps ME, Becker DP. Source: The Journal of Head Trauma Rehabilitation. 2001 April; 16(2): 135-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11275575&dopt=Abstract
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Multidisciplinary and multiagency contributions to care for those with learning disability who have epilepsy. Author(s): Kerr M, Bowley C.
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Source: Epilepsia. 2001; 42 Suppl 1: 55-6; Discussion 57-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11422361&dopt=Abstract •
One-year trend in pain and disability relief recall in acute and chronic ambulatory low back pain patients. Author(s): Haas M, Nyiendo J, Aickin M. Source: Pain. 2002 January; 95(1-2): 83-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11790470&dopt=Abstract
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Pain and disability, perceptions and beliefs of a rural Indian population: A WHOILAR COPCORD study. WHO-International League of Associations for Rheumatology. Community Oriented Program for Control of Rheumatic Diseases. Author(s): Chopra A, Saluja M, Patil J, Tandale HS. Source: The Journal of Rheumatology. 2002 March; 29(3): 614-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11908580&dopt=Abstract
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Pain, disability, and satisfaction outcomes and predictors of outcomes: a practicebased study of chronic low back pain patients attending primary care and chiropractic physicians. Author(s): Nyiendo J, Haas M, Goldberg B, Sexton G. Source: Journal of Manipulative and Physiological Therapeutics. 2001 September; 24(7): 433-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11562650&dopt=Abstract
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Positive effects of mime therapy on sequelae of facial paralysis: stiffness, lip mobility, and social and physical aspects of facial disability. Author(s): Beurskens CH, Heymans PG. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2003 July; 24(4): 677-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12851564&dopt=Abstract
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Promoting group empowerment and self-reliance through participatory research: a case study of people with physical disability. Author(s): Stewart R, Bhagwanjee A. Source: Disability and Rehabilitation. 1999 July; 21(7): 338-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10471164&dopt=Abstract
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Psychological treatment of reported sleep disorder in adults with intellectual disability using a multiple baseline design. Author(s): Gunning MJ, Espie CA.
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Source: Journal of Intellectual Disability Research : Jidr. 2003 March; 47(Pt 3): 191-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12603516&dopt=Abstract •
Reduction of tremor severity and disability following behavioral relaxation training. Author(s): Lundervold DA, Belwood MF, Craney JL, Poppen R. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1999 June; 30(2): 11935. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10489088&dopt=Abstract
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Review: some herbal medicines and plant extracts reduced pain and disability and improved function in osteoarthritis. Author(s): Ribeiro V. Source: Evidence-Based Nursing. 2002 April; 5(2): 57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11995660&dopt=Abstract
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Sexuality: meaning and relevance to learning disability nurses. Author(s): Wheeler P. Source: British Journal of Nursing (Mark Allen Publishing). 2001 July 26-August 8; 10(14): 920-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11927897&dopt=Abstract
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Shoulder disability questionnaire design and responsiveness of a functional status measure. Author(s): van der Heijden GJ, Leffers P, Bouter LM. Source: Journal of Clinical Epidemiology. 2000 January; 53(1): 29-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10693901&dopt=Abstract
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Skin potential response in letter recognition task as an alternative communication channel for individuals with severe motor disability. Author(s): Tsukahara R, Aoki H. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2002 November; 113(11): 1723-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12417225&dopt=Abstract
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Sleep-wake schedule disorder disability: a lifelong untreatable pathology of the circadian time structure. Author(s): Dagan Y, Abadi J. Source: Chronobiology International. 2001 November; 18(6): 1019-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11777076&dopt=Abstract
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Spiritual issues associated with traumatic-onset disability. Author(s): McColl MA, Bickenbach J, Johnston J, Nishihama S, Schumaker M, Smith K, Smith M, Yealland B.
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Source: Disability and Rehabilitation. 2000 August 15; 22(12): 555-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11005745&dopt=Abstract •
The body as object versus the body as subject: the case of disability. Author(s): Edwards SD. Source: Medicine, Health Care, and Philosophy. 1998; 1(1): 47-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11081282&dopt=Abstract
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The impact of treatment confidence on pain and related disability among patients with low-back pain: results from the University of California, Los Angeles, low-back pain study. Author(s): Goldstein MS, Morgenstern H, Hurwitz EL, Yu F. Source: The Spine Journal : Official Journal of the North American Spine Society. 2002 November-December; 2(6): 391-9; Discussion 399-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14589256&dopt=Abstract
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The perceived effects of parent-led support groups for parents of children with disabilities. Author(s): Law M, King S, Stewart D, King G. Source: Physical & Occupational Therapy in Pediatrics. 2001; 21(2-3): 29-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12029852&dopt=Abstract
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The use of revised Oswestry Disability Questionnaire. Author(s): Fairbank JC. Source: Spine. 2000 November 1; 25(21): 2846-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11064536&dopt=Abstract
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Therapeutic caring: a learning disability experience. Author(s): Green C, Nicoll L. Source: Complementary Therapies in Nursing & Midwifery. 2001 November; 7(4): 180-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11855800&dopt=Abstract
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Validity of the neck disability index, Northwick Park neck pain questionnaire, and problem elicitation technique for measuring disability associated with whiplashassociated disorders. Author(s): Hoving JL, O'Leary EF, Niere KR, Green S, Buchbinder R. Source: Pain. 2003 April; 102(3): 273-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670669&dopt=Abstract
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Women aging with childhood onset disability. A holistic approach using the life course paradigm. Author(s): Harrison T.
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Source: Journal of Holistic Nursing : Official Journal of the American Holistic Nurses' Association. 2003 September; 21(3): 242-59. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14528849&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMD®Health: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to disability; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Attention Deficit-Hyperactivity Disorder Source: Healthnotes, Inc.; www.healthnotes.com Birth Defects Prevention Source: Healthnotes, Inc.; www.healthnotes.com Bone Loss Source: Integrative Medicine Communications; www.drkoop.com Epilepsy Source: Healthnotes, Inc.; www.healthnotes.com
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Heat Exhaustion Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Healthnotes, Inc.; www.healthnotes.com Low Back Pain Source: Healthnotes, Inc.; www.healthnotes.com Meningitis Source: Integrative Medicine Communications; www.drkoop.com Multiple Sclerosis Source: Healthnotes, Inc.; www.healthnotes.com Muscular Dystrophy Source: Integrative Medicine Communications; www.drkoop.com Osteoarthritis Source: Healthnotes, Inc.; www.healthnotes.com Osteoarthritis Source: Integrative Medicine Communications; www.drkoop.com Osteoporosis Source: Integrative Medicine Communications; www.drkoop.com Pregnancy and Postpartum Support Source: Healthnotes, Inc.; www.healthnotes.com Rheumatoid Arthritis Source: Healthnotes, Inc.; www.healthnotes.com Sprains and Strains Source: Integrative Medicine Communications; www.drkoop.com •
Alternative Therapy Music Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,719,00.html Tai Chi Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,737,00.html
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Herbs and Supplements Boswellia Alternative names: Frankincense; Boswellia serrata Roxb. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Glutamine Source: Integrative Medicine Communications; www.drkoop.com Gotu Kola Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10031,00.html L-tyrosine Source: Healthnotes, Inc.; www.healthnotes.com N-acetyl Cysteine Source: Healthnotes, Inc.; www.healthnotes.com NADH Source: Healthnotes, Inc.; www.healthnotes.com NADH Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10047,00.html Phenylalanine Source: Integrative Medicine Communications; www.drkoop.com
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. CLINICAL TRIALS AND DISABILITY Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning disability.
Recent Trials on Disability The following is a list of recent trials dedicated to disability.8 Further information on a trial is available at the Web site indicated. •
Functioning, Disability, and Quality of Life in the Adult Hearing Impaired Condition(s): Hearing impaired Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Rehabilitation Research and Development Service Purpose - Excerpt: The short-term research objectives of the proposed study are as follows: (1) To measure the effects of audiological intervention on selected domain specific (i.e., Communicative, Interpersonal, and Social roles) and overall functioning using the WHO-DASII, a generic health measure conceptually grounded in the ICIDH-2 model of disablement and functioning. (2) To measure the effects of audiological intervention on selected domain specific (i.e., Role Functioning-Emotional; and, Social Functioning) and overall functioning using the MOS-SF36V, a generic health measure currently utilized in the Veteran's Health Administration. (3) To determine the accuracy with which measures of audibility (SII), hearing handicap (HHIE), and, hearing disability (APHAB) predict domain specific and overall functioning, and life-satisfaction as measured by the WHO-DASII and the MOS-SF36V will be evaluated. (4) To compare hearing aid treatment effects as measured by changes in WHO-DASII domain specific and overall functioning scores to those measured by changes in disease specific instruments examining similar constructs. (5) To compare hearing aid treatment effects as measured by changes in MOS-SF36V domain specific and overall functioning scores to those measured by changes in disease specific instruments examining similar
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These are listed at www.ClinicalTrials.gov.
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constructs. (6) To determine and compare cost-effectiveness of hearing aid intervention as calculated using WHO-DASII and MOS SF-36V outcome data. The long-term research objective is to compare the cost-effectiveness and cost-utility of audiologic intervention with those of other health care interventions commonly associated with the veteran population (e.g. mental health, cardiology, pulmonary, orthopedic, etc.). Phase(s): Phase II Study Type: Interventional Contact(s): Harvey Abrams 727-398-9395
[email protected] Web Site: http://clinicaltrials.gov/ct/show/NCT00037986 •
Improving Functional Health Literacy in Older Veterans Condition(s): Visual And Cognitive Disability Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Rehabilitation Research and Development Service Purpose - Excerpt: The objective of this two parallel component study is to develop interventions for the visual and cognitive related health literacy disabilities of older veterans. The first component will test two interventions for improving functional health literacy performance (enhancing the design of health literacy materials and training reading skills) by using a 2 x 2 between subjects factorial design. The second component consists of patient, family, and provider focus groups who will help determine where to apply and disseminate the interventions by identifying problematic sources of text-based health materials. Finally, as a result of both components improved health information design guidelines and training protocols will be developed as rehabilitative interventions for health literacy disability. Phase(s): Phase II; MedlinePlus consumer health information Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00038337
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Socioeconomic and Age-related Disability in a Biracial Community Condition(s): Healthy; MedlinePlus consumer health information Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Environmental Health Sciences (NIEHS) Purpose - Excerpt: The overall goal of the proposed project is to examine the reasons for the higher levels of disability in older people of lower socioeconomic status. Study Type: Observational Contact(s): Carlos F. Mendes de Leon, Ph.D. 312-942-3350
[email protected] Web Site: http://clinicaltrials.gov/ct/show/NCT00042133
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Mechanisms of Disability in Peripheral Arterial Disease Condition(s): Cardiovascular Diseases; Arterial Occlusive Diseases; Peripheral Vascular Diseases
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Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To determine the mechanisms by which atherosclerotic peripheral artery disease (PAD) causes functional impairment and to define the degree to which peripheral artery disease associated pathophysiologic findings change over time. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00046592 •
A study to evaluate the effects of YM872 on brain function and disability when administered in combination with alteplase (tissue plasminogen activator) Condition(s): Acute ischemic stroke Study Status: This study is completed. Sponsor(s): Yamanouchi Pharma America Purpose - Excerpt: The purpose of this study is to determine if YM872 in combination with t-PA can reduce disability and brain damage from stroke. YM872 or placebo will be given as a continuous intravenous (iv) infusion for 24 hours. It is important that the study medication, YM872 or placebo, is administered prior to the completion of the t-PA administration. The clinical effects of YM872 in addition to t-PA will be determined by assessing neurological function and disability scores at follow up visits through Day 90 of the study. Phase(s): Phase II; MedlinePlus consumer health information Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00044057
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Disability Among Adults with Asthma Condition(s): Asthma; Lung Diseases Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To identify risk factors for work disability among adults with asthma treated by pulmonary and allergy specialists. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005440
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Prevention of Arthritis-Related Work Disability Condition(s): Rheumatoid Arthritis; Systemic Lupus Erythematosus; Osteoarthritis, Knee; Ankylosing Spondylitis Study Status: This study is completed. Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
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Purpose - Excerpt: People with rheumatic disorders (arthritis) often have trouble keeping their jobs. This study will look at whether vocational rehabilitation (VR) will improve the ability of employed people with arthritis to keep their jobs. Job retention VR services target key factors that increase the risk of job loss. They aim to modify jobs to reduce barriers caused by functional limitations and disease symptoms, future career planning, and establish a partnership with a VR counselor for ongoing help. We will conduct the study among patients with rheumatic disorders recruited in eastern Massachusetts. We will give 120 study participants job retention services provided by VR counselors. We will give another 120 participants literature about employmentrelated resources. We will compare the outcomes of the two groups to evaluate the usefulness of job retention services in preventing job loss in people with rheumatic disorders. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000416 •
Trial of Pentoxifylline in Patients with Functional Disability Caused by RadiationInduced Advanced Regional Fibrosis Condition(s): Fibrosis; Radiation Injuries Study Status: This study is completed. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: After initial assessment of their condition by specified clinical and laboratory parameters, each of the patients will be treated for 8 weeks at the standard pentoxifylline dose (400 mg po TID). Objective and subjective response parameters will be re-assessed at the end of the treatment and 8 weeks later for possible decay of response. Phase(s): Phase II; MedlinePlus consumer health information Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001437
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “disability” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical
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trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 5. PATENTS ON DISABILITY Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “disability” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on disability, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Disability By performing a patent search focusing on disability, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We
9Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on disability: •
Devices to reduce onset of symptoms of median nerve entrapment, carpal tunnel syndrome, reduce tactile deficit of fingers, and increase identification of mass in breast and other self examinations Inventor(s): Choate; John I. M. (c/o P.O. Box 65, Seminole, OK 74818-0065) Assignee(s): None Reported Patent Number: 6,692,435 Date filed: February 16, 1998 Abstract: A method of using devices or compounds which reduce onset of symptoms of median nerve entrapment or carpal tunnel syndrome or repetitive stress syndrome, reduce tactile deficit of fingers, and increase identification of cancer mass in subcutaneous palpation by self examinations, disability accommodation, medical and physical therapy, cancer discovery and prevention, as well as many other applications. This includes improving the efficiency of the movement of the fingers, reducing the inflammation in the carpal canal, reducing the tendon excursion in the carpal canal, reducing finger flexion, reducing loss of nerve sensation, reducing loss of tactile sensation, increasing tactile sensitivity of the fingers, increasing movement of the dorsal interossei muscles of the hand, increasing movement of the volar interossei palmar muscles of the hand, and increasing movement of the lumbrical muscles of fingers. Excerpt(s): Pursuant to 37 CFR 1.71(e); A portion of the disclosure of this patent document contains material which is subject to copyright protection. The copyright owner has no objection to the facsimile reproduction by anyone of the patent document or the patent disclosure, as it appears in the Patent and Trademark Office patent file or records, but otherwise reserves all copyright rights whatsoever. References in parenthesis in the specification are to sources appended at the end. The present invention is directed to using and testing devices or compounds which reduce onset of symptoms of median nerve entrapment or carpal tunnel syndrome or repetitive stress syndrome, reduce tactile deficit of fingers, and increase identification of foreign mass in breast and other self examinations, disability accommodation, medical and physical therapy, cancer discovery and prevention. Devices will improve the movement of the fingers, reduce the inflammation in the carpal canal, reduce the tendon excursion in the carpal canal, reduce finger flexion, reduce loss of nerve sensation, reduce loss of tactile sensation, increase tactile sensitivity of the fingers, increase movement of the dorsal interossei muscles of the hand, increase movement of the volar interossei palmar muscles of the hand, and increase movement of the lumbrical muscles of fingers, as well as many other applications. Web site: http://www.delphion.com/details?pn=US06692435__
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Method and device for managing freezing gait disorders Inventor(s): Perry; Linda (38 Hemlock Rd., West Roxbury, MA 02132), Perry; Robert E. (32 Abbott St., South Weymouth, MA 02190) Assignee(s): None Reported Patent Number: 5,575,294 Date filed: March 21, 1994 Abstract: A method and device for managing akinetic episodes of "freezing" and "start hesitation" experienced by individuals who suffer from Parkinson's disease and related disorders of the extrapyramidal nervous system projects a beam of light to facilitate mobility. The projection device, used alone or adapted to an assistive support such as a cane or walker, or to an item of clothing, projects a thin beam or discrete pattern of light using a laser, flash or other high-intensity light source to provide a luminous mark in the path of a standing individual. The mark is flashed at will by push-button control, and provides a visual cue to the operator encouraging him or her to step up and over the projected image. This cue breaks the freeze and permits the user to resume motion. Preferably a timer extinguishes the light after a brief interval. Circuitry may blink the light during the projection interval to enhance its efficacy. Operation of this device requires no significant physical or mental effort, and is to be implemented as a mechanical treatment under existing health and disability programs. Excerpt(s): Parkinson's disease is a chronic, progressive, neurologic disorder resulting from the selective degeneration of specific brain cells of the substantia nigra. These cells produce dopamine, a neurotransmitter which is necessary to communicate the neurochemical messages required for normal body movement and coordination. The incidence of Parkinson's disease is reported as 1% of the population over the age of 50, and as high as 10% over the age of 65, with some occurrence in younger individuals but negligible incidence in children. Over half a million people in the United States are afflicted with this condition. Clinical presentation of the disease includes tremors, muscular stiffness, slowness of movement and balance impairment. Walking difficulties may include shuffling, festination and akinetic episodes which are popularly referred to as "freezing." The course of Parkinson's disease and related extrapyramid disorders is variable but is usually characterized by a slow progression. The clinical manifestations of Parkinson's disease are divided into five stages from mild to severe, each stage reflecting the individual's capacity for functional ability. The hallmark of progression is when balance begins to deteriorate and the individual experiences complications of medical treatment. Web site: http://www.delphion.com/details?pn=US05575294__
Patent Applications on Disability As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to disability:
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This has been a common practice outside the United States prior to December 2000.
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Ergonomic computer mouse Inventor(s): Edwards, George Neil; (Mountain View, CA), Lippert, Stephen Lee; (San Jose, CA) Correspondence: Leary & Associates; 3900 Newpark Mall RD.; Third Floor, Suite 317; Newark; CA; 94560; US Patent Application Number: 20020105500 Date filed: March 26, 2002 Abstract: This invention relates to an improved form of computer mouse. In particular, the physical form of this mouse is designed such that the hand position required to manipulate the mouse is a natural "resting" or neutral position. This position will allow the mouse to be used for long periods of time while minimizing pain and disability in the hand and wrist. The hand is inclined to the horizontal plane typically at an angle of at least 50 degrees. The fingers are flexed, the thumb and index finger are opposed and in close proximity. The wrist is not pulled backwards nor drooped, nor is it angled to one side or the other. There is no deviated wrist movement. Wrist movement is in the natural plane of the wrist. Excerpt(s): This application is a divisional of U.S. patent application Ser. No. 08/689,385, filed Aug. 7, 1996, now U.S. Pat. No. 6,362,811, issued Mar. 26, 2002, which claims the benefit of U.S. Provisional Application No. 60/011,909, filed Feb. 20, 1996, the specifications of which are hereby incorporated by reference in their entirety. This invention relates to an improved form of computer mouse, designed such that the hand position required to manipulate the mouse is a natural "resting" position, thus minimizing pain and disability in the hand and wrist. Pronation in which the wrist is rotated from the neutral position towards a horizontal position where the palm is approximately parallel to the work surface. Because almost all mouse buttons are relatively flat to the desktop, mouse users must rotate the wrist in order to push a button. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Ergonomic syringe Inventor(s): Benz, Philip David; (Tigard, OR), Huseby, William Richard; (Vancouver, WA), Mergen, Benjamin Peter; (Corbett, OR), Semler, Herbert J.; (Portland, OR) Correspondence: Philip D. Benz; 13339 SW Essex DR.; Tigard; OR; 97223; US Patent Application Number: 20030060777 Date filed: September 21, 2001 Abstract: The ergonomic syringe is used by an operator to inject fluid under pressure into a patient during a medical procedure, which can include angiographic procedures where catheters are used. Although said ergonomic syringe may be connected to and used with a catheter of any size, it is particularly suited for use by an operator to inject radiopaque dye through catheters having small diameters. The large handgrip and locations of the fingergrips, together with other features on these elements of the ergonomic syringe, increase comfort and reduce the fatigue, strain, and risk of disability which may be associated with achieving the force required for each injection to achieve high pressures necessary for proper dye density in the blood flow in the target blood vessels, where such force is greater in smaller catheters than in larger catheters.
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Excerpt(s): Not applicable. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Motion activated plug-in outlet Inventor(s): Patel, Jitendra Ambalal; (Wappingers Falls, NY) Correspondence: Jitendra Ambalal Patel; 8 Sherrywood Road; Wappingers Falls; NY; 12590; US Patent Application Number: 20040009700 Date filed: July 11, 2002 Abstract: A motion activated plug-in type electrical outlet which conveniently plugs into a standard power outlet is disclosed. The device allows non-motion sensor equipped ordinary household electrical devices to function as if they are equipped with a motion sensor. The device does not contain any switch making it easy to use by everyone, particularly, those who may be suffering from mental or physical disability. The device can be used with any wall or ceiling mounted electrical outlet to automatically turn ON and OFF ordinary household plug-in type electrical devices such as night lights, table/floor lamps, table top water fountains, Christmas and other decorative lights, radios, heaters, and thereof, when presence of one or more person is detected. This device conveniently plugs into any wall power outlet by means of two or three prongs without requiring new wiring or re-wiring of the existing electric circuit. Excerpt(s): Basic motion sensor operated lighting systems are well known in prior art. Generally, these devices automatically turn on a light source when presence of one or more person is detected within its range. The light source continues to illuminate for a preset time after the detection ceases. A light sensitive component is usually incorporated to inhibit the activation of the light source when the ambient light level is high. However, devices equipped with both motion detection and a light sensitive component such as a photocell have limitations as it can not be used for controlling devices other than household light fixtures during the day time when ambient light level is high. There are two general categories, namely indoor and outdoor automatic motion activated lights. Both of these categories require installation and wiring or rewiring, usually by trained professionals. Indoor automatic and security lights such as disclosed in U.S. Pat. No. 5,015,994 by Kenneth Hoberman and Kim Kirwan solve the installation problem as they can be plugged into a standard wall power outlet by a prolonged plug built into the self-contained lighting devices. However, their application is limited because existing wall outlets may not be situated in a favorable location for detection, illumination and/or ambient light sensing. This constraint may render it impossible to use such devices under certain circumstances. In addition, the selfcontained construction of such indoor devices limit the type, size and wattage of the bulbs used. A motion and/or light activated outlet disclosed in U.S. Pat. No. 5,673,022 by Jitendra A. Patel solves the installation problem as this invention is plugged into a standard wall power outlet but one has to set motion and photocell switch to the desired position. While this feature gives someone a flexibility, it is inconvenient for those who may be suffering from disability. While all preceding systems of the prior art have brought about a certain degree of convenience and protection providing automatic lighting and security, there remains a need for a device that is activated by motion without having to set switches, easily installed, user friendly and can be used to provide illumination, or to turn on devices such as radios, night lights, tabletop water fountains, Christmas lights, table and floor fan, plug-in air fresheners etc. in places such as
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bathrooms, living rooms, family rooms and hallways regardless of the ambient light conditions. There remains the need for a small electronic/electrical device which is capable of allowing consumers to operate many non-motion sensor equipped household electrical products to operate as if they are equipped with a motional sensor in response to the presence of one or more persons in the area that are often dark (e.g. bathrooms and hallways), which is small, lightweight, requires no tools to install, no re-wiring, easily portable, and which can be installed and de-installed at will by consumers. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Orthosis device Inventor(s): Rahman, Tariq; (Wilmington, DE), Sample, Whitney; (Wilmington, DE) Correspondence: Mcguirewoods; Suite 1800; 1750 Tysons Boulevard; Tysons Corner; Mclean; VA; 22102-4215; US Patent Application Number: 20030023195 Date filed: December 21, 2001 Abstract: An orthosis device generally includes two limb sections pivotably attached to each other in at least one degree of freedom and adapted for insertion of or attachment to adjacent portions of a limb of a user. Each limb section further includes a four-bar linkage and a spring member adapted to provide an equilibrium-inducing force corresponding to a combined weight of the limb section and the limb inserted therein or attached thereto. The equilibrium-inducing force allows every point in threedimensional space to be a balanced position, such that a user with muscular abnormalities can move his or her limbs and hold them in place. A pivotable shoulder bracket for attaching the orthosis device to a wheelchair may also be provided. Furthermore, the orthosis device can be adapted to accommodate individuals of varying weight or with varying levels of disability by adjusting the spring member or providing powered actuators and force sensors. Excerpt(s): This application claims priority under 35 U.S.C.sctn.sctn. 119(e) and 120 of U.S. Provisional Patent Application Serial No. 60/308,109, Docket No. 06510022PR, filed Jul. 30, 2001, the content of which is hereby incorporated by reference. The present invention relates generally to assistive medical devices. More particularly, the present invention relates to a device for assisting and augmenting the movements of a person with neuromuscular abnormalities or weakness. Individuals with neuromuscular abnormalities, such as anterior horn cell disease or muscular disorders (e.g., Muscular Dystrophy), often lose the ability to place their limbs in space due to the weakening of their proximal muscles. Typically, the muscles of these individuals become so weak that they cannot support their arms against gravity, thereby making it difficult to perform routine tasks such as eating. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Patient lift and transfer apparatus Inventor(s): Wake, Sindy Lu; (Sacramento, CA) Correspondence: Sindy L. Wake; 7113 Minoress Way; Sacramento; CA; 95842; US Patent Application Number: 20030140414 Date filed: January 24, 2003 Abstract: A two piece incorporated device designed to assist in the lifting and transfer of such person who is partially incapacitated by infirmity or disability from one sitting position in one location to another sitting position in another location. (ex: wheelchair to toilet, bed to chair, etc. ) The device includes a torso belt with hold and support handles on back, secured by sewn on hook and loop style fastener; and a thigh support segment with handles sewn into either end, which supports the posterior and weight of said patient. The connection of these two pieces with quick-disconnect buckles provides a greater sense of balance for patient and attendant(s) and helps eliminate weight stress on the patient by virtue of proper weight distribution. The thigh support segment is also equipped with forward positioning straps (at either end), which facilitate a rocking forward by the attendant(s), bringing patient closer prior to lifting. Excerpt(s): Previous efforts in this environment displays a rather profound lack of ingenuity in addressing this problem. Indeed there are many devices that assist in the lift and carry of such a patient, however such devices do not consider the physical weight stress upon the patient, nor do such devices consider the proper balance of patient weight which would ease the physical requirement and stress of the attendant(s). Moreover such devices do not address the emplacement or removal of such a device reference the comfort to the patient and the accommodation to the attendant(s). In U.S. Pat. Nos. 4,782,539 and 5,515,549 the inventions are chair-like and have no means of securing the patient into the transfer device. U.S. Pat. No. 4,450,991 is not easily adaptable for transfer purposes, as the open torso strap does not allow for torso support contiguous to the thighs. U.S. Pat. No. D366,550 is completely inadequate to support the thighs during transfer. U.S. Pat. Nos. 4,944,057 and D366,550 are extremely difficult to get under the pateint prior to the transfer; U.S. Pat. No. 4,944,057 is a bucket-style seat, which gives no torso (or trunk) support. The current invention goes beyond the method for transfer described in U.S. Pat. No. 5,297,834 with its ability to be used by one or more attendants and with its support of the torso. The present invention relates primarily to devices and or apparatus which assist in the lifting and transfer of those persons who are partially incapacitated by infirmity or disability from one sitting position, in one location, to a sitting position in another location, and from a sitting position to that of a standing position. The present invention overcomes all of the problems associated with the prior art. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Transgenic mouse model of inclusion body myositis Inventor(s): LaFerla, Frank M.; (Irvine, CA) Correspondence: Christie, Parker & Hale, Llp; P.O. Box 7068; Pasadena; CA; 91109-7068; US Patent Application Number: 20030126627 Date filed: November 4, 2002
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Abstract: Inclusion body myositis (IBM), the most common age-related muscle disease in the elderly population, is an incurable disorder leading to severe disability. Sporadic IBM has an unknown etiology, although affected muscles fibers are characterized by many of the pathobiochemical alterations traditionally associated with neurodegenerative brain disorders such as Alzheimer's disease (AD). Accumulation of the amyloid-.beta. peptide (A.beta.), which is derived from proteolysis of the larger amyloid-.beta. precursor protein (.beta.APP), appears to be an early pathological event in AD and also in IBM, where in the latter, it occurs predominantly intracellularly within affected myofibers. To elucidate the possible role of.beta.APP mismetabolism in the pathogenesis of IBM, transgenic mice were derived in which.beta.APP overexpression was selectively targeted to skeletal muscle using the muscle creatine kinase promoter. Skeletal muscle from transgenic mice older than 10 months was shown to contain intracellular immunoreactivity to.beta.APP and its proteolytic derivatives, which was quantifiable by ELISA. In this transgenic model, selective overexpression of.beta.APP leads to the development of a subset of other histopathological and clinical features characteristic of IBM, including centric nuclei, inflammation, and deficiencies in motor performance. Excerpt(s): This application claims the benefit of U.S. Provisional Application Ser. No. 60/338,832, entitled "Transgenic Mouse Model of Inclusion Body Myositis," filed Nov. 5, 2001, the contents of which are hereby incorporated by reference in its entirety. Brain and skeletal muscle are the only two known tissues in humans marked by the pathological accumulation of the highly amyloidogenic amyloid-.beta. (A.beta.) peptide. In brain, A.beta. deposition is associated with several genetically-related neurodegenerative disorders including Alzheimer's disease (AD), Down syndrome, and hereditary cerebral hemorrhage with amyloidosis-Dutch type. Selkoe, D. J. (2001) Physiol Rev 81: 741-66. Based on genetic evidence A.beta. accumulation appears to be an early pathogenic event, although it remains to be determined whether A.beta. directly leads to cell degeneration or if this is carried out by other downstream factors induced by it. In muscle, A.beta. accumulation is associated with inclusion body myositis (IBM), the most common muscle disorder to afflict the elderly. IBM is, therefore, the first human disorder marked by the pathological accumulation of this amyloidogenic peptide outside the CNS. Notably, A.beta. and/or other A.beta.-containing fragments produced by proteolysis of the amyloid-.beta. precursor protein (.beta.APP) are not implicated in other myopathies, suggesting that.beta.APP mismetabolism is an integral component of the molecular pathogenesis of IBM. Like AD, IBM is an age-related degenerative disorder with a slowly progressive clinical course for which no effective treatment is available. Clinically characterized by muscle weakness and atrophy involving both proximal and distal muscle groups of the limbs (Dalakas, M. C. (1992) Clin. Neuropharmacol. 15: 327-51; Oldfors, A. & Lindberg, C. (1999) Curr. Opin. Neurol. 12: 527-33; Askanas, V. & Engel, W. K. (1993) Curr. Opin. Rheumatol. 5: 732-41), IBM was first recognized as its own disorder in the early 1970s (Yunis, E. J. & Samaha, F. J. (1971) Lab. Invest. 25:240-8). Prior to that time, IBM was often diagnosed as polymyositis. Amato, A. A. & Barohn, R. J. (1997) Neurol. Clin. 15:615-48. That A.beta.containing fragments are involved in the pathogenesis of IBM is somewhat surprising because no obvious genetic link exists to either the.beta.APP gene or to other AD-related genes such as apolipoprotein E. Askanas, V., et al. (1996) Ann. Neurol. 40: 264-5; Harrington, C. R., Anderson, J. R. & Chan, K. K. (1995) Neurosci. Lett. 183: 35-8. Nevertheless, IBM and AD share many pathobiochemical features including the occurrence of twisted intracellular tubulofilaments consisting of hyperphosphorylated tau (Askanas, V., et al. (1994) Am. J. Pathol. 144:177-87) and the aberrant accumulation of other "dementia"-related proteins, including apoE, presenilin, prion protein, and
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alpha-synuclein (Askanas, V., et al. (1994) Lancet 343:364-5; Askanas, V., et al. (1993) Neuroreport 5:25-8; Askanas, V., et al. (1998) Am. J. Pathol. 152: 889-95; Askanas, V., et al. (2000) J. Neuropathol. Exp. Neurol. 59: 592-8). These data suggest that following an initial insult, a coordinated molecular cascade occurs, triggering the accumulation of these "dementia"-related proteins both in muscle and in brain. Along these lines, AD patients also contain slightly elevated levels of amyloidogenic A.beta.sub.1-42 peptides in their muscle but this seems to be without pathological consequence, perhaps due to their low levels. Kuo, Y. M., et al. (2000) Am. J. Pathol. 156:797-805. Curiously, it has recently been reported that myoglobin can also form amyloid fibrils, but whether this plays a role in muscle disease is not yet established. Fandrich, M., Fletcher, M. A. & Dobson, C. M. (2001) Nature 410: 165-6. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Triazole derivatives Inventor(s): Arlt, Michael; (Jugenheim, DE), Greiner, Hartmut; (Weiterstadt, DE), Hamaguchi, Wataru; (Tsukuba-shi, JP), Kimizuka, Tetsuya; (Itabashi-ku, JP), Kohara, Atsuyuki; (Tsukuba-shi, JP), Maeno, Kyoichi; (Tsukuba-shi, JP), Miyata, Junji; (Tsukubashi, JP), Morita, Takuma; (Tsukuba-shi, JP), Shimada, Itsuro; (Tsukuba-shi, JP), Sugane, Takashi; (Tsukuba-shi, JP), Suzuki, Takeshi; (Tsukuba-shi, JP), Tobe, Takahiko; (Tsukuba-shi, JP) Correspondence: Sughrue Mion, Pllc; 2100 Pennsylvania Avenue, N.W.; Washington; DC; 20037; US Patent Application Number: 20030216385 Date filed: November 18, 2002 Abstract: The invention relates to a triazole derivative with an activity inhibiting glycine transporter and for use as a pharmaceutical drug, and a novel triazole derivative. The inventive triazole derivative has an excellent activity inhibiting glycine transporter and is useful as a therapeutic agent of dementia, schizophrenia, cognitive disorders, or cognitive disorders involved in various diseases such as Alzheimer disease, Parkinson's disease, or Huntington disease or the like, or spasm involved in diseases such as nerve degenerative diseases and cerebrovascular disorders, or the like. Particularly, the pharmaceutical drug is useful for the amelioration of learning disability of dementia and the like. Excerpt(s): The present invention relates to the pharmaceutical composition conprising triazole derivative as an effective ingredient, which is useful as an inhibitor of the activity of glycine transporter, and a novel trizole derivative with an action as an inhibitor of the activity of glycine transporter. Glycine is known as an excitatory and inhibitory neurotransmitter in the central and peripheral nervous systems. These functions work via two different types of receptors, in which different types of glycine transporter are independently involved. The function as a inhibitory neurotransmitter works via the strychnine-sensitive glycine receptor present mainly in spinal cord and brain stem. Alternatively, the function as an excitatory neurotransmitter works via Nmethyl-D-aspartic acid (NMDA) receptor known as a subtype of glutamate receptors. Glycine is known as a coagonist for the NMDA receptor (Johnson J. W. and Asher P., Glycine potentiates the NMDA response in clutured mouse brain neurons, Nature, 325, 529-531, (1987)). The NMDA receptor is widely distributed in brain, particularly in cerebral cortex and hippocampus. Neurotransmitter transporter plays a significant role in the control of the concentration of neurotransmitter in the synaptic cleft, by
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incorporating the neurotransmitter inside the cells. Additionally, it is considered that neurotransmitter transporter makes a contribution to the recycling of neurotransmitter, by incorporating the neurotransmitter into the presynapse terminus. It is considered that the control of the functions of neurotransmitter transporter is useful for therapeutically treating various diseased conditions due to abnormalities in nerve functions, through the control of the concentration of neurotransmitter in the synaptic cleft. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Urinary dysfunction treatment apparatus Inventor(s): Forsell, Peter; (Menzingen, CH) Correspondence: Nixon & Vanderhye P.C.; 1100 North Glebe Road, 8th Floor; Arlington; VA; 22201; US Patent Application Number: 20030009201 Date filed: June 29, 2001 Abstract: A urinary dysfunction treatment apparatus comprises an electric stimulation device (56) implanted in a patient, who suffers from urinary dysfunction. The stimulation device comprises electric conductors adapted to directly engage with a muscle that affects the evacuation of the patient's urine bladder, for example the urethral sphincter (58) or the bladder contraction muscle, to electrically stimulate the muscle to increase the tonus thereof. A control device (62) is provided for controlling a source of energy (64), which may or may not be implanted, to release electric energy for use in connection with the power of the stimulation device. The apparatus can be used for treating patients suffering from urinary incontinence or disability to urinate. Excerpt(s): Urinary dysfunction may involve disability of controlling the muscle that contracts the urine bladder. In particular paralysed patients may suffer from this dysfunction. Furthermore, urinary dysfunction may involve urinary incontinence, i.e disability to close the urethral sphincter. Urinary incontinence is a widespread disease. Although some people suffering from this disease are helped through training of the muscles in the pelvic floor, too many have severe problems with urine leakage. Many different implant devices have been tried to remedy urinary incontinence. For example, there is a prior manually operated urinary incontinence treatment apparatus having an artificial hydraulic sphincter device engaging the urethra and connected to an elastic reservoir implanted in the scrotum or in the region of the labia majora. A disadvantage of this prior apparatus is that over time hard fibrosis is developed around the reservoir, which may cause malfunction of pumping components. Furthermore, it is a rather complicated task to manually squeeze the elastic implanted reservoir to pump hydraulic fluid to open the sphincter device when the patient needs to urinate. In particular women can get their fingers wet. The created fibrosis will sooner or later become a hard fibrotic layer, which may make it even more difficult to pump the reservoir. Yet a further disadvantage is that the use of hydraulic fluid always entails a risk of fluid leaking from implanted hydraulic components. A prior hydraulic apparatus designed to compress the urethra is disclosed in U.S. Pat. No. 5,520,606. A prosthetic sphincter with an inflatable cuff, which surrounds the urethra or encloses it on two sides, is disclosed in for example U.S. Pat. Nos. 4,571,749 and 4,222,377. U.S. Pat. No. 4,969,474 discloses a hydraulic method for treating both men and women having urinary incontinence in the same way. The apparatus of U.S. Pat. No. 4,969,474 includes a reservoir containing fluid and an inflatable compression means designed to compress the urethra without risking
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tissue loss or necrosis to occur. An artificial hydraulically operated urethral sphincter employing an external magnet to achieve closure of the urethral cuff is disclosed in U.S. Pat. No. 5,562,598. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with disability, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “disability” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on disability. You can also use this procedure to view pending patent applications concerning disability. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 6. BOOKS ON DISABILITY Overview This chapter provides bibliographic book references relating to disability. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on disability include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “disability” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on disability: •
Computer Resources for People with Disabilities: A Guide to Exploring Today's Assistive Technology Source: Alameda, CA: Hunter House Publishers. 1996. 352 p. Contact: Available from Hunter House Publishers. P.O. Box 2914, Alameda, CA 94501. (510) 865-5282; Fax (510) 865-4295; E-mail:
[email protected]. PRICE: $17.95 (paperback); $22.95 (spiral bound); $27.95 (hard cover); $22.95 (ASCII disk), plus shipping and handling. ISBN: 0897931963 (paperback); 0897931971 (spiral bound). Summary: Current computer hardware and software can give people with different kinds of disability new ways to interact with the world. In this book, the authors bring together support and information about how to make use of conventional, assistive, and information technologies. The book includes real-life stories about people of all ages and disabilities who are using technology successfully; a 'toolbox' section with the latest computer technology, including screen enhancements, speech synthesizers, and
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customized keyboards; and a list of support organizations, vendors, publications, and online resources to contact for more information. The book is the product of the Alliance for Technology Access, a network of community-based resource centers dedicated to providing information and support services to children and adults with disabilities, and increasing their use of standard, assistive, and information technologies. A subject index concludes the book. (AA-M). •
Meeting the Challenge of Learning Disabilities in Adulthood Source: Baltimore, MD. Brookes Publishing Co. 2000. 336p. Contact: Available from Brookes Publishing Co. P.O. Box 10624, Baltimore, MD 212850624. (800)638-3775; (410)337-9580; Fax: (410)337-8539. E:mail:
[email protected]. Website: http://www.pbrookes.com/. PRICE: $25.95 (paperback) plus shipping and handling. ISBN: 1-55766-430-7. Summary: In this book various adults with learning disabilities (LD) and some with attention deficit/hyperactivity disorder (ADHD), describe how they cope with the daily challenges of their disability at work and at home. The text covers both the challenges and benefits that learning disabilities can present in a wide range of areas, including overall mental health, day-to-day life, dating, long-term relationships, parenthood, higher education, and employment. Practical suggestions and approaches are offered to help adults identify and make the most of their strengths, and promote quality of life.
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Including Students With Severe Disabilities in Schools: Fostering Communication, Interaction, and Participation Source: San Diego, CA: Singular Publishing Group, Inc. 1994. 285 p. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $35.95 plus shipping and handling. ISBN: 1565930800. Summary: The purpose of this book is to provide teachers, speech-language pathologists, parents, school psychologists, and others with a vision of how communication and other skills can be taught to students with severe disabilities in regular classrooms and related settings. Communication is presented as a means of enhancing students' active participation in meaningful activities in and out of school, and as a means for developing and maintaining relationships with family and friends. Six chapters focus on topics including the evolution of best practices in educating students with severe disabilities; developing individualized inclusive educational programs; modifying the curriculum and short-term objectives to foster inclusion; designing and implementing communicative assessments in inclusive settings; communicative intervention as a means to successful inclusion; and the transition to adult living, including the need to promote natural supports and self-determination.
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Learning Disabilities, Literacy, and Adult Education Source: Baltimore, MD: Paul H. Brookes Publishing Co. 1998. 400 p. Contact: Available from Paul H. Brookes Publishing Co. P.O. Box 10624, Baltimore, MD 21285. (800) 638-3775. Fax (410) 337-8539. Website: www.brookespublishing.com. PRICE: $49.95 plus shipping and handling. ISBN: 1557663475.
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Summary: This book deals with the long neglected problem of learning disabilities (LD) and the relationship of LD to difficulties in the acquisition of literacy. The book includes 17 sections in five sections; each section begins with a preview that helps the reader to identify the main themes and content of each chapter in that section. The chapters in Section I address some of the most basic questions surrounding LD, including the definition, cause, prevalence, and characteristics of the disorder. This Section also covers legal factors, the educational attainment of adults with LD, and information for teachers about adult literacy education. The chapters in Section II address, from various vantage points, the basic questions of whether and how adult education students with LD should be identified. Topics include standards, criteria and procedures used to evaluate screening measures, informal assessment, screening measures that use computer assisted procedures, and examples of real world screening procedures. The chapters in Section III address the question of how adult education students with LD should be taught; topics include reading instruction, mathematics, and using assistive technology to augment basic skills. The chapters in Section IV address various important issues beyond the classroom for adults with LD: career counseling, job training, and transition to employment. The final Section features one chapter that reviews the complete book from an adult literacy perspective and concludes with various recommendations for future directions in research, policy, and practice. Following Section V are three appendices: a list of accommodations that may be helpful when a student has a suspected or identified learning disability; a product resource list of technology for adults with LD; and an information resource and clearinghouse list of major sources of information in the fields of LD, literacy, and adult education. •
Deciphering the System: A Guide for Families of Young Children With Disabilities Source: Cambridge, MA: Brookline Books. 1993. 216 p. Contact: Available from Brookline Books. P.O. Box 1046, Cambridge, MA 02238. (617) 868-0360; Fax (617) 868-1772. PRICE: $21.95. ISBN: 0914797875. Summary: This book is for parents and families of young children with disabilities who are between birth and approximately 5 years of age and for older children, and is written by parents and professionals who have experience with the disability service system. The authors provide basic information about parents' rights under recent legislation affecting young children with disabilities. Topics include the educational assessment process; how parents can work with multiple service providers; ways to manage the large amount of information that accumulates; and what parents can expect when service providers seek information about their family. There are also tips about handling educational planning meetings, due process hearings, the transitions from preschool to the regular schools, and ways to obtain support from other parents. The book includes a glossary of terms, a list of state and national resource organizations, and a subject index. (AA-M).
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Fitness programming and physical disability Source: Champaign, IL: Human Kinetics. 1995. 222 pp. Contact: Available from Human Kinetics, P.O. Box 5076, Champaign, IL 61825- 5076. Telephone: (800) DIAL-HKP. $29.00 plus $3.75 for 1st item, each additional item $0.85 shipping and handling. Summary: This book is intended to be a resource for fitness professionals on the principles and practices of developing fitness programs for the physically disabled. The book addresses theoretical and practical details about individualizing instruction for the
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individual in a group setting. It includes an introduction to physical disabilities, including suggestions for preferred behaviors and language. Additional sections cover the theories and principles behind decisions about adaptation of exercises, and specific information about adapting conditioning exercises, resistance training, stretching, and aerobics. Also included is information on managing fitness programs, including emergencies in the exercise setting, and providing assistance to wheelchair users. Appendices include a list of drugs and their effects on heart rate and blood pressure, a sample registration form, a list of resources on fitness for the disabled, and a glossary. •
Legal Rights of Persons with Disabilities: An Analysis of Federal Law Source: Horsham, PA: LRP Publications, 1992, unpaged. Contact: Available from LRP Publications, 747 Dresher Rd., Suite 500, Horsham, PA 19044. (800)341-7874. (215)784-0860. PRICE: $85.00. ISBN 0934753466. Summary: This book is intended to serve as an overview and analysis of the federal laws enacted by Congress to aid in eliminating the major types of discrimination confronted by disabled Americans. The topics covered include employment, education, public accommodations, housing, transportation, access to services, the elimination of architectural barriers, and special issues relating to disabled newborns. It includes texts of the major federal laws discussed in the volume, a sample IEP form, and a curriculum checklist which can be used to measure the academic progress of children with disabilities. There is also a table of legal cases involving rights of individuals with disabilities.
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Yes You Can!: A Guide for Parents of Children with Disabilities Source: Buffalo, NY: Stoddart Publishing Company. 1997. 302 p. Contact: Available from General Distribution Services, Inc. 85 River Rock Drive, Suite 202, Buffalo, NY 14207-2710. (800) 805-1083; Fax (800) 481-6207; E-mail:
[email protected]. PRICE: $13.95 each. ISBN: 0773758666. Summary: This book offers strategies for parents of children with disabilities to help them cope with all aspects of their child's care. The authors guide parents through decisions required in finding the appropriate health care professionals, eliminating the barriers to the child's education and social activities, forming or joining support groups, contacting the right people and organizations for help, managing finances and the child's long term security, and arranging for respite care. Chapters are also included on coping with the diagnosis, family responsibilities, handling stress, and educational options. The author emphasizes the need for parents to become well-educated about their child's disability and to act as an advocate on their child's behalf. The author shares his own experiences of growing up with cerebral palsy in western Canada in the 1940's and 50's, and how his parents coped. The book includes an appendix of sample letters for dealing with health care providers, schools, and other institutions. A second appendix provides a directory of disability-related organizations, organized alphabetically by name in two sections, one for Canada and one for the United States. A bibliography and subject index conclude the volume. 52 references.
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How It Feels To Live with a Physical Disability Source: New York, NY: Simon and Schuster. 1992. 176 p. Contact: Available from Simon and Schuster. Order Department, 200 Old Tappan Road, Old Tappan, NJ 07675. (800) 223-2336. PRICE: $18.00. ISBN: 0671723715.
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Summary: This book portrays the lives of twelve children who live with physical disabilities, including blindness, dwarfism, paralysis, birth anomalies, spasticity, and cerebral palsy. Captured in text and photos, these children tell their own stories and speak with candor about their lives, their accomplishments and disappointments, and their hopes, fears, goals, and dreams. Topics addressed include physical limitations caused by their disabilities; surgeries, medications, and physical therapy; the pain and frustration they experience; and the mental strength that enables them to overcome obstacles. One of the young people featured has Treacher Collins syndrome. •
Person to person: A guide for professionals working with people with disabilities. (3rd ed.) Source: Baltimore, MD: Paul H. Brookes Publishing Company. 1997. 371 pp. Contact: Available from Paul H. Brookes Publishing Company, P.O. Box 10624, Baltimore, MD 21285-0624. Telephone: (800) 638-3775 or (410) 337-9580 / fax: (410) 3378539 / e-mail:
[email protected]. $39.00 includes shipping and handling. Summary: This book presents information about people with disabilities in Australia. Chapters discuss the nature of different disabilities, and issues in living with the disability (personal adjustment, sexuality, parenting, lifestyle, family, community living, education, and employment). The book covers the following specific disabilities: acquired brain injury, amputation, arthritis, cerebral palsy, diabetes mellitus, epilepsy, hearing impairment and deafness, spinal cord impairment, intellectual disability, mental illness, multiple sclerosis, muscular dystrophies, short stature, and severe vision impairment and blindness. The chapters incorporate personal comments from persons with particular disabilities. They give suggestions for interaction with people with specific disabilities and lists of further resources.
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ACSMs exercise management for persons with chronic diseases and disabilities Source: Champaign, IL: Human Kinetics. 1997. 269 pp. Contact: Available from Human Kinetics, P.O. Box 5076, Champaign, IL 61825- 5076. Telephone: (800) DIAL-HKP. $39.00 plus $4.50 shipping and handling and $0.90 each additional item. Summary: This book presents information on how to manage an exercise program for a person with chronic illness or disability. The book is intended for health and exercise professionals. Each chapter gives information on a specific illness or disability, the physiological effects of the disability, the effects of commonly used medications. and recommendations for testing and appropriate exercise programs. The illnesses and disabilities addressed are cardiovascular and pulmonary diseases, metabolic diseases, immunological and hematological disorders, orthopedic diseases and disabilities, neuromuscular disorders, and cognitive, emotional, and sensory disorders. Each chapter includes a list of suggested readings.
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Summary of Existing Legislation Affecting People with Disabilities Source: Washington, DC: U.S. Department of Education, Office of Special Education and Rehabilitative Services, 1992, 235 p. Contact: Available free of charge from the Clearinghouse on Disability Information, Office of Special Education and Rehabilitative Services, U.S. Department of Education, Room 3132, Switzer Building, Washington, DC 20202-2524. (202)205-8241 Voice/TDD/TT. (202)205-8723 Voice/TDD/TT.
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Summary: This book provides a wide-ranging summary of relevant federal legislation for use by consumers, professionals, providers, advocates, family members, and others interested in the legal rights and benefits available to persons with disabilities, including disorders of communication. It offers a summary of over sixty key federal laws. The various laws are organized into general subject areas. After providing a brief overview of the law's basic purpose and structure, the major programs authorized under the statute which affect persons with disabilities are described. Appendices include a legislative history of key statutes related to persons with disabilities and a table of programs. •
Directory of National Information Sources on Disabilities Source: Washington, DC: National Institute on Disability and Rehabilitation Research (NIDRR), Office of Special Education and Rehabilitative Services, U.S. Department of Education. 1994. 731 p. Contact: Available from National Rehabilitation Information Center (NARIC). National Institute on Disability and Rehabilitation Research (NIDRR), 8455 Colesville Road, Suite 935, Silver Spring, MD 20910-3319. Voice/TTY (800) 346-2742 or (301) 588-9284; TTY (301) 495-5426; Fax (301) 587-1967; http://www.naric.com/naric. PRICE: $5.00 each. Summary: This directory was compiled to serve as a resource to organizations that provide information, referral, or direct services relating to disabilities. The directory includes organizations supplying disability-related information, referral, and direct services on a nationwide basis. Regional and local resources are not included unless they provide national information and referral. Private, for-profit companies are also not included. The directory is presented in two volumes. Volume I contains the first part of the Primary Index (or Main Section) with alphabetical listings from A to M of organizations' names, contact information, and descriptions. Following the Introduction is a glossary of acronyms for organization names. Volume II contains the alphabetical listings of organizations from N to Z, followed by two appendices (databases and directories) and the subject index. Organizations providing services or information under more than one subject area are cross-referenced in the Subject Index.
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NARIC Guide to Resources for the Americans with Disabilities Act (ADA). 2nd ed Source: Silver Spring, MD: National Rehabilitation Information Center (NARIC). 1996. 69 p. Contact: Available from National Rehabilitation Information Center (NARIC). 8455 Colesville Road, Suite 935, Silver Spring, MD 20910-3319. Voice (800) 346-2742 or (301) 588-9284. TTY (301) 495-5626. E-mail:
[email protected]. Website: www.naric.com/naric. PRICE: $5.00 each. Summary: This document presents the National Rehabilitation Information Center (NARIC) guide to resources regarding the Americans with Disabilities Act (ADA). The ADA is legislation (Public Law 101-336) that guarantees equal opportunities for people with disabilities in the areas of employment, State and local government services, public accommodations, and telecommunications. This document lists and discusses guides, manuals, publications, training programs, and technical assistance programs concerning the ADA. Resources are categorized in four groups, conforming to the ADA's four main titles, noted above. Within each section, references to Federal ADA regulatory agencies are listed first, followed by other resource organizations listed alphabetically. Most organization listings include a phone number (TTY numbers are noted with a TT designation). Pricing information for documents is not included. Each Federal agency's
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publication is available in accessible formats, including braille, large print, cassette tape, and computer diskette. At the end of each section of the guide, NARIC provides a selected bibliography appropriate for the particular section. •
Disability Workbook for Social Security Applicants, Fifth Edition Source: Arnold, MD: Physicians' Disability Services, Inc. 2000. 152 p. Contact: Available from Lupus Foundation of America. 1300 Piccard Drive, Suite 200, Rockville, MD 20850-4303. (800) 558-0121 or (301) 670-9292. Fax (301) 670-9486. Website: www.lupus.org/lupus. PRICE: $19.95. ISBN 1878140116. Summary: This handbook provides disabled workers with information on applying for Social Security Disability Insurance (SSDI) benefits. The handbook is also useful for disabled adults claiming Supplemental Security Income. Chapter 1 explains where to apply for SSDI benefits and how long the approval process takes. Chapter 2 deals with proving a disability, focusing on what the evidence must prove and steps involved in the conventional and prototype claims and appeals processes. Chapter 3 examines the role of the Social Security Administration (SSA), the claimant, and the claimant's doctor in the disability claims process. Chapter 4 offers practical hints on increasing the probability of winning a disability claim, including applying promptly, applying in person if possible, keeping records, having complete information when filling out SSA forms, organizing information effectively, and appealing unfavorable decisions. Chapter 5 explains the process of appealing an unfavorable decision. Chapter 6 focuses on obtaining professional assistance from lawyers and members of Congress in handling disability claims. In addition, the workbook presents a glossary of terms; provides worksheets that identify key disability information that SSA needs; lists selected Disability Determination Services addresses; answers frequently asked questions; explains how to use SSA notices; discusses disability involving drug or alcohol addiction, managing an award, and dealing with a claim in a disability redesign prototype state; and offers two SSA booklets. 4 figures and 16 references.
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Handbook for the care of infants, toddlers, and young children with disabilities and chronic conditions Source: Austin, TX: Pro-Ed. 1997. 446 pp. Contact: Available from Attn: Customer Services, Pro-Ed, 8700 Shoal Creek Boulevard, Austin, TX 78757-6897. Telephone: (512) 451-3246 / fax: 512-451-8542. $39.00 plus 10 percent shipping and handling; prepayment required. Summary: This handbook, written for child caregivers, describes child development, the chronic conditions that may affect children, how to care for the children with these conditions, and some aspects of how the child fits into the community. It was developed by the First Start Program, a training program for paraprofessionals and education aides working with infants, toddlers, and preschoolers with disabilities or chronic conditions, that was developed at the University of Colorado Health Sciences Center in 1985. The aim is to keep the caregiver's focus on the child, not his disability, but to give the caregiver a basic understanding of what the disability entails so that he can help to manage it.
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Disability etiquette: Tips on interacting with people with disabilities Source: Buffalo, NY: Eastern Paralyzed Veterans Association. [1998]. 51 pp.
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Contact: Available from Eastern Paralyzed Veterans Association, 75-20 Astoria Boulevard, Jackson Heights, NY 11370. Telephone: (718) 803-3782 / fax: (718) 803-0414 / e-mail:
[email protected] / Web site: http://www.epva.org. Available from the Web site at no charge. Summary: This illustrated booklet is for anyone-with or without a disability- who wants to interact more effectively with people with disabilities. Topics include sensitivity in offering assistance, physical contact, general conversation, and the Americans with Disabilities Act. Chapters offer tips unique to the type of disability encountered; blind/visually impaired; deaf/hard of hearing; speech disabilities; short stature; cerebral palsy; Tourette syndrome; multiple chemical sensitivity; epilepsy; HIV and AIDS; psychiatric disabilities; cognitive disabilities; and emergency evacuation procedures. Additional information is provided about print, Web, and other special resources. •
Medical and Disability Programs for People With AIDS or HIV Disease Contact: Utah Department of Health, Division of Epidemiology and Laboratory Services, Bureau of HIV/AIDS/TB Control/Refugee Health, PO Box 142105, Salt Lake City, UT, 84114-2105, (801) 538-6096, http://www.health.state.ut.us/els/hivaids/index.html. Summary: This manual lists medical and disability programs in the State of Utah available to Persons with AIDS (PWA's) and persons who have tested positive for Human immunodeficiency virus (HIV) antibodies, the etiologic agent of Acquired immunodeficiency syndrome (AIDS). Information is provided concerning benefits, monthly financial payments, medical and disability coverage, and procedures for application. Programs covered include Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Medicaid, Medicare, the Utah AZT Program, Utah Medical Assistance Program (UMAP), the Department of Veterans Affairs, and the energy-assistance programs, HEAT and REACH.
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Communication Supports Checklist for Programs Serving Individuals with Severe Disabilities Source: Baltimore, MD: Paul H. Brookes Publishing Company. 1998. 212 p. Contact: Available from Paul H. Brookes Publishing Company. P.O. Box 10624, Baltimore, MD 21285-0624. (800) 638-3775. Fax (410) 337-8539. E-mail:
[email protected]. Website: www.brookespublishing.com. PRICE: $35.95 plus shipping and handling. ISBN: 1557663610. Summary: This manual provides explicit guidelines (the Communication Supports Checklist, or CSC) for meeting the communication needs of people with severe disabilities, including mental retardation, autism, and other disorders. The manual includes blank forms ready to copy and use, including the Checklist (a multipage form for identifying program strengths and weaknesses) and the Action Plan (a guide to making programmatic changes and increasing the effectiveness of services and quality of life). The book includes example forms completed by actual users of the CSC in school and residential settings illustrate the CSC in action. Introductory material discusses the importance of communication, the Communication Bill of Rights, improving program support for communication, and how to use the CSC. The CSC is then offered in three sections: overall program support for communication; assessment practices, goal setting practices, and program implementation; and team competencies. The manual concludes with samples of actual use of the CSC and a glossary of terms.
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Regulation, Litigation and Dispute Resolution Under the Americans with Disabilities Act: A Practioneer's Guide to Implementation Source: Washington, DC: Commission on Mental and Physical Disability Law, American Bar Association (ABA). 1996. 191 p. Contact: Available from American Bar Association (ABA). Commission on Mental and Physical Disability Law, 740 15th Street, N.W., Washington, DC 20005-1009. Voice (202) 662-1570; TTY (202) 662-1012; Fax (202) 662-1032; E-mail:
[email protected]. PRICE: $35.00 plus shipping and handling. ISBN:1570733546. Summary: This manual provides guidelines for regulation, litigation, and dispute resolution under the Americans With Disabilities Act (ADA). This edition brings readers up-to-date on significant legal decisions, new regulations, and other relevant materials. The author focuses on those provisions that address discrimination, particularly in Titles I, II, and III, but also addresses provisions in Title V that deal with enforcement, preemption, and attorneys' fees. Five sections cover statutory foundations, employment, State and local governments, public accommodations, and alternative dispute resolution mechanisms. The appendices include key definitions and terms, nationwide resource organizations, and a table of cases. A subject index concludes the book.
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Families, Illness & Disability: An Integrative Treatment Model Contact: Harper Collins Publishers, 1000 Keystone Industrial Park, Scranton, PA, 185124621, (717) 941-1500. Summary: This monograph describes the Family Systems Illness Model for families in which a member has a chronic illness or disability and provides a practical guide for interventions as well. The author looks at psychosocial interactions of chronic illness with health care, religion, and education over time. The second part examines the strains placed on the family over the course of an illness and at all life cycle stages. The last section deals with treatment issues for chronic disorders in childhood, parental illness, and aging parents. This health model is most effective in a preventive manner, with a psychosocial component in care which includes family members, near the time of onset.
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What Business Must Know About the Americans With Disabilities Act Contact: US Chamber of Commerce, 1615 H St NW, Washington, DC, 20062, (202) 4635533. Summary: This monograph explains employers' obligations under the Americans with Disabilities Act. It is designed to help businesses understand what they must do with regard to employment and access to goods and services. The monograph says that employers must remove barriers to the employment of people with disabilities, which include Human immunodeficiency virus (HIV) infection and Acquired immunodeficiency syndrome (AIDS). There are 43 million disabled Americans, and 67 percent are unemployed. The act has three major provisions: Employers may not discriminate against any qualified individual because of a disability; employers may not conduct or require a medical examination with the purpose of excluding a disabled person from a job; and current illegal use of drugs or alcohol disqualifies individuals from the first two provisions of the act. The act defines a disabled person as one who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a previous record of such an impairment, or a person who is perceived as having an impairment. The monograph explains how these provisions relate to employment and access to public accommodations and services. Appendixes
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provide a directory of State rehabilitation offices and some common questions and answers about the act. •
Red Book on Work Incentives: A Summary Guide to Social and Supplemental Security Income Work Incentives for People With Disabilities Contact: US Department of Health and Human Services, Social Security Administration, Office of Programs, Office of Disability, Altmeyer Bldg, 6401 Security Blvd, Baltimore, MD, 21235, (410) 965-3424. Summary: This monograph is designed to assist professionals in the public and private sectors who work with people with disabilities. The first section provides the following information about Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI): Eligibility requirements; how payment amounts are figured out; the waiting period for payments; the Medicare qualifying period (SSDI only); substantial gainful activity; and how often a disability case is reviewed. The subsequent section provides an overview of work incentives. Next, there is a detailed section on SSDI and SSI work incentives providing information on impairment-related work expenses, subsidies, and continued payment under a vocational rehabilitation program. The last two sections address SSDI and SSI work incentives separately. (Persons with the Human immunodeficiency virus (HIV) or Acquired immunodeficiency syndrome (AIDS) are eligible for these Social Security programs).
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Caring for Children With Special Needs: The Americans With Disabilities Act and Child Care Contact: Child Care Law Center, 973 Market St Ste 550, San Francisco, CA, 94103, (415) 495-5498. Summary: This report addresses logistical, legal, and medical considerations that must be taken into account when providing services to children with special needs. It informs care providers that many children with special needs can be integrated into present programs without necessitating changes to the routine or physical environment; that some support services exit to help care for children with special needs; and that the experience of working with special needs children can be a rewarding one. The Americans with Disabilities Act (ADA) prohibits the denial of care to any child because that child has a disability. This document teaches child care providers the law to ensure that no disabled child is excluded from care based on his or her disability. The report discussion program admission standards, the four reasons that allow a provider to deny care, fees for service, training, licensing, accommodations, disclosures, architectural changes, tax benefits, and other considerations, including insurance and liability.
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Special Child: A Source Book for Parents of Children with Developmental Disabilities. 2nd ed Source: Baltimore, MD: Paul H. Brookes Publishing Company. 1994. 457 p. Contact: Available from Paul H. Brookes Publishing Company. P.O. Box 10624, Baltimore, MD 21285-0624. Voice (800) 638-3775. Fax (410) 337-8539. E-mail:
[email protected]. Website: www.brookespublishing.com. PRICE: $ 26.00 plus shipping and handling. Item Number 1677. ISBN: 1557661677. Summary: This sourcebook was written to provide information, guidance, and encouragement to parents of children with developmental disabilities. Five sections include an introduction to children with special needs, their parents, and the
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professionals who care for them; common problems and disabilities in children with special needs; inherited and acquired developmental disabilities; special care for the child, including procedures, assistive devices, and surgical treatments; and assessments, education, and resource development. Intended to complement the professional services that parents receive, this home reference book offers advice on how to manage the complex issues brought on by disability, choose a specialist and facilitate partnerships with professionals, obtain an appropriate education for the child, uphold the child's legal rights, and plan for the child's future. The book includes a resource section guiding parents to additional information on health care, insurance, advocacy, financial aid, and more. A subject index concludes the volume. 154 references. •
Educating Students Who Have Visual Impairments with Other Disabilities Source: Baltimore, MD: Paul H. Brookes Publishing Co. 1998. 519 p. Contact: Available from Paul H. Brookes Publishing Co. P.O. Box 10624, Baltimore, MD 21285. (800) 638-3775. Fax (410) 337-8539. Website: www.brookespublishing.com. PRICE: $49.95 plus shipping and handling. ISBN: 1557662800. Summary: This text brings together expertise from a broad range of disciplines to assist general educators, special educators, related services personnel, and families in developing methods and strategies to meet the educational needs of students who have visual impairments along with other disabilities. The authors use realistic vignettes, sample assessment and data forms, and examples of specialized curricula to help readers design instruction that is meaningful and useful. The first section of the text deals with the characteristics of students who have multiple disabilities and various approaches to assessment. Part II discusses instructional strategies for educating students who have visual impairments with a variety of other disabilities, including deafblindness, learning disabilities, orthopedic (mobility) disabilities, neurological (nervous system) disabilities, and emotional and behavioral problems. A third section addresses disability specific areas of instruction, including assessing and enhancing the use of functional vision, designing strategies to develop functional language and communication, orientation and mobility skills, and adaptive technology. Each chapter begins with a vignette that describes the specific educational needs of a student or that illustrates a specialized method of instruction; chapter objectives are also provided. Each chapter concludes with a list of references and a subject index concludes the text.
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Dysphagia and the Child with Developmental Disabilities: Medical, Clinical and Family Interventions Source: San Diego, CA: Singular Publishing Group, Inc. 1994. 430 p. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $65.00 plus shipping and handling. ISBN: 1565930894. Summary: This text covers the medical, clinical, and family interventions utilized in children who have developmental disabilities and dysphagia. Eighteen chapters cover the symptomatology and etiology of dysphagia; the comprehensive team evaluation; clinical evaluation and treatment; nutritional support; nutritional support for the child with AIDS; dysphagia in children with AIDS; the behavioral aspects of feeding disorders; the influence of posture and positioning on oral motor development and dysphagia; the radiologic assessment of pediatric swallowing; otolaryngology considerations; respiratory conditions and care; gastrointestinal problems; the surgical
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management of gastroesophageal reflux in children; dental treatment; dental care; nursing assessment and management; the family perspective on raising a child with developmental disability; ethical issues in treatment; and pharmacology. Each chapter includes numerous references and a subject index concludes the text. •
Communication Strategies for People with Developmental Disabilities: Issues from Theory and Practice Source: Baltimore, MD: Paul H. Brookes Publishing Co., Inc. 1994. 232 p. Contact: Available from Paul H. Brookes Publishing Co., Inc. P.O. Box 10624, Baltimore, MD 21285-0624. (800) 638-3775. Fax (410) 337-8539. E-mail:
[email protected]. Website: www.brookespublishing.com. PRICE: $33.00 plus shipping and handling. ISBN: 1557661707. Summary: This text is designed to help education and rehabilitation practitioners stay abreast of advances in the field of communication disorders. The authors explore developments in communication disorders theory, various methods of assessment, research findings that can improve intervention strategies, and the direction of future research and training efforts. Eight chapters cover communicative behavior in the least restrictive environment; play as an assessment and intervention strategy for children with language and intellectual disabilities; requesting behaviors of preschool children with mild developmental disabilities; selection of initial vocabularies for use in manual sign language programs; functional communication and the role of context; the use of a synthetic speech output communication aid with a youth having severe developmental disability; communication instruction in the 1990s; and enhancing communication in functional settings. Each chapter includes extensive references and a subject index concludes the text.
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Life Beyond the Classroom: Transition Strategies for Young People with Disabilities. 2nd ed Source: Baltimore, MD: Paul H. Brookes Publishing Company. 1996. 559 p. Contact: Available from Paul H. Brookes Publishing Company. P.O. Box 10624, Baltimore, MD 21285-0624. (800) 638-3775. Fax (410) 337-8539. E-mail:
[email protected]. Website: www.brookespublishing.com. PRICE: $55.00 plus shipping and handling. ISBN: 1557662487. Summary: This textbook helps health professionals, special educators, and disability advocates comply with the federal mandate for transition services. The author offers a guide to planning, designing, and implementing successful transition programs for students with disabilities, including those with communication disorders. The chapters cover the techniques and strategies for designing effective, individualized transition plans (ITPs); initiating a local transition program; creating community-based work programs; teaching vocational skills; making accurate assessments; and implementing the job development process. The text includes illustrative case studies and sample forms, tables, and charts. Also included is an examination of the educational, legal, and social issues surrounding transition, from policy and program initiatives to service delivery systems and vocational training methods. Each chapter concludes with study questions; a subject index concludes the textbook. 720 references.
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Teaching Communication Skills to Students with Severe Disabilities Source: Baltimore, MD: Paul H. Brookes Publishing Co. 1999. 198 p.
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Contact: Available from Paul H. Brookes Publishing Co. P.O. Box 10624, Baltimore, MD 21285-0624. (800)638-3775. Fax (410) 337-8539. Website: www.brookespublishing.com. PRICE: $34.95 plus shipping and handling. ISBN: 1557663858. Summary: This textbook offers guidelines to classroom teachers for teaching communication skills to students with severe disabilities. Designed for the inclusive classroom, the text helps teachers facilitate good communication with all their students, regardless of disability. The author offers strategies for assessing the communication skills of students with very complex and multiple disabilities; for determining a student's needs and helping the student onto a track for success; for assisting students with peer interaction in typical settings and across the age span; and for acquiring intervention techniques to promote alternative forms of communication such as gestures, body language, signing, and using both objects and pictorial AAC (augmentative and alternative communication) devices. The author also discusses the role of communicative partners and the importance of working together with parents and other professionals to ensure integrated service delivery. The author stresses that educators must help all individuals communicate by providing appropriate motivation, keeping expectations high, and letting those with disabilities realize that what they have to say is valued. Each chapter concludes with a list of references and the text concludes with an AAC resource list, and a subject index. •
Special child: A source book for parents of children with developmental disabilities. (2nd ed.) Source: Baltimore, MD: Paul H. Brookes Publishing Company. 1995. 436 pp. Contact: Available from Paul H. Brookes Publishing Company, P.O. Box 10624, Baltimore, MD 21285-0624. Telephone: (800) 638-3775 or (410) 337-9580 / fax: (410) 3378539 / e-mail:
[email protected]. $26.00. Summary: Written for parents of children with developmental disabilities, this book is designed as a general resource for helping parents manage the complex issues involved in caring for their child. It points out how to recognize developmental problems and how to obtain an evaluation that may lead to a specific diagnosis. It discusses the effects a disability can have on family life. It suggests ways to choose a health specialist and describes the parent-professional partnership that is important for enhancing a child's care. Several sections highlight a number of specific tests and procedures, medications, treatments, and operations commonly performed. Other sections focus on educational and legal issues and on learning about and utilizing community resources. The book concludes with a list of resource organizations and a suggested reading list.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: When following the link below, you may discover non-medical books that use the generic term “disability” (or a synonym) in their titles. •
Amazon.com: http://www.amazon.com/exec/obidos/externalsearch?tag=icongroupinterna&keyword=disability&mode=books
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Chapters on Disability In order to find chapters that specifically relate to disability, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and disability using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “disability” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on disability: •
Approaches to Language Disability Source: in Crystal, D. and Varley, R. Introduction to Language Pathology. 4th ed. Baltimore, MD: Brookes Publishing Co. 1998. p. 22-61. Contact: Available from Paul H. Brookes Publishing Co. P.O. Box 10624, Baltimore, MD 21285-0624. (800) 638-3775. Fax (410) 337-8539. Website: www.brookespublishing.com. PRICE: $47.00 plus shipping and handling. ISBN: 1557664447. Summary: Communicative disorders occur in many different forms, and range from conditions such as autism and cleft palate to the apparently inexplicable failure of some children to learn their native language at a normal rate and in a normal way. This chapter on approaches to language disability is from a textbook on language pathology which reflects the increasing influence of information processing psychology on language pathology. In this chapter, the authors examine the influence which the behavioral and medical sciences have exercised over language pathology. Topics include the scientific approach, aspects of the medical approach, aspects of the behavioral approach, linguistics, models of language structure, psychology, and correlating medical and behavioral data. The authors emphasize that the two approaches to investigation (medical and behavioral) provide very different kinds of information about a patient, and that both are necessary in order to get anywhere near a full understanding of the patient's abilities and limitations, and a positive rationale for treatment and rehabilitation. The chapter concludes with a brief list of review questions (for readers to test their comprehension of the material presented), and a set of tutorial activities that accompany the concepts in the chapter. 1 figure. 1 table.
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Exercise in Diabetic Patients with Disabilities Source: in Devlin, J.T. and Schneider, S.H., eds. Handbook of Exercise in Diabetes. Alexandria, VA: American Diabetes Association. 2002. p.601-611. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $69.95 plus shipping and handling. ISBN: 1580400191. Summary: Disability and diabetes commonly coexist. Diabetes is a risk factor for stroke, amputation, and neuropathy (nerve disease). This chapter on exercise in diabetic patients with disabilities is from a book that provides a practical, comprehensive guide to diabetes and exercise for health care professionals involved in patient care. Stroke is a common disabling condition in people with diabetes. Exercise therapy is a key component of rehabilitation after stroke. Recent studies have provided increasing evidence that exercise can facilitate stroke recovery. The high prevalence of coronary
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artery disease in people with diabetes who sustain a stroke should be considered when prescribing exercise for these individuals. Both diabetes and stroke may be risk factors for carpal tunnel syndrome (CPS). Treatment of CPS may be complicated by coexisting disability (e.g., hemiparesis, muscle weakness, in the other arm). Leg amputation may occur as a complication of diabetes and imposes increased energy costs for ambulation (walking). The energy requirements of walking with an above-the-knee amputation are substantially higher than with a below-the-knee amputation. Neuropathy is an important cause of disability in individuals with diabetes. Ankle dorsiflexion weakness ('foot drop') may be effectively managed with the use of an ankle foot orthosis. In severe cases of neuropathy, a Charcot arthropathy may develop in the foot or ankle. This has a substantial impact on the ability to exercise and may result in amputation in some cases. Lower extremity braces may be useful as a compensatory tool for individuals with leg weakness from stroke or neuropathy. Either plastic lightweight braces or metal braces attached to shoes may be appropriate in different situations. The least restrictive brace possible should generally be prescribed. 1 figure. 31 references. •
Disability, the Young and the Elderly Source: in Scully, C. and Cawson, R.A. Medical Problems in Dentistry. 4th ed. Woburn, MA: Butterworth-Heinemann. 1998. p. 470-487. Contact: Available from Butterworth-Heinemann. 225 Wildwood Avenue, Woburn, MA 01801-2041. (800) 366-2665 or (781) 904-2500. Fax (800) 446-6520 or (781) 933-6333. E-mail:
[email protected]. Website: www.bh.com. PRICE: $110.00. ISBN: 0723610568. Summary: Disability is caused by handicapping conditions that impair normal social, educational, or recreational activities. Such patients need dental attention and treatment to at least the same standard as non-handicapped patients; frequently this population has a greater predisposition to dental disease. This chapter on disability, the young and the elderly is from a text that covers the general medical and surgical conditions relevant to the oral health care sciences. This chapter covers only patients with mental and related handicaps, some specific conditions, children, and the elderly; patients with other important specific diseases, such as hemophilia, neurological disorders and muscular dystrophies, are covered in other chapters. Topics include learning disability, chromosomal anomalies (including Down syndrome and fragile X syndrome), thalidomide defect, hydrocephalus, cleft lip and palate, autism, the overactive child (hyperkinetic child), child abuse, self-inflicted oral lesions, juvenile delinquency, and problems in the elderly, including multiple disease, intellectual failure, social problems, drug compliance and reactions. For each condition, the authors discuss general aspects, diagnosis and management issues, dental aspects, and patient care strategies. The chapter includes a summary of the points covered. 1 appendix. 5 figures. 8 tables. 46 references.
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Child with More than One Disability Source: in Cornett, R.O. and Daisey, M.E. Cued Speech Resource Book for Parents of Deaf Children. 2nd ed. Cleveland, OH: National Cued Speech Association. 2001. p. 537562. Contact: Available from National Cued Speech Association. 23970 Hermitage Road, Cleveland, OH 44122-4008. Voice/TTY (800) 459-3529 or (216) 292-6213. E-mail:
[email protected]. PRICE: $37.50 for members; $39.50 for nonmembers, plus shipping and handling. ISBN: 0963316419.
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Summary: Hearing impairment often occurs concurrently with one or more other disabling conditions that may impede communication or learning, such as memory problems, mental retardation, aphasia (lack of language comprehension), dyslexia, dysarthria (motor speech disorders), cerebral palsy, Usher syndrome (a cause of deaf blindness), and others. This chapter on children with more than one disability is from a book that offers an overview of cued speech, the use of hand cues with speech that permits the deaf child to learn the English language. The book includes information and advice for parents who have decided to use Cued Speech with a child who is deaf or hard of hearing, or are considering doing so. The authors discuss specific overlying conditions, including minor or correctable conditions, cerebral palsy, memory problems, aphasia, apraxia (difficulty in expressive language), dyslexia, deaf blindness, and nonspecific learning disability. The chapter then offers case histories of children who have at least one other learning problem in addition to hearing impairment. Two case histories, while not featuring additional learning problems, tell of children whose early years were so dominated by health problems that there appeared to be little hope for normal development of language, communication, or reading. •
Attitudes are the Real Disability Source: in Gartley, C. Managing Incontinence: A Guide to Living with Loss of Bladder Control. Ottawa, IL: Jameson Books, Inc. 1985. p. 34-39. Contact: Available from Jameson Books, Inc. 722 Columbus Street, Ottawa, IL 61350. (815) 434-7905. ISBN: 091546313X. PRICE: $12.95; plus shipping and handling. Summary: Incontinence deserves an enlightened social climate. Sanity, compassion, and fair play are experiences that help many people overcome the barriers of their handicap. So contends the author of this chapter on attitude, which is published in a book that offers information and practical advice for people with urinary incontinence. The authors of the book offer medical advice, practical help, product information, and conversations with others who have urinary incontinence (because of disease, injuries, operations, or birth anomalies). In this chapter, the author explores the attitudes of the medical profession and societal attitudes about disability and bodily functions. The chapter includes numerous and lengthy quotes from real people sharing their experiences.
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Dental Treatment for Adults: Oral Health for Adults with Disabilities Source: in Fenton, S.J.; Perlman, S.; Turner, H., eds. Oral Healthcare for People with Special Needs: Guidelines for Comprehensive Care. River Edge, NJ: Exceptional Parent, Psy-Ed Corp. 2003. p. 36-38. Contact: Available as part of a monograph from Exceptional Parent, Psy-Ed Corp. 65 East Route 4, River Edge, NJ 07661. (800) EPARENT or (800) 372-7368. E-mail:
[email protected]. Website: www.eparent.com. PRICE: Contact publisher. Summary: Special care dentistry is a term commonly used for addressing the oral health needs of a person who is medically compromised or an individual with some type of mental, physical, or developmental disability. Special care dentistry may include consulting with the person's physician, coordinating dental treatment with other care providers, assisting a person with the aid of the family and direct support professionals, adaptations to the treatment procedure, communicating through an interpreter, and treatment planning with the person to mitigate future oral health problems. This article on dental treatment for adults is from a monograph that offers guidelines for the comprehensive oral health care for people with special needs. The monograph is
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designed to help oral health care providers embrace more fully all the members of their communities, while being respectful of a variety of special needs. In this article, the authors note that oral diseases for individuals with disabilities do not differ from those of individuals without disabilities, but that various factors related to disabilities can make preventing and treating dental disease more difficult. Topics include common changes seen as people with disabilities age, including broken teeth, dry mouth (xerostomia), cavities or caries (tooth decay), decayed roots (root caries), gum disease (gingivitis), missing teeth (tooth loss), tooth replacement, bad breath (halitosis), food pocketing (pouching), and regurgitation; appropriate dental care for adults with disabilities; oral hygiene; treatment goals; disease prevention and maintenance of the mouth; and barriers to treatment for adults with disabilities. •
Disability as a Public Health Outcome in the Aging Population Source: in Omenn , G.S.; Fielding, J.E.; Lave, L.B. ( Eds ). Annual Review of Public Health. Palo Alto, CA: Annual Reviews Inc. 1996. p. 25-46. Contact: Available from Annual Reviews Preprints and Reprints, 4139 El Camino Way, P.O. Box 10139, Palo Alto, CA 94303-0139. (800) 347-8007. (415) 259-5017. Summary: This chapter for health professionals examines the public health problems of disease and disability and related utilization of medical care and need for supportive and long-term care in the aging population. The chapter reviews current knowledge about the measurement of disability, the prevalence of disability in the older population, the social and health consequences of disability, the risk factors for functional decrements in aging, and the prevention of disability in the older population. Topics with relevance to musculoskeletal disability include disability from arthritis; the risk of disability from the coexistence of knee osteoarthritis and other conditions; and physical performance measures that are used to assess range of motion, strength, balance, and mobility in older individuals. 98 references and 2 figures. (AA-M).
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Theoretical and Applied Insights from Multimedia Facilitation of Communication Skills in Children with Autism, Deaf Children, and Children with Other Disabilities Source: in Adamson, L.B.; Romski, A.R., eds. Communication and Language Acquisition: Discoveries from Atypical Development. Baltimore, MD: Paul H. Brookes Publishing Company. 1997. p. 295-325. Contact: Available from Paul H. Brookes Publishing Company. P.O. Box 10624, Baltimore, MD 21285-0624. (800) 638-3775 or (410) 337-9580. Fax (410) 337-8539. E-mail:
[email protected]. Website: www.brookespublishing.com. PRICE: $44.00 plus shipping and handling. ISBN: 1557662797. Summary: This chapter is from a text that explores research on atypical communication and language development as a source of knowledge about how children become accomplished communicators. The authors of this chapter discuss their studies of advances in reading and writing under multimedia literacy instruction in children with disabilities. The children in the studies ranged in age from 5 year olds who are beginning to read to 10 to 16 year olds with serious delays in reading and writing skills. Their disabilities included autism, deafness, motor disabilities, dyslexia, and attention deficit hyperactivity disorder (ADHD). Regardless of age and disability, these children worked with multimedia computer software designed to facilitate skills in the text mode by patterning text sentences together rapidly with other media channels, including graphics, voice, and sign language. The first section in the chapter provides the theoretical basis for the multimedia procedures, including the application of Rare Event
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Learning (REL) theory. The next section reviews results of field research for children's advances in reading and writing and for related teacher and child variables. Most of the results involve children with deafness and other hearing impairments and children with autism. 6 tables. 75 references. •
AAC Issues for People with Developmental Disabilities Source: in Beukelman, D.R. and Mirenda, P. Augmentative and Alternative Communication: Management of Severe Communication Disorders in Children and Adults. 2nd ed. Baltimore, MD: Paul H. Brookes Publishing Co. 1998. p. 245-264. Contact: Available from Paul H. Brookes Publishing Co. P.O. Box 10624, Baltimore, MD 21285. (800) 638-3775. Fax (410) 337-8539. Website: www.brookespublishing.com. PRICE: $59.95 plus shipping and handling. ISBN: 1557663335. Summary: This chapter on AAC issues for people with developmental disabilities is from a textbook that promotes a comprehensive approach to designing and providing augmentative and alternative communication (AAC) services for people with a full range of congenital (present at birth) and acquired communication disorders, including those associated with cerebral palsy, autism, aphasia, and traumatic brain injury (TBI). This chapter serves as an introduction to the part of the text that addresses the communication needs of people who are acquiring communication and language skills for the first time. These people have disabilities that were either present since birth or before the age of 18 and that affect one or more aspects of development (physical, sensory, cognitive). AAC techniques are used quite routinely with people who experience developmental disabilities, including cerebral palsy, cognitive disability (i.e., mental retardation), autism and the associated spectrum disorders, and developmental apraxia of speech. In this chapter, each of these impairments is defined and explained briefly in terms of its description, prevalence, and major characteristics. An overview of the AAC issues most pertinent to each impairment is provided. The chapter includes sidebars that offer relevant quotes from the literature, that share stories from the authors' experiences, and that pose questions for readers to consider while reading the chapter. 2 tables.
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Assistive Communication Technology for Elders with Motor Speech Disability Source: in Lubinski, R.; Higginbotham, D.J., eds. Communication Technologies for the Elderly: Vision, Hearing, and Speech. San Diego, CA: Singular Publishing Group, Inc. 1997. p. 235-261. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $49.95 plus shipping and handling. ISBN: 1565936345. Summary: This chapter on assistive communication technology for elders with motor speech disabilities is from a book that supports enhancing communication opportunities for elders through the use of technology. This chapter and the previous one provide an introduction to the application of assistive communication technology for elders. This chapter reviews four groups of adults with acquired motor speech disorders: individuals with locked-in syndrome, amyotrophic lateral sclerosis (ALS), Parkinson's disease, and apraxia of speech and aphasia. The authors selected these disorders because of their frequency of occurrence and because each represents a different type of impairment. Therefore, the assistive technology needs of each group will vary. The authors include a definition of each disorder, common causes, natural course, and
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speech characteristics. Typical assistive technology interventions and associated training issues are also presented. The chapter concludes with a brief resource list. 2 tables. 46 references. (AA-M). •
Communication-Other Disabilities: Scholarships, Fellowships-Grants, Loans, Grantsin-Aid, Awards Source: in Schlachter, G.A.; Weber, R.D. Financial Aid for the Disabled and Their Families. 1996-1998. El Dorado Hills, CA: Reference Service Press. 1996. p. 199-207. Contact: Available from Reference Service Press. 5000 Windplay Drive, Suite 4, El Dorado Hills, CA 95762. (916) 939-9620; Fax (916) 939-9626. PRICE: $39.50 plus shipping and handling. ISBN: 0918276365. Summary: This chapter on communication and other disabilities is from a Directory that provides comprehensive information about more than 800 resources set aside for persons with disabilities or for members of their family. This chapter describes 30 programs open to individuals who have a communication disorder (such as stuttering or voice impairment), have a learning disability (including such conditions as brain injury and dyslexia), are emotionally disturbed, or have other chronic or acute health problems, such as heart condition, tuberculosis, epilepsy, or hemophilia. Included are scholarships, fellowships or grants, loans, grants-in-aid, and awards. Entries list program title, sponsoring organization, purpose of the program, eligibility, financial data, duration and renewal, special features, limitations, number awarded, and deadline.
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Disability in Diabetes Source: in Harris, M.I., et al., eds., for the National Diabetes Data Group (NDDG). Diabetes in America. 2nd ed. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. 1995. p. 259-282. Contact: Available from National Diabetes Information Clearinghouse (NDIC). 1 Information Way, Bethesda, MD 20892-3560. (800) 860-8747 or (301) 654-3327. Fax (301) 634-0716. E-mail:
[email protected]. Also available at http://www.niddk.nih.gov/. PRICE: Full-text book and chapter available online at no charge; book may be purchased for $20.00. Order number: DM-96 (book). Summary: This chapter on disability in diabetes is from a compilation and assessment of data on diabetes and its complications in the United States. Persons with diabetes, in general, report rates of disability that are substantially higher than those reported by the general U.S. population. Moreover, the largest impact of disability in the population with diabetes appears to be in the most severe forms of disability, including being unable to work. Disability in persons with diabetes is influenced by a number of demographic and diabetes-related factors. Disability is more common in minority groups. Disability appears to affect persons with NIDDM, particularly those using insulin, more than persons with IDDM. Presence of the late complications of diabetes appears to be a major determinant for disability. The consequences of disability in the diabetes population are extensive. Disabled IDDM subjects have lower rates of employment than those not disabled (49 percent not working versus 12 percent) and higher rates of absenteeism (13.8 days per year versus 3.0 days per year). Reported income levels are also lower for IDDM subjects developing disability. Disabled persons with diabetes use health care services more frequently than those not limited in activity (32.4 percent were hospitalized in the past year versus 13.2 percent). The average number of physician visits among persons seeing a physician was 13.9 per year for
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persons limited in activity, compared with 6.5 visits per year for those not limited. Limitations are more common among people with diabetes than nondiabetic individuals. Not surprisingly, disabled persons rate their general health status at lower levels than those not disabled. 4 appendices. 27 figures. 19 tables. 47 references. (AA-M). •
Hearing Disabilities: Scholarships, Fellowships-Grants, Loans, Grants-in-Aid, Awards Source: in Schlachter, G.A.; Weber, R.D. Financial Aid for the Disabled and Their Families. 1996-1998. El Dorado Hills, CA: Reference Service Press. 1996. p. 129-146. Contact: Available from Reference Service Press. 5000 Windplay Drive, Suite 4, El Dorado Hills, CA 95762. (916) 939-9620; Fax (916) 939-9626. PRICE: $39.95 plus shipping and handling. ISBN: 0918276365. Summary: This chapter on hearing disabilities is from a Directory that provides comprehensive information about more than 800 resources set aside for persons with disabilities or for members of their family. This chapter describes 57 programs open to individuals who have difficulties in receiving linguistic information, with or without amplification. Included are scholarships, fellowships or grants, loans, grants-in-aid, and awards. Entries list program title, sponsoring organization, purpose of the program, eligibility, financial data, duration and renewal, special features, limitations, number awarded, and deadline.
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Insurance and Disability Advocacy Issues in Inflammatory Bowel Disease Source: in Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 555-559. Contact: Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email:
[email protected]. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220. Summary: This chapter on insurance and disability advocacy issues is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn's disease (CD) and ulcerative colitis (UC), together known as inflammatory bowel disease (IBD). The author stresses that physicians can be good advocates for their patients with IBD. The key to being a good advocate is to be knowledgeable about the issues and to be able to offer facts and guidance to patients with their many insurance and disability related issues. The author discusses the vulnerable age peak for obtaining insurance; changing employment; benefits programs including Medicare, Medicaid, high risk insurance pools, and Family and Medical Leave; and disability programs, including Social Security disability benefits, the Americans with Disabilities Act (ADA), and education issues for children with IBD. The chapter offers a list of tips for patients. Do not let current health insurance coverage lapse. If the patient does not have health insurance, look into the options available to obtain it. Have regular visits with the doctor, as insurers look favorably on patients who have regular visits, and this will also help the patient to stay well. Take medication as prescribed, because the condition likely will not improve on its own, even if the use of medication temporarily disallows eligibility to an insurance plan. If possible, choose a job with group insurance and portable benefits. For parents of children with IBD, anticipate their need for modified coverage prior to their eighteenth birthday. Determine with the insurance agent or benefits representative what the best options are for the teenager prior to turning 18 so that no lapse in coverage occurs.
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Learning Disabilities Source: in Batshaw, M.L., ed. Children with Disabilities. 4th ed. Baltimore, MD: Paul H. Brookes Publishing Company. 1997. p. 471-497. Contact: Available from Paul H. Brookes Publishing Company. P.O. Box 10624, Baltimore, MD 21285-0624. (800) 638-3775 or (410) 337-9580. Fax (410) 337-8539. E-mail:
[email protected]. Website: www.brookespublishing.com. PRICE: $49.95 plus shipping and handling. ISBN: 1557662932. Summary: This chapter on learning disabilities is from a textbook that addresses the impact of disabilities on child development and function. The authors define learning disability as a disorder in which a healthy child with typical intelligence fails to learn adequately in one or more subjects. The authors discuss impairments associated with learning disabilities, methods of early identification, various intervention strategies, and outcomes for children with learning disabilities. Two sections discuss the causes and neuroanatomy of specific reading disability, the most common form of learning disability. Impairments associated with learning disabilities include impairments in executive functions, memory impairments, attention deficit or hyperactivity disorder, social skills impairments, and emotional and behavior disorders. The authors emphasize that early detection of a specific learning disability is important because, if untreated, the child may develop secondary emotional and behavioral problems that hinder progress. The chapter concludes with illustrative case studies of a child with dyslexia and a child with dysgraphia and dyscalculia. As medical terms are introduced in the text, they appear in bold type; definitions for these terms are provided in a glossary at the end of the book. 1 figure. 2 tables. 191 references.
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Voice and Speech Impairment and Disability Source: in Sataloff, R.T., ed. Professional Voice: The Science and Art of Clinical Care. 2nd ed. San Diego, CA: Singular Publishing Group, Inc. 1997. p. 795-800. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $325.00 plus shipping and handling. ISBN: 1565937287. Summary: This chapter, from a book on the clinical care of the professional voice, considers voice and speech impairment and disability. The author stresses that principles of impairment, disability, handicap, and compensation are complex both medically and legally. Readers are encouraged to review their definitions in other, more lengthy, sources. The author contends that an understanding of their differences is necessary in order to appreciate the nature and importance of many otolaryngologic disabilities, including voice disorders. The evaluation of voice and speech involves an assessment of a person's ability to produce phonation and articulate speech, and does not involve assessment of content, language, or structure. The author reviews the various tests and objective measures of voice that are in use and then considers the suggested criteria for voice or speech impairment. The methods suggested for calculating impairment and disability are consistent with the principles and standards followed in the AMA Guides. 2 tables. 14 references.
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Acquired Neurological Disabilities in Hispanic Adults Source: in Langdon, H.W. and Cheng, L.L., eds. Hispanic Children and Adults with Communication Disorders. Gaithersburg, MD: Aspen Publishers, Inc. 1992. p. 373-407.
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Contact: Available from Aspen Publishers, Inc. 200 Orchard Drive, Gaithersburg, MD 20878. (800) 638-8437; Fax (301) 417-7650. PRICE: $58.00 plus shipping and handling. ISBN: 0834202883. Summary: This chapter, from a textbook on Hispanic children and adults with communication disorders, discusses acquired neurological disabilities in Hispanic adults. Topics covered include a description of acquired neurological disabilities; the impact of acquired neurological disability on the bilingual individual; recovery patterns for bilingual individuals; a clinical evaluation protocol; and intervention options. The chapter includes four illustrative case studies. 5 tables. 74 references. •
Physical Disability and Sensory Impairment Source: in Griffiths, J. and Boyle, S. Colour Guide to Holistic Oral Care: A Practical Approach. Mosby-Year Book Europe. 1993. p. 131-150. Contact: Available from Mosby-Year Book Europe. Lynton House, 7-12 Tavistock Square, London WC1H 9LB, England. Telephone 0171-391 4471. Fax 0171-391 6598. ISBN: 0723417792. Summary: This chapter, from a textbook that outlines the role of the nurse in oral health care, discusses the oral care of people with physical disability or sensory impairment. The authors summarize the more common conditions that may affect manual dexterity, arm control, and mobility. Topics covered include the prevalence of physical disability; barriers to oral health; arthritis; brittle bone disease (osteogenesis imperfecta); rickets and osteomalacia; osteoporosis; Paget's disease (oteitis deformans); muscular dystrophies and myotonic disorders; myasthenia gravis; motor neurone disease; multiple sclerosis; Guillain-Barre syndrome; stroke (cerebrovascular accident); Bell's palsy; Parkinson's disease; cleft lip and palate; cerebral palsy; spina bifida and hydrocephalus; spinal injuries and trauma; head injury; epilepsy; and sensory impairment. 6 tables. 22 references. (AA-M).
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Work and Disability Source: in Green, W.F. First Year: Hepatitis B. New York, NY: Marlowe and Company. 2002. p. 170-180. Contact: Available from Marlowe and Company. 161 William Street, 16th Floor, New York, NY 10038. PRICE: $15.95 plus shipping and handling. ISBN: 1569245339. Summary: Viral hepatitis B (liver infection) is one of the most preventable medical conditions due to the availability of a hepatitis B vaccine, yet an estimated 100,000 people in the United States are infected each year, and 6,000 die from complications. When the author of this book was diagnosed in 1993, he decided to be proactive in his quest to understand and manage his illness. In this chapter, the author focuses on what readers may be experiencing by the sixth month after they receive their diagnosis of hepatitis B virus (HBV) infection, discussing the issues surrounding work and disability. The chapter is in two parts: first, a focus on the psychosocial aspects that the reader might experience, followed by a section of instructional material. In nontechnical language, the author discusses the application process for government disability, the Social Security disability insurance program, the Supplemental Security Income (SSI) program, recordkeeping, and the need for persistence. The second section addresses insurance and financial planning, including managed health care plans, high-risk pools, preexisting conditions, and eligibility considerations.
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Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to disability have been published that consolidate information across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:11 •
Directory of Grants for Organizations Serving People with Disabilities. 10th ed Source: Margate, FL: Research Grant Guides, Inc. 1997. 152 p. Contact: Available from Research Grant Guides, Inc. Department 3A, P.O. Box 1214, Loxahatchee, FL 33470. (561) 795-6129; Fax (561) 795-7794. PRICE: $59.50 per copy, plus $6.00 for shipping and handling. ISBN: 094507817X. Summary: Designed to help nonprofit organizations identify and obtain grants, this directory profiles 800 foundations that support services for people with disabilities. Each profile identifies the areas of support, geographic restrictions, grant range, and previously awarded grants. The foundations are listed geographically (by state). The introductory material presents three instructional essays to help readers write more competitive grant proposals. The appendices describe two centers that can provide assistance for grant writers: the Foundation Center and the Grantsmanship Center. The directory includes an alphabetical index and a subject index. The subject index includes the following subjects: accessibility projects, blindness and visual impairments, cultural programs, deafness and hearing impairments, education, independent living programs, learning disabilities, mental health, mentally disabilities, physical disabilities, recreation, rehabilitation, speech impairments, vocational training, and youth.
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Directory of Indiana parent leaders of children with disabilities and chronic illness. (2nd ed.) Source: Indianapolis, IN: Indianapolis Parent Information Network. 1993. 82 pp. Contact: Available from Indiana Parent Information Network, 4755 Kingsway Drive, Suite 105, Indianapolis, IN 46205. Telephone: (317) 257-8683. Summary: This directory includes contact information for Indiana parents of children with disabilities or chronic illnesses who have demonstrated a commitment to improving the quality of life for children with special needs. They are involved in activities such as local, state and national committees, educational activities for parents and/or professionals, and advocacy efforts for children in schools, hospitals, the state legislature, and Congress. The directory includes information about their child's disability and age as well as information about the parents' group affiliations, experience, skills, interests, and related employment. [Funded by the Maternal and Child Health Bureau].
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Directory of College Facilities and Services for People with Disabilities. 4th ed Source: Phoenix, AZ: Oryx Press. 1996. 437 p.
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You will need to limit your search to “Directory” and “disability” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “disability” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.
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Contact: Available from Oryx Press. 4041 North Central Avenue, Suite 700, Phoenix, AZ 85012-3397. (800) 279-6799 or (602) 265-2651; Fax (602) 265-6250; E-mail:
[email protected]. PRICE: 115.00 plus shipping and handling. ISBN: 897748948. Summary: This directory lists 1,532 colleges and universities that offer facilities and services for people with disabilities. Each institutional entry includes the name and address of the institution, telephone number for the contact person, and the name of that individual. This is followed by information in four categories: profile, campus and facilities, services, and comments. Entries are arranged alphabetically by institution name within each state. The listings section is followed by two indexes: the first is a categorical listing of disabilities and includes the number of students served at the institution for that category; the second is an alphabetical arrangement of colleges and universities and indicates those institutions with special financial aid programs and/or with residential facilities. •
National Information Center for Children and Youth with Disabilities State Resource Sheets Source: Washington, DC: National Information Center for Children and Youth with Disabilities (NICHCY). 1997. 216 p. Contact: National Information Center for Children and Youth with Disabilities (NICHCY). P.O. Box 1492, Washington, DC 20013-1492. Voice/TTY (800) 695-0285 or (202) 884-8200; E-mail:
[email protected]; http://www.nichcy.org. PRICE: $10.00 for complete set; copy of state resource sheet is available at no charge. Order Number GR6 (state resource sheet); Number GR7 (complete set of state resource sheets). Summary: This directory lists individual state resources for children and youth with disabilities. Fifty separate chapters list the resources in each state. Included are the contact information for the senators and the governor, the state's department of education, programs for children with disabilities, programs for infants and toddlers with disabilities, the state vocational rehabilitation agency, state mental health representative for children and youth, state mental retardation program, state developmental disabilities planning council, protection and advocacy agency, client assistance program, programs for children with special health care needs, disability organizations, university-affiliated programs, technology-related assistance, parent training information project, parent teacher association, and other disability organizations. For each organization or program listed, the directory provides the director's name, the address, and the telephone numbers.
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Disability information at your fingertips: A guide to toll-free telephone resources Source: Centereach, NY: Disability Resources. 1994. 13 pp. Contact: Available from Disability Resources, Four Glatter Lane, Centereach, NY 117201032. Telephone: (516) 585-0290. $3.00; discounts are available for bulk orders. Summary: This directory lists the toll-free telephone numbers of national organizations that provide information and resource materials for and about people with disabilities. It is arranged alphabetically by subject/disability.
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Complete Directory for People with Disabilities Source: Lakeville, CT: Grey House Publishing, Inc. 1997. 832 p.
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Contact: Available from Grey House Publishing, Inc. Pocket Knife Square, Lakeville, CT 06039. (860) 435-0868. Fax (860) 435-0867. PRICE: $145.00. ISBN: 0939300869. Summary: This directory, the sixth edition, is a 27-chapter compilation of the latest products and resources for people with disabilities. Products and resources are categorized as follows: art, assistive devices, associations and organizations, books, camps, clothing, computers, conferences and shows, construction and architecture, consultants, education, exchange programs, foundations, government agencies, independent living centers, law, libraries and research centers, periodicals, acute rehabilitation facilities, sports, support groups and hotlines, toys and games, travel and transportation, veterans, videotapes and films, and vocational/employment programs. Entries list the name, address, and telephone number of the resource, as well as a fax number and e-mail address if available. Some entries contain a brief description of the resource and provide a contact person. The directory also includes disability, geographic, and title or entry name indexes. •
All Kids Count: Child Care and the Americans with Disabilities Act (ADA) Source: Arlington, TX: Association for Retarded Citizens (ARC). 1993. 99 p. Contact: Available from Association for Retarded Citizens (ARC). National Headquarters, Publications Department, 500 East Border Street, S-300, Arlington, TX 76010. Voice (817) 261-6003. TTY (817) 277-0553. PRICE: $12.50. Publication Number 3017. Summary: This guide is designed to help child care providers successfully include children with disabilities in regular child care environments, in compliance with Title III of the Americans with Disabilities Act (ADA). The authors offer an overview of the law, as well as practical solutions to common problems and advice to ensure success in caring for children with disabilities. Specific topics covered include definitions and eligibility for ADA, policies, barrier removal, complying with Title III, health and safety issues, helping children who have difficulties with language, learning or memory, children with hearing impairments, and children with physical disabilities, cost and tax considerations, the benefits of including children, the use of 'people-first' language, and specific scenarios of children with disabilities. The final chapter provides extensive information on finding resources, including print, audiovisual, information and advocacy groups, and federal agencies.
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Resources for People with Disabilities: A National Directory Source: Chicago, IL: Ferguson Publishing Company. 1998. Contact: Available from Ferguson Publishing Company. 200 West Madison, Suite 300, Chicago, IL 60606. (800) 306-9941. Fax (800) 306-9942. E-mail:
[email protected]. Website: www.fergpubco.com. PRICE: $89.95 for either format. ISBN: 0894342428 for print version; 0894342568 for CD-ROM. Summary: This resource directory includes more than 8,000 entries of resources for people with disabilities. Included are assistive technology sources, organizations and associations, funding sources, publications, publishers, and conferences. The section on assistive technology includes computers and technology, daily living aids, and mobility and transportation. The section on funding sources includes education, nonprofits, publications, research, and technology. The section of organizations and associations includes Americans With Disabilities Act (ADA) agencies and organizations, education, Federal and State government agencies, independent living centers, legal assistance
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organizations, libraries, medical organizations and hospitals, professional associations, rehabilitation centers, self help and advocacy organizations, Alliance for Technology Access resource centers, university organizations, and vocational assistance organizations. Each entry notes the title of the resource, the address and telephone contact information, the disability served, and a sentence or paragraph describing the resource. The directory also includes five essays on topics including improving the learning environment, the basics of assistive technology, making libraries more accessible, communicating with people who have disabilities, and locating the resources to go to college. The directory includes a disabilities index, a State and city index, and an organization name index (alphabetical list of all entries). The directory is available in a 2volume printed format, or on CD-ROM. The CD-ROM version allows full-text boolean searching. •
Mealtime Manual for People With Disabilities and the Aging Source: Thorofare, NJ: SLACK Incorporated. 1997. 232 p. Contact: Available from SLACK Incorporated. 6900 Grove Road, Thorofare, NJ 080869447. (800) 257-8290; (609) 848-1000. Internet access: http:\\www.slackinc.com. PRICE: $26.00 plus $4.50 shipping and handling. ISBN: 1556423411. Summary: This resource manual provides caregivers of people with Alzheimer's disease (AD) information about where to purchase equipment and tools, as well as a list of helpful organizations and agencies. It also lists periodicals dealing with disability, health, and family services. A variety of meal preparation and eating aids are described that may help caregivers. Additional tools are presented that may help people with AD eat their meals more independently. Photographs, figures, and index are included.
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CHAPTER 7. MULTIMEDIA ON DISABILITY Overview In this chapter, we show you how to keep current on multimedia sources of information on disability. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on disability is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “disability” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “disability” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on disability: •
Americans with Disabilities Act (ADA): Responsibilities for Postsecondary Education Programs Serving Deaf and Hard of Hearing Students Source: St. Paul, MN: Midwest Center for Postsecondary Outreach, St. Paul Technical College. 1997. (videocassette). Contact: Available from PEPNet Resource Center. National Center on Deafness, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 913308267. Voice/TTY (888) 684-4695 or (818) 677-2611. Fax (818) 677-4899. Website: www.pepnet.org. PRICE: $20.00. Summary: This video program depicts a satellite teleconference, held in May 1997, on 'The Americans with Disabilities Act: Responsibilities for Postsecondary Institutions Serving Deaf and Hard of Hearing Students.' The program features Jeanne M. Kincaid, a specialist in disability and law in education, with two other panelists, Dr. Patty Hughes (who offers the perspective of the deaf consumer), and Teresa Johnson, a service provider. The conference was hosted by the Midwest Center for Postsecondary
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Outreach, one of four national regional centers that comprise the Postsecondary Education Programs Network (PEPNet) that are available to help educators who are working with people who are deaf or hard of hearing. These centers work primarily at the institutional level to increase and enhance postsecondary educational opportunities for individuals who are deaf and hard of hearing. The program first introduces the legal aspects of accommodating deaf persons in higher education, then describes the applicable sections of the Americans With Disabilities Act (ADA) and Section 504 of the Rehabilitation Act. The panelists answer questions from the teleconference and studio audience. Topics covered include reasonable accommodations, auxiliary aids and services (interpreting, notetaking, and captioning), specific situations including deaf versus hard of hearing students, defining disabilities, literacy, vocational rehabilitation, administration, residence halls, and equipment. The information provided should not be considered legal advice, but should merely serve as guidance in assisting providers, colleges, universities at large, and others in understanding the obligation institutions of higher learning have to serve students who are deaf and hard of hearing. The video features open captioning, voice over for the people using sign language, and a sign language interpreter window for people who are voicing. •
Ten Commandments of Communicating with People with Disabilities Source: Columbus, OH: Irene M. Ward and Associates. 1994. (videocassette, pamphlet). Contact: Available from Program Development Associates. 5620 Business Avenue, Suite B, Cicero, NY 13039. (800) 543-2119 or (315) 452-0643; Fax (315) 452-0710. PRICE: $195.00 plus shipping and handling. Resource Number TC103. Summary: This videotape features people with various types of disabilities in a series of vignettes showing everyday life. Designed as a community awareness tool for use by working professionals and the people they serve, the video uses humor to make its points about communication. The video demonstrates problems with awkwardness, the inability of people to make eye contact with someone who has a disability, trying too hard, and treating persons with disabilities like children. The video is available in closed-captioned format, or in open-captioned format with audio descriptor. The accompanying written materials include suggested uses for the video; a written version of the video; and fact sheets on topics including myths and facts, the power of words, job analysis, commonly used terms, accommodations to get the job done, interacting with people with mental health disabilities, and publications and resources.
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Hiring Individuals with Disabilities: Its Good Business Source: Toluca Lake, CA: Corporate Productions, Inc. 199x. (videocassette, reference guide). Contact: Available from Corporate Productions, Inc. 4516 Mariota Avenue, Toluca Lake, CA 91602. (818) 760-2622; Fax (818) 760-8619. PRICE: $129.00 plus shipping and handling. Summary: This videotape program outlines most of the requirements employers must meet in any employment relationship because of the Americans With Disabilities Act (ADA). The video shows how a small employer (a shopping mall), a mid-size employer (a medical center), and a large employer (a manufacturing company) have approached accommodating individuals with disabilities in the workplace. It outlines the basic requirements regarding employment, suggests practical steps to promote compliance, and tells where to turn for more information and assistance. For accommodations that are specialized and costly, tax credits, tax deductions, or financial or technical assistance
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may be available; information on these resources is provided. The accompanying reference guide includes key definitions and requirements, as well as clarifications on concepts that could not be addressed easily or fully in the video. The videotape is closed-captioned. •
Augmentative Alternative Communication (AAC) and Persons with Multiple Disabilities: A Clinical Perspective Source: Tucson, AZ: National Center for Neurogenic Communication Disorders, University of Arizona. 2000. (videocassette). Contact: Available from National Center for Neurogenic Communication Disorders, University of Arizona. P.O. Box 210071, Tucson, AZ 85721-0071. (520) 621-1472. Fax (520) 621-2226. PRICE: $25.00 plus shipping and handling. Order Number TR-52. Summary: This videotape program, which is part of the Telerounds videoconference series from the National Center for Neurogenic Communication Disorders at the University of Arizona (funded partly by NIDCD), is the first teleconference in a three part series on augmentative and alternative communication (AAC). AAC is an area of clinical practice that attempts to compensate for the impairment and disability patterns of people who have severe expressive communication disorders. The speaker introduces the viewer to basic terms related to AAC, including unaided and aided systems, access methods, switches, and scanning. This is followed by a discussion of the fundamental principles for selecting an AAC system and the identification of community resources. The speaker also explains how to teach a child to use an AAC system and describes various types of AAC devices. Case examples are used to illustrate AAC intervention techniques for children and adults with multiple disabilities. The program concludes by answering questions asked by the host and phoned in by the teleconference audience and by providing information about joining Centernet, the online forum operated by the Center.
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Enable: People with Disabilities and Computers Source: Redmond, WA: Microsoft Corporation. 1999. (videocassette). Contact: Available from Microsoft Corporation. One Microsoft Way, Redmond, WA 98052-6399. (800) 573-2256. TTY (800) 736-1123. Website: www.microsoft.com/enable/productions. PRICE: Single copy free. Summary: With the help of the personal computer, people with disabilities are working, creating, communicating, and juggling the activities of life. In this videotape program, the Flying Karamazov Brothers introduce viewers to people who are using the personal computer and other technologies to allow them to get back into the rhythm of life. The program begins by discussing how complicated everyone's life has become, then addresses some of the issues that arise when a disability is present. The program emphasizes the role of the computer as a way to empower people and to give them access to what they need, no matter what their disability. The program features interviews with a variety of people, including a person in a wheelchair and on a respirator who uses the computer for his business; a man who was paralyzed on one side by a stroke who uses the computer for enrichment and for keeping in touch with family and friends through e-mail; a young blind woman who uses her computer, a Braille'n'Speak program, and a Braille printer; a young hearing impaired woman who uses a computer and notetaker in the university classroom; a man who is in a wheelchair and uses the Internet to run a support network for people with quadraplegia; an older man with cerebral palsy who uses a variety of high and lower
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tech augmentative and alternative communication devices to communicate; and a deaf blind university student who uses a personal computer and a Braille display to communicate with others. The program features a suppertime gathering of the Karamazov Brothers and a group of people with different disabilities; the group discusses some of the joys and frustrations of coping with a disability and demonstrate some of the ways people can communicate (including sign language). The program also offers numerous inspirational quotes between scenes, stressing the resiliency of the human spirit and the role of the computer in helping all people to achieve their potential.
Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “disability” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on disability: •
Discovering Abilities Within the Disability of Autism Source: Rockville, MD: American Speech-Language-Hearing Association (ASHA). 1997. (audiocassettes, manual). Contact: Available from American Speech-Language-Hearing Association (ASHA). Product Sales, 10801 Rockville Pike, Rockville, MD 20852. (888) 498-6699. TTY (301) 8970157. Website: www.asha.org. PRICE: $38.00 plus shipping and handling. Order number 0112070. Summary: This audiocassette program and accompanying manual present a conference titled, 'Discovering Abilities Within the Disability of Autism.' The workshop was undertaken to clarify an eclectic functional definition of autism for cross-disciplinary programming; to introduce strategies to maximize learning opportunities despite behavioral disruptions; and to examine current intervention models and discuss the decision making process in designing treatment. Specific topics include the Federal IDEA definition and other definitions, diagnostic decision making, medical versus educational labels, behavioral observation, patient care team members, integration of services, behavioral strategies (sensory system differences, behavioral modifications, and nonverbal communication), communication strategies (receptive language comprehension, automatic speech and echolalia, oral motor exercises, and alternative and augmentative communication), and general management strategies. The manual includes reprints of the slides used in the presentation and space for participants to take notes or record questions. The manual also includes some related reprints and materials with which listeners can obtain continuing education credits.
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Hidden Disabilities in the Workplace: Will They Get Treatment Under ADA: The 15th Annual Conference of the President's Committee on Employment of People With Disabilities; Washington, D.C., May 27-29, Contact: Audio Recording Services, Incorporated, 203 Romancoke Rd Ste 507, Stevensville, MD, 21666, (410) 643-4220.
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Summary: This sound recording of proceedings from the 15th Annual Conference of the President's Committee on Employment of People with Disabilities, held May 27-29, 1992, in Washington, D.C., identifies problem areas associated with hidden disabilities in the workplace. The following panelists represent a combination of persons with hidden disabilities and professionals who work with them: Tom Goad, American Society of Training and Development, California Chapter, President; Mickey Moore, Coalition for Adults with Learning Differences; Dr. Clydene Granfors, Clinical Psychologist; and Ray Lacey, National Association of Mental Illness. Definitions are provided of when a medical impairment is considered a disability. Another topic of discussion is the employer's responsibilities according to the Americans with Disabilities Act (ADA), focusing on reasonable accommodations.
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CHAPTER 8. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for disability. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP).
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Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.
PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.
Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to disability by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “disability” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for
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marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for disability: •
Colchicine http://www.rarediseases.org/nord/search/nodd_full?code=660
If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute12: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
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These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.13 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:14 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
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Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 14 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database
A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “disability” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “disability” (or synonyms) into the “For these words:” box. The following is a sample result: •
HIV/AIDS and Disability Network: Mission Statement Contact: HIV/AIDS and Disability Alliance of Massachusetts, 95 Berkeley St, Boston, MA, 02116, (617) 350-6900. Summary: In this statement, the HIV/AIDS and Disability Network outlines its objectives, which include increasing awareness about the disability dimensions of infection with Human immunodeficiency virus (HIV), the etiologic agent of Acquired immunodeficiency syndrome (AIDS), and forging linkages between HIV and other disability communities. Other goals include advocacy for policies and programs that respond to the needs of persons with HIV infection and other disabilities, and to educate providers on the needs of persons with HIV infection who also experience other disabling conditions.
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CYDLINE Reviews: An Introduction to Youth With Disabilities; Annotated Bibliography Contact: University of Minnesota, Institute for Health and Disability, National Center for Youth with Disabilities, PO Box 721, Minneapolis, MN, 55455, (612) 626-2825. Summary: This bibliography contains 38 titles on issues related to youth with disabilities and chronic illness and their families. It has four sections which cover the following topics: psychosocial issues, health, education, and community living. Each citation includes the author, title, source, and an abstract.
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Commission on Mental and Physical Disability Law: 1997 Catalog of the American Bar Association Source: Washington, DC: Commission on Mental and Physical Disability, American Bar Association (ABA). 1997. 15 p. Contact: Available from American Bar Association (ABA). Commission on Mental and Physical Disability Law, 740 15th Street, N.W., Washington, DC 20005-1009. Voice (202) 662-1570; TTY (202) 662-1012; Fax (202) 662-1032. PRICE: Single copy free. Summary: This catalog presents the disability law products and services available through the American Bar Association's Commission on Mental and Physical Disability
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Law. The catalog includes information about subscription services, including the Mental and Physical Disability Law Reporter; autoBOOK, the ABA's Americans with Disabilities Act (ADA) software and subscription service; books and articles about the ADA; and books and articles covering topics such as guardianship and civil competency, inpatient and outpatient commitment, rights in institutions and facilities, the right to refuse mental health treatment, AIDs and HIV, and children with disabilities. Each item is described in detail, with pricing information provided. An order form is also included. •
Chartbook on women and disability in the United States Source: Washington, DC: National Institute on Disability and Rehabilitation Research, U.S. Department of Education. 1999. 95 pp. Contact: Available from National Institute on Disability and Rehabilitation Research, U.S. Department of Education, 600 Independence Avenue, S.W., Room 3060 MES, Washington, DC 20202-2572. Telephone: (202) 205-8134 or (202) 205-5479 TDD / fax: (202) 205-8515 / e-mail:
[email protected] / Web site: http://www.ed.gov/offices/OSERS/NIDRR. Summary: This chartbook describes the status of women with disabilities in different aspects of life. It is organized in seven major sections: section one introduces the topic of women and disability throughout the life cycle. Section two focuses on children and adolescents with disability. Section three examines the issues of women with disabilities and work. Section four covers the topics of family life, living arrangements, and medical experiences. Section five reviews differences between women and men in terms of disability due to mental illness. Section six discusses the disability related effects of aging on women. Section seven presents gaps in the research on women and disabilities.
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Study on Policy and Funding Alternatives to Promote Community and Supportive Services for Older Persons With a Disability. Working Paper: Toward a Policy Definition of Geriatric Rehabilitation Source: Los Angeles, CA: Andrus Gerontology Center, University of Southern California. January 1990. 26 p. Contact: Available from Andrus Gerontology Center, University of Southern California. Los Angeles, CA 90089-0191. (213) 743-6805. PRICE: Free. Summary: This concept paper attempts to characterize relevant factors and variables and identify complexities that must be addressed in developing a working definition of geriatric rehabilitation. One of the complexities discussed is the prevalance of both mental illness and dementia such as Alzheimer's disease among nursing home populations. The current literature is reviewed with this goal in mind, and a draft-model working definition is presented to aid in the formulation of public policy which can better serve consumers of geriatric rehabilitation services. The paper examines the current policy, definitions of geriatric rehabilitation, available services, and cost factors, and elaborates in detail on various aspects of the actual rehabilitation process. Finally, the components of a new policy definition of geriatric rehabilitation are discussed as a working model definition. 46 references.
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Fact Sheet: Americans With Disabilities Act (ADA) of 1990 Contact: Disability Rights Education and Defense Fund Incorporated, 2212 6th St, Berkeley, CA, 94710, (510) 644-2555, http://www.dredf.org.
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Summary: This fact sheet gives general information about the Americans with Disabilities Act (ADA), looking at how its provisions affect employment, transportation, public accommodations, public services, and telecommunications. (Persons with Human immunodeficiency virus (HIV) infection are considered disabled under this law). •
Americans with Disabilities Act of 1990: Q and A Source: Arlington, TX: Association for Retarded Citizens (ARC). February 1994. 2 p. Contact: Available from Association of Retarded Citizens (ARC). National Headquarters, 500 East Border Street, Suite 300, Arlington, TX 76010. (800) 433-5255. PRICE: Single copy free. Summary: This fact sheet provides information about the Americans with Disabilities Act (ADA) of 1990 and how it affects individuals with mental retardation. Written in a question-and-answer format, the fact sheet discusses the purpose of the ADA, how disability is defined by the ADA, areas covered by the ADA, including employment, transportation, state and local government services, public accommodations, telecommunications, when the law takes effect in each area, what an individual should do if he or she experiences discrimination, and what the chapters of the Association of Retarded Citizens (ARC) can do to help implement the ADA. The fact sheet concludes with a list of agencies through which readers can obtain more information about the ADA as well as related technical assistance.
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What You Should Know About Returning to Work Before Talking With Your Disability Provider Contact: National AIDS Fund, 1400 Eye St NW Ste 1220, Washington, DC, 20005-2208, (202) 408-4848, http://www.aidsfund.org/. Summary: This guideline discusses what a person with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) needs to do before returning to work. The guideline recommends a self-assessment to discover what one can do concerning physical/mental energy level, medical treatment side effects, and what kind of work one can accomplish without over exertion. It advises the reader to obtain documents such as disability insurance Summary Plan Description and a written statement from one's health provider, as well as, to know the insurance and other work options that are available. It describes the various individuals in the insurance industry and how they can help in one's efforts to return to work. It encourages the reader to plan a strategy before calling the insurer. The guideline explains how the insurer views the client and disability plans funded by the employer. It guides the reader through how to make contact and plan returning to work with the insurer. The guideline makes recommendations concerning how to return to work with the most successful results.
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AIDS Information Resources for People With Disabilities: A Handbook for Information Providers in Libraries, AIDS Organizations, and Disability Organizations Contact: Talking Books Plus, Suffolk Cooperative Library System, 627 N Sunrise Svc Rd, Bellport, NY, 11713, (516) 286-1600. Summary: This handbook, for information providers in libraries, AIDS organizations, and disability organizations, details AIDS information resources for people with hearing, visual, developmental, and other disabilities. It includes an introductory section about access to AIDS information resources for people with disabilities and four
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separate sections on AIDS information resources for hearing impairments, visual impairments, developmental disabilities, and other disabilities. Each section contains three parts: Part One familiarizes AIDS information providers with some of the special needs of people with the particular disability addressed and how they can adapt conventional information for people with that disability; Part Two describes the resources that have been specifically developed for consumers with that disability; and the Third Part specifies resources that have been designed for professionals who are working with consumers with that disability. This handbook catalogs consumer and professional resources alphabetically by title and lists the addresses and phone numbers of publishers and producers in a directory. It offers appendices on : 1) selected AIDS hotlines and information numbers, 2) New York State AIDS hotline tape library, 3) sex, drugs, and disabilities: Additional Sources of Information, 4) Association for the Advancement of Health Education/Council for Exceptional Children Checklist for Materials Selection, and 5) HIV Prevention for Exceptional Youth. •
What Federal Law Requires for Nursing Home Residents' Psychological Well-Being: Mental Disability and the Elderly: Issue Paper No. 3 Source: Washington, DC: Mental Health Law Project. 1992. 38 p. Contact: Available from Mental Health Law Project. 1101 Fifteenth Street, NW, Suite 1212, Washington, DC 20005. (202) 467-5730. FAX (202) 223-0409. PRICE: Single copies free to AoA-funded attorneys and advocacy organizations; $5.00 for others; $4.20 per copy for orders of 10 or more. Summary: This issue paper is the third in a series on mental disability law and the elderly. Under federal law, nursing home residents with mental disabilities are now entitled to assistance that is specifically designed to maintain or improve their mental well being. The Omnibus Budget Reconciliation Act of 1987 (OBRA) provides a broad mandate for nursing homes to go beyond physical nursing care to specialized rehabilitative services for residents with mental disabilities. The second section describes the types of services and support that can enhance their well being. The last section discusses how residents and their advocates can ensure that assistance is actually provided, focusing on issues of enforcement and costs. The paper stresses the right of residents to choose the services they need and to participate in assessing the outcome of their service. A variety of examples illustrate possibilities for approaches that provide appropriate services for residents with mental disabilities. 43 references.
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Guide to Medical and Disability Programs for People With HIV Disease Contact: Utah Department of Health, Division of Epidemiology and Laboratory Services, Bureau of HIV/AIDS/TB Control/Refugee Health, PO Box 142105, Salt Lake City, UT, 84114-2105, (801) 538-6096, http://www.health.state.ut.us/els/hivaids/index.html. Summary: This manual lists medical and disability programs in the State of Utah available to persons who have tested positive for Human immunodeficiency virus (HIV) antibodies, the etiologic agent of Acquired immunodeficiency syndrome (AIDS). Information is provided concerning benefits, monthly financial payments, medical and disability coverage, and procedures for application. Programs covered include Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Medicaid, Medicare, the Utah AZT Program, Utah Medical Assistance Program (UMAP), the Department of Veterans Affairs, and the energy-assistance programs, HEAT and REACH.
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A Technical Assistance Manual on the Employment Provisions (Title I) of the Americans With Disabilities Act. Translated title Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Recording for the Blind, 20 Roszel Rd, Princeton, NJ, 08540, (609) 452-0606. Summary: This manual provides guidance on the practical application of legal requirements established in the statute and Equal Employment Opportunity Commission (EEOC) regulations. This manual is designed to be updated periodically with supplements as the EEOC develops further policy guidance and identifies additional resources. The information is presented in 10 chapters that are designed to explain the American with Disabilities Act (ADA) basic employment nondiscrimination requirements. The first three chapters provide an overview of ADA and Title I legal requirements, and discuss in detail the basic requirement not to discriminate against a qualified individual with a disability. This section includes the requirement for reasonable accommodation. The following chapters apply these legal requirements to specific employment practices and activities such as medical examinations, preemployment inquiries, recruitment, drug and alcohol abuse, and work-related injuries. (Persons with the Human immunodeficiency virus (HIV) and Acquired immunodeficiency syndrome are protected under the ADA).
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Americans With Disabilities Act Handbook Contact: US Department of Justice, Civil Rights Division, Office on the Americans with Disabilities Act, PO Box 66118, Washington, DC, 20035-6118, (202) 514-0301. US Equal Employment Opportunity Commission, National Office, 1801 L St NW, Washington, DC, 20507, (800) 669-3362, http://www.eeoc.gov. Summary: This manual provides information and assistance on the Americans with Disabilities Act (ADA), which was signed into law by U.S. President George Bush on July 26, 1990. It serves as a basic resource document on the ADA, and which applies to persons with Human immunodeficiency virus (HIV) infection. It contains annotated regulations for Titles I, II, and III of the act, resources for obtaining additional assistance, and supplementary information in the appendix. The three sections look at Title I, Equal Employment Opportunity for Individuals with Disabilities; Title II, Nondiscrimination on the Basis of Disability in State and Local Government Services; and Title III, Nondiscrimination on the Basis of Disability by Public Accommodations and in Commercial Facilities. Each of these sections includes summary, background, rulemaking history, overview, and annotated rule.
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Independent Living With AIDS/HIV As a Disability Contact: British Columbia Coalition of People with Disabilities, AIDS and Disability Action Program, 204-456 W Broadway, Vancouver, (604) 875-0188, http://www.bccpd.bc.ca. Summary: This paper addresses the concept of living independently in spite of being handicapped by Acquired immunodeficiency syndrome (AIDS). It promotes the concept of optimal health, pointing out that while Persons with AIDS (PWA's) may possess a different range of capabilities than people who are free of disabilities, the principles of optimal health encourage people to live and perform at the upper range of their abilities. It says that PWA's, and people with other disabilities, have increasingly grown dissatisfied with health-care delivery, and they have developed basic approaches to living with a disabling disease or condition. The paper outlines some models and
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philosophies on independent living and advocacy, health-care delivery, common needs and barriers to those needs, and points of common contact. •
Building Coalitions to Provide HIV Legal Advocacy Services: Utilizing Existing Disability Models Contact: National Association of Protection and Advocacy Systems, 900 2nd St NE, Washington, DC, 20002, (202) 408-9514, http://www.protectionandadvocacy.com. Summary: This paper discusses strategies for the formation of coalitions between groups who represent persons with Human immunodeficiency virus (HIV) infection or Acquired immunodeficiency syndrome (AIDS) to provide legal advocacy services to address legal issues, discrimination, and service delivery. It discusses the use of existing disability models for provision of these services.
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Common Barriers: Toward an Understanding of AIDS and Disability Contact: British Columbia Coalition of People with Disabilities, AIDS and Disability Action Program, 204-456 W Broadway, Vancouver, (604) 875-0188, http://www.bccpd.bc.ca. Summary: This paper examines issues surrounding Acquired immunodeficiency syndrome (AIDS), caused by Human immunodeficiency virus (HIV), that are of concern to people with disabilities. AIDS may be defined as a disability under World Health Organization (WHO) guidelines, suggesting that generalization about AIDS or other disabilities can be misleading. The development of self-help and self-care programs by the homosexual community in response to AIDS is another important disability issue. AIDS focuses on the social issues associated with consideration of any any disabling condition or disease. In the section which overviews AIDS and medicine, the stages of AIDS and their symptoms are described. This section also outlines the multifactoral and other alternative models of AIDS. The second section, dealing with the homosexual perspective on AIDS, covers the issues of homophobia and discrimination, and describes the response of the homosexual community to the AIDS epidemic. The third section describes the social and legal issues that have characterized the moral panic accompanying AIDS. The final section examines definitions of disability as they pertain to AIDS and look for areas of common interest, one of which is the concept of independent living, which challenges traditional ideas of medicine, and the role of professionals with regard to persons living with various disabilities.
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Removing Barriers: A Disability Perspective on Isolation and Segregation of People With HIV or AIDS Contact: British Columbia Coalition of People with Disabilities, AIDS and Disability Action Program, 204-456 W Broadway, Vancouver, (604) 875-0188, http://www.bccpd.bc.ca. Summary: This paper examines the issues and controversy surrounding the issue of isolation and quarantine of HIV-positive persons, Persons with AIDS (PWA's), and other persons with disabilities. It raises discussion points and makes recommendations on dealing with fear and hysteria, and taking steps to insure that quarantine measures are not contemplated.
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The invisible disability: Understanding learning disabilities in the context of health and education Source: Washington, DC: National Health and Education Consortium, Institute for Educational Leadership. 1996. 50 pp. Contact: Available from Institute for Educational Leadership, 1001 Connecticut Avenue, N.W., Suite 310, Washington, DC 20036. Telephone: (202) 822-8405 / fax: (202) 872-4050 / e-mail:
[email protected]. $7.50 includes shipping and handling if prepaid; otherwise shipping is $2.00 for first item, $1.00 for each additional item; discounts available for bulk orders; make checks payable to IEL. Summary: This report addresses learning disabilities in the context of the link between health and education. It describes learning disabilities, estimates their prevalence, and notes some of the associated medical problems. It discusses the roles of the health care and education communities and of the parents in addressing these problems, and makes recommendations.
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HIV Education for Persons With Mental Disabilities Contact: National Association of Protection and Advocacy Systems, 900 2nd St NE, Washington, DC, 20002, (202) 408-9514, http://www.protectionandadvocacy.com. Summary: This report deals with legal, policy, and advocacy issues pertaining to mental health, developmental services, and Acquired immunodeficiency syndrome (AIDS). It says that the Human immunodeficiency virus (HIV) will increasingly impact developmental disability and mental health services. Education is the primary means of preventing the spread of HIV, and primary health education and disease prevention activities should be an integral part of these services. This paper looks at strategies and presents a Protection & Advocacy HIV education model that may help service providers and community-based AIDS service organizations. Its goal is to help disability service providers link resources. It discusses an introduction to health education theories, and includes strategies for advocates and service providers who wish to implement educational programs. After presenting general background information, it makes suggestions for advocates, and explains health education policy and theory, then turns to educational models.
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Social security: Rapid rise in children on SSI disability rolls follows new regulations Source: Washington, DC: U.S. General Accounting Office. 1994. 23 pp. Contact: Available from U.S. General Accounting Office, P.O. Box 37050, Washington, DC 20013. Telephone: (202) 512-6806 or (202) 512-2537 TDD / fax: (202) 512-2837 / email:
[email protected] / Web site: http://www.gao.gov. First copy available at no charge; additional copies $2.00; prepayment required; make check or money order to Superintendent of Documents; bulk discounts available. Summary: This report describes the growth in the number of children receiving Supplemental Security Income (SSI) disability benefits during the last four years. It discusses changes in policies that account for the increases.
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Sexuality issues for youth with disabilities and chronic health conditions Source: Gainesville, FL: Center for Policy and Partnerships, Institute for Child Health Policy. 2000. 16 pp.
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Contact: Available from National Maternal and Child Health Clearinghouse, 2070 Chain Bridge Road, Suite 450, Vienna, VA 22182-2536. Telephone: (703) 356-1964 or (888) 4344MCH / fax: (703) 821-2098 / e-mail:
[email protected] / Web site: http://www.nmchc.org. Available at no charge. Summary: This report discusses adolescent pregnancy prevention within the subgroup of youth with disabilities. Topics covered include: (1) who are youth with disability; (2) what are their risk factors for adolescent pregnancy; (3) what are their unique needs; (4) what accommodations are necessary; (5) what are next steps; and (6) where are the best programs and resources. [Funded by the Maternal and Child Health Bureau]. •
Supplemental security income for children with disabilities: Report to Congress Source: [Baltimore, MD: Social Security Administration, U.S. Department of Health and Human Services]. 1995. ca.250 pp. Contact: Available from U.S. Social Security Administration, Office of Public Affairs, U.S. Department of Health and Human Services, Public Information Distribution Center, P.O. Box 17743, Baltimore, MD 21223. Telephone: (410) 965-0945 or (800) 7721213 / fax: (410) 965-0696. Summary: This report examines the appropriateness of the present definition of disability and the advantages and disadvantages of alternatives. Topics include: 1) an overview of the Supplemental Security Income Childhood Disability Program, 2) profiles of children receiving SSI, 3) the Commission's deliberations, 4) recommendations to Congress, 5) alternative forms of support, 6) health care coverage for children with disabilities, and 7) research for future policy directions.
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The Financial Implications of AIDS on Individual Disability Insurance in the United States: Report of the Task Force on the Financial Implication of AIDS Contact: Society of Actuaries, 475 N Martingale Rd Ste 800, Schaumburg, IL, 60173, (847) 706-3500, http://www.soa.org. Summary: This report is about the principles and techniques for the financial recognition of Acquired immunodeficiency syndrome (AIDS) by insurance companies, recognizing both statutory and GAAP accounting. The first section discusses the effect of AIDS on individual disability morbidity. The second section covers the development of Human immunodeficiency virus (HIV) related disability claim costs. In conclusion, the third section gives a financial analysis and reserve considerations.
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HIV/AIDS, Disability, and Employment Contact: US Department of Education, Office of Special Education and Rehabilitative Research, National Institute on Disability and Rehabilitation Research, 400 Maryland Ave SW, Washington, DC, 20202, (202) 732-1134. Summary: This report on HIV/AIDS, disability, and employment provides the diagnostic history of people living with HIV and its relation to function, disability, and labor force participation over time. The report provides a baseline profile, from a U.S. nationwide longitudinal sample of HIV-infected men and women, of HIV-related health status, degree of functional limitation and depressive affect, recipientship and denial of publicly funded disability benefits, private and publicly funded health insurance coverage labor force participation, and illness-related changes made in employment status. Loss of physical and cognitive function with HIV progression is one of the major factors leading to decreased labor force participation among people with HIV/AIDS,
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particularly among men. The data suggest that efforts to reduce functional limitations among people with HIV/AIDS may enable a larger percentage of them to continue to work. •
HIV Liability & Disability Services Providers: An Introduction to Tort Principals Contact: National Association of Protection and Advocacy Systems, 900 2nd St NE, Washington, DC, 20002, (202) 408-9514, http://www.protectionandadvocacy.com. Summary: This report presents strategies for developing Acquired immunodeficiency syndrome (AIDS) and Human immunodeficiency virus (HIV) policy guidelines in mental health and developmental disability service systems. It provides a series of case examples, questions, background information, and resources illustrating legal and policy issues associated with HIV and AIDS. Informed consent, confidentiality, infection-control issues, and a chronological listing of disability legislation and court rulings are included in the discussion.
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Students with Disabilities in Postsecondary Education: A Profile of Preparation, Participation, and Outcomes Source: Washington, DC: National Center for Education Statistics. 1999. NCES Publication Number 1999-187. Contact: Available from U.S. Department of Education. ED Pubs, P.O. Box 1398, Jessup, MD 20794-1398. (877) 433-7827. TTY/TDD (877) 576-7734. Website: nces.ed.gov/pubsearch/index.asp. PRICE: Single copy free. Summary: This report provides a comprehensive profile of students with disabilities enrolled in postsecondary education. The report is based on an analysis of four different surveys conducted by the National Center for Education Statistics. The surveys are The National Postsecondary Student Aid Study (1995 to 1996), the National Education Longitudinal Study (1988), the Beginning Postsecondary Students Longitudinal Study (1990 to 1994), and the Baccalaureate and Beyond Longitudinal Study (1993 to 1994). These surveys were used to address four issues: representation of students with disabilities enrolled in postsecondary education; who among high school students with disabilities gains access to postsecondary education; among those who enroll in postsecondary education, how well do they persist to degree attainment; and among college graduates, what are the early labor market outcomes and graduate school enrollment rates of students with disabilities. The report includes an executive summary, a foreword, and the report itself, which provides numerous charts and tables of data. Appendices offer a glossary of terms and abbreviations, a description of the technical methodology used in the studies, and supplemental tables. 7 figures. 43 tables. 13 references.
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Deinstitutionalization of persons with developmental disabilities: A technical assistance report for legislators Source: Washington, DC: Forum for State Health Policy Leadership. 1999. 39 pp. Contact: Available from Forum for State Health Policy Leadership, National Conference of State Legislatures, 444 North Capitol Street, N.W., Suite 515, Washington, DC 20001. Telephone: (202) 624-5400 / fax: (202) 737-1069 / e-mail:
[email protected]. Summary: This report provides profiles of states that have made innovative changes in their service delivery systems for people with developmental disabilities. These changes increase the number of community-based placements and reduce institutional
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placements. Information was gathered from interviews with state disability service directors, academics, advocates and state policymakers. Topics covered in the interviews were (1) state progress in deinstitutionalization, (2) the percentage of disabled people who live in community settings and state hospitals, (3) the kinds of medical and social services needed by people with disabilities and service gaps, if any, (4) models of care that could be considered best practices for states, and (5) costs and funding associated with care for this population. •
AIDS As A Disability: Ethical Issues & Community Empowerment; Conference Report Contact: British Columbia Coalition of People with Disabilities, AIDS and Disability Action Program, 204-456 W Broadway, Vancouver, (604) 875-0188, http://www.bccpd.bc.ca. Summary: This report summarizes speeches and workshops given at "AIDS as a Disability: Ethical Issues & Community Empowerment," held in November 1991 in British Columbia, Canada. It starts with an overview of the Acquired immunodeficiency syndrome (AIDS) & Disability Project, then examines four primary topics of the conference: The role of the third-party advocate in pediatric Human immunodeficiency virus (HIV) infection; independent living for Persons with AIDS (PWA's) and HIVpositive persons; the role of self-help groups in treatment and research; and ethical issues involving disability, segregation, and discrimination. A listing of conference speakers and moderators, and the goals of the Project, are included.
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AIDS and Persons With Developmental Disabilities: The Legal Perspective Contact: American Bar Association, Commission on Mental and Physical Disability Law, 740 15th St NW 9th Fl, Washington, DC, 20005, (202) 662-1570, http://www.abanet.org. Summary: This report, compiled by the AIDS and Developmental Disabilities Project of the American Bar Association, presents information about legal issues pertaining to Human immunodeficiency virus (HIV) infection in persons with developmental disability. It discusses Federal and State laws regarding the rights and responsibilities of handicapped persons and service providers, explains their application to persons who have tested positive for HIV antibodies, and provides guidelines for policy development. It covers antidiscrimination statutes; HIV testing, medical treatment, and informed consent; confidentiality and provider liability; isolation and involuntary civil commitment; and Federal Benefit and Entitlement programs. The report discusses these topics in relation to housing and residential facilities, health care, child welfare services, day care, education, vocational training, and employment. It also presents a medical overview of HIV infection, which can lead to Acquired immunodeficiency syndrome (AIDS); a glossary; and a bibliography.
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Social security: Review of SSAs implementation of new SSI childhood disability legislation Source: Baltimore, MD: Social Security Administration, U.S. Department of Health and Human Services. 1997. 65 pp. Contact: Available from U.S. Social Security Administration, Office of Public Affairs, U.S. Department of Health and Human Services, Public Information Distribution Center, P.O. Box 17743, Baltimore, MD 21223. Telephone: (410) 965-0945 or (800) 7721213 / fax: (410) 965-0696.
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Summary: This review of Supplemental Security Income (SSI) eligibility legislation for disabled children defines disability in children, and discusses eligibility review and implementation of the new legislation. Some corrective actions are recommended to ensure that every child receives a fair assessment. The three specific areas of concern identified were: cessation of eligibility of children classified as having mental retardation, quality of case processing, and appeals and requests for benefit continuation during appeal. •
Criteria for determining disability in infants and children: Low birth weight Source: Rockville, MD: U.S. Agency for Healthcare Research and Quality. 2002. 2 v.; summ. (7 pp.). Contact: Available from U.S. Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850. Telephone: (301) 427-1360 AHRQ public affairs or (301) 4271200 or (800) 358-9295 AHRQ Clearinghouse / e-mail:
[email protected] / Web site: http://www.ahrq.gov. Available at no charge. Summary: This two-volume set examines evidence to determine if very-lowbirthweight in infants, with or without other conditions, is associated with long-term disabling outcomes. Volume one reviews six primary outcomes of interest included in this report: (1) cerebral palsy and neurologic disability, (2) abnormal cognitive development and mental retardation, (3) hearing / speech / language impairments, (4) visual disability, (5) adverse pulmonary function, and (6) impaired growth. Report sections include a topic overview, reporting the evidence, study methods, an outline of the findings, and future research. Two additional sections review conclusions and future research. References and a bibliography are provided along with appendices including search strategies, a data abstraction form, acronyms and abbreviations, and acknowledgments. Statistics are included throughout the report. Volume two contains the evidence tables evaluating associations between low-birth-weight and 13 outcomes or disorders.
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Living in the Community with a Disability: Demographic Characteristics of the Population with Disabilities Under Age 65 Source: Washington, DC: Public Policy Institute, American Association of Retired Persons (AARP). 1995. 75 p. Contact: Available from American Association of Retired Persons (AARP). Fulfillment, 601 E Street, NW, Washington, DC 20049. (800) 424-3410. PRICE: Single copy free; bulk orders available. Summary: This volume provides an overview of the prevalence and characteristics of disability among persons under the age of 65 who live in the community. Current measures of disability often mix together or average information across a broad range of ages and disabilities. Alternatively, this publication presents data on a wide range of chronic conditions and disabilities, including developmental disabilities, mental illness, physical limitations, and sensory impairments. Data are included that examine a wide array of measures of functional limitation and life activities of persons of different ages. To the extent possible, the graphs present statistics for children, students between the ages of 18 and 22 who are making the transition to a work environment, young adults (age 23 to 44) who are trying to live and work in the community, and older adults (age 45 to 64), who may be experiencing new disabilities due to the aging process. Most of the data is presented in the form of pie or bar charts. An appendix describes the data sources used. 54 figures. (AA-M).
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The NLM Gateway15 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “disability” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 44788 2415 806 489 508 49006
HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.19 Simply search by “disability” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists20 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. 15
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
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The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18 19
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 20 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
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Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.21 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.22 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
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Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
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The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 22 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on disability can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to disability. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to disability. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “disability”:
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Guides on disability Disabilities http://www.nlm.nih.gov/medlineplus/disabilities.html
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Other guides Assistive Devices http://www.nlm.nih.gov/medlineplus/assistivedevices.html Developmental Disabilities http://www.nlm.nih.gov/medlineplus/developmentaldisabilities.html Learning Disorders http://www.nlm.nih.gov/medlineplus/learningdisorders.html Rehabilitation http://www.nlm.nih.gov/medlineplus/rehabilitation.html
Within the health topic page dedicated to disability, the following was listed: •
General/Overviews Developmental Disabilities - An Overview Source: American Academy of Pediatrics http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZPUU2KGD C&sub_cat=105 JAMA Patient Page: Mental Retardation Source: American Medical Association http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZXSH0HC6D &sub_cat=105 What Is Mental Retardation? Source: National Center on Birth Defects and Developmental Disabilities http://www.cdc.gov/ncbddd/dd/ddmr.htm
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Diagnosis/Symptoms Basics for Parents: Your Child's Evaluation Source: National Information Center for Children and Youth with Disabilities http://www.nichcy.org/pubs/basicpar/bp1txt.htm
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Coping Including Your Child Source: Dept. of Education, Office of Educational Research and Improvement http://www.ed.gov/pubs/parents/Including/title.html Individualized Education Plans (IEPs) Source: Nemours Foundation http://kidshealth.org/parent/growth/learning/iep.html
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Specific Conditions/Aspects Communicating with Your Child's School Through Letter Writing Source: National Information Center for Children and Youth with Disabilities http://www.nichcy.org/pubs/parent/pa9txt.htm Developing Your Childs IEP Source: National Information Center for Children and Youth with Disabilities http://www.nichcy.org/pubs/parent/pa12txt.htm Developmental Dyspraxia Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/dyspraxia.htm Importance of Physical Activity for Persons with Mental Retardation Source: American Orthopaedic Society for Sports Medicine http://www.sportsmed.org/Publications/mental.htm Intermediate Care Facility for People with Mental Retardation Program (ICF/MR) Source: Centers for Medicare & Medicaid Services http://www.cms.hhs.gov/medicaid/icfmr/default.asp Living with Fetal Alcohol Syndrome http://www.cdc.gov/ncbddd/factsheets/living_fas.pdf Mental Retardation Source: National Information Center for Children and Youth with Disabilities http://www.nichcy.org/pubs/factshe/fs8txt.htm Mental Retardation: Learning How to Help Your Child Source: American Academy of Family Physicians http://familydoctor.org/549.xml Parent Training and Information Centers Source: National Information Center for Children and Youth with Disabilities http://www.nichcy.org/pubs/basicpar/bp3txt.htm Pervasive Developmental Disorders Source: Nemours Foundation http://kidshealth.org/parent/medical/learning/pervasive_develop_disorders.htm l Speech and Language Impairments Source: National Information Center for Children and Youth with Disabilities http://www.nichcy.org/pubs/factshe/fs11txt.htm
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Children Coping with Disaster: Suggestions for Helping Children with Cognitive Disabilities Source: Administration for Children and Families http://www.acf.dhhs.gov/programs/add/Sept11/addcoping.html Kids' Quest on Disability and Health Source: National Center on Birth Defects and Developmental Disabilities http://www.cdc.gov/ncbddd/kids/
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Mainstreaming in Classrooms Source: Nemours Foundation http://kidshealth.org/kid/grow/school_stuff/mainstreaming.html Zigawhat Source: National Information Center for Children and Youth with Disabilities http://www.nichcy.org/kids/ •
From the National Institutes of Health Multiple Congenital Anomaly/Mental Retardation Syndromes Database Source: National Library of Medicine http://www.nlm.nih.gov/mesh/jablonski/syndrome_title.html Pervasive Developmental Disorders Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/pdd.htm
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Law and Policy Benefits for Children with Disabilities Source: Social Security Administration http://www.ssa.gov/pubs/10026.html Closing the Gap: A National Blueprint to Improve the Health of Persons with Mental Retardation Source: National Institute of Child Health and Human Development http://www.nichd.nih.gov/publications/pubs/closingthegap/index.htm Guide to the Individualized Education Program Source: Dept. of Education http://www.ed.gov/parents/needs/speced/iepguide/index.html Questions and Answers about IDEA Source: National Information Center for Children and Youth with Disabilities http://www.nichcy.org/pubs/newsdig/nd21txt.htm Related Services for School-Aged Children with Disabilities Source: National Information Center for Children and Youth with Disabilities http://www.nichcy.org/pubs/newsdig/nd16txt.htm Services in School for Children with Special Needs: What Parents Need to Know Source: American Academy of Child and Adolescent Psychiatry http://www.aacap.org/publications/factsfam/83.htm
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Men Women with Disabilities: Developmental Disabilities Source: National Women's Health Information Center http://www.4woman.gov/wwd/wwd.cfm?page=43
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Organizations Administration on Developmental Disabilities http://www.acf.dhhs.gov/programs/add/
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DisabilityInfo.gov Source: Office of Disability Employment Policy http://disabilityinfo.gov/ National Center on Birth Defects and Developmental Disabilities http://www.cdc.gov/ncbddd/ National Center on Physical Activity and Disability http://www.ncpad.org/ National Fathers Network http://www.fathersnetwork.org/ National Information Center for Children and Youth with Disabilities http://www.nichcy.org/ National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/ National Organization on Disability http://www.nod.org/ Rehabilitation Services Administration http://www.ed.gov/about/offices/list/osers/rsa/ •
Prevention/Screening Newborn Screening Tests Source: March of Dimes Birth Defects Foundation http://www.marchofdimes.com/pnhec/298_834.asp
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Research Birth Defects and Developmental Disabilities Source: National Institute of Child Health and Human Development http://www.nichd.nih.gov/womenshealth/birth_defects.cfm Mental Retardation and Developmental Disabilities Branch (MRDD) Source: National Institute of Child Health and Human Development http://www.nichd.nih.gov/about/crmc/mrdd/mrdd.htm Possible Gene for Form of Mental Retardation, Brain Development Identified Source: National Institute of Child Health and Human Development http://www.nih.gov/news/pr/jun2002/nichd-27.htm
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Women Women with Disabilities: Developmental Disabilities Source: National Women's Health Information Center http://www.4woman.gov/wwd/wwd.cfm?page=43
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating
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unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on disability. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Interstitial Cystitis and Social Security Disability Insurance Source: Rockville, MD: Interstitial Cystitis Association (ICA). 2001. 1 p. Contact: Available from Interstitial Cystitis Association (ICA). 110 North Washington Street, Suite 340, Rockville, MD 20850. (301) 610-5300. Fax (301) 610-5308. E-mail:
[email protected]. Website: www.ichelp.org. PRICE: $1.00 for members; $1.25 for nonmembers; plus shipping and handling. Item number: RFI01. Summary: Social Security Disability Insurance (SSDI) is a Federal insurance program, financed through payroll withholding, that covers most American workers. SSDI was designed to help people meet their financial obligations and obtain necessary medical treatment. This fact sheet reviews the use of SSDI for people with interstitial cystitis (IC). Topics include why SSDI might be necessary, how SSDI works, who is eligible for SSDI, information needed to submit a claim, and what happens once a claim is submitted. In order to submit a claim, patients should identify their impairments and the medical condition(s) they think are responsible for their impairments; identify medical treatment sources; describe any medication or therapy they are taking and side effects; describe activities of daily living and education; and describe their jobs of the past 15 years and their major physical and mental demands. A thorough medical report from the doctor, addressing in detail their specific disability, is essential. The fact sheet notes the services of the Interstitial Cystitis Association (ICA), including documents that can support SSDI claims.
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The facts about obesity as a disability Source: American Obesity Association. Contact: American Obesity Association, 1250 24th Street, N.W., Suite 300, Washington, DC 20037. 1-800-98-OBESE. Summary: The dictionary definition of disable is to weaken, incapacitate, cripple or immobilize. Persons with sever obesity report bodily pain that affects normal daily activities. Obesity would be considered a disability when applying to the dictionary definition. Legal definitions of disability, and obesity as a disability are much more complex. The Social Security Administration (SSA) and the Department of Justice (DOJ), which handles legal cases involving the American with Disabilities Act (ADA), use legal definitions to define disability. This fact sheet explains how the SSA and the ADA interpret obesity and disability.
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Americans with Disabilities Act in Brief: Focus on Employment Source: Washington, DC: President's Committee on Employment of People with Disabilities. 1992. [2 p.]. Contact: Available from President's Committee on Employment of People with Disabilities. 1331 F Street, NW, Washington, DC 20004-1107. Voice (202) 376-6200. TTY (202) 376-6205. Fax (202) 376-6219. PRICE: Single copy free. Summary: The purpose of the Americans With Disabilities Act (ADA), PL 101-336, is to extend to people with disabilities civil rights similar to those now available on the basis of race, color, national origin, sex, and religion (as established in the Civil Rights Act of 1964). The ADA prohibits discrimination on the basis of disability in employment, services rendered by State and local governments, places of public accommodation, transportation, and telecommunications services. This brochure, one in a series, outlines the major employment provisions of the ADA. The ADA requires equal opportunity in selection, testing, and hiring of qualified applicants with disabilities; prohibits discrimination against workers with disabilities; requires equal treatment in promotion and benefits; requires reasonable accommodation for applicants and workers with disabilities when such accommodations would not impose undue hardship; and forbids preemployment inquiries about an applicant's disability or preemployment medical exams. The brochure includes a list of key definitions, including disability, qualified individual with a disability, reasonable accommodation, and undue hardship. The brochure concludes with the names and telephone/TTY numbers of organizations and agencies through which readers can get more information.
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Summer Pre-college Programs for Students with Disabilities, 2002 Edition Source: American Council on Education. HEATH Resource Center. Washington, DC. 2001. www.heath-resource-center.org. Contact: Available from HEATH Resource Center. American Council on Education, One Dupont Circle, Suite 800, Washington, DC 20036. Voice (202) 939-9320. Voice/TTY (800) 544-3284. Fax (202) 833-5696. E-mail:
[email protected]. Web site: http://www.heathresource-center.org. PRICE: single copy free. Summary: These educational resources, listed by state, are for students with disabilities seeking ways to prepare for college and enhance college performance. The HEATH Resource Center operates the national clearinghouse on postsecondary education for individuals with disabilities, supported by the U.S. Department of Education.
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Bibliography for Families: Assessing Children for the Presence of a Disability Source: Washington, DC: National Information Center for Children and Youth with Disabilities (NICHCY). 1994. 4 p. Contact: Available from National Information Center for Children and Youth with Disabilities (NICHCY). P.O. Box 1492, Washington, DC 20013-1492. Voice/TTY (800) 695-0285. PRICE: Single copy free. Summary: This bibliography provides families with resources for information on the assessment of school-aged children. The books and articles listed are designed to be useful to families of children being assessed to determine if they have disabilities and are thus are eligible for special education and related services. Being knowledgeable about the evaluation process equips parents to advocate for a thorough, appropriate, and well-conducted evaluation of their child and also assists them in making sense of
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the results. Items listed include materials for consumers; textbooks; resources providing reviews and critiques of specific tests; resources on curriculum-based assessment; resources on dynamic assessment; resources on specific disabilities or skill areas, including attention deficit disorder, behavior, hearing or visual impairments, intelligence, language, learning or reading disabilities, mental retardation, nonverbal individuals, and physical or multiple disabilities; and resources on assessment of minorities. The bibliography concludes with a list of publishers and their contact information. •
National Resources for Adults with Learning Disabilities Source: Washington, DC: Heath Resource Center. August 1994. 32 p. Contact: Available from Heath Resource Center. One Dupont Circle, Suite 800, Washington, DC 20036. Voice/TTY (800) 544-3284 or (202) 884-8185. PRICE: Single copy free. Summary: This booklet is designed for adults who may have a learning disability and for family and friends who wish to help. The guide provides information on where to go for help and information; on assessing the problem; a learning disabilities checklist; and a selection of resources. The guide is intended to provide a starting point for gaining information that can lead to obtaining services at the state or local level. A short description of each resource organization's activities is provided to help readers identify which resources are best suited to their needs and concerns. Resources are categorized as follows: national resource centers; general education; learning disability organizations; attention deficit disorder (ADD) organizations; employment; technology; and life management. An additional section lists and annotates recommended publications. The final section provides a list of toll-free numbers available for some of the resource organizations.
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Developmental Disabilities and Alzheimer's Disease: What You Should Know Source: Arlington, TX: The Arc of the United States. 1995. 43 p. Contact: Arc of the United States. The Arc's Publication Desk, 3300 Pleasant Valley Lane, Suite C, Arlington, TX 76015. 888-368-8007; FAX: 817-277-3491; TDD (817) 277-0553. Internet: http://www.thearc.org. PRICE: $13.74. The text may be downloaded free from http://TheArc.org/misc/alzbk.html. Order number: 10-12. Summary: This booklet is designed for caregivers who are concerned about Alzheimer's disease (AD) in an older person with a developmental disability. First, it describes AD, its symptoms, general progression, and other conditions which can produce the same symptoms. Then, it discusses the risk factors for AD and other dementias in people with developmental disabilities, age-related changes and the risk of AD in people with Down syndrome, evaluations and tests for AD, where to get evaluated, strategies for dealing with behavioral and functional changes, additional concerns as the disease progresses, community services for families and caregivers, and resources for information and assistance. The booklet includes a glossary and resource list.
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Understanding the ADA: Americans with Disabilities Act Source: Jackson Heights, NY: Eastern Paralyzed Veterans Association (EPVA). 199x. 40 p.
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Contact: Available from Eastern Paralyzed Veterans Association (EPVA). 75-20 Astoria Boulevard, Jackson Heights, NY 11370-1177. (800) 444-0120 or (718) 803-EPVA. PRICE: Single copy free; requests for bulk copies should be made in writing. Summary: This booklet provides a detailed introduction to the Americans With Disabilities Act (ADA), a comprehensive law that protects the civil rights of individuals with disabilities. The ADA includes provisions for employment, state and local government services, public transportation, privately operated transportation available to the public, places of public accommodation, and telecommunications services offered to the public. After an introductory section that answers some common questions about the ADA, the booklet covers the following topics: the definition of a person with a disability, key employment provisions (Title I), reasonable accommodation, undue hardship, the cost of implementing the ADA, pre-employment medical screenings and drug use, the ADA in the public and private sectors, major provisions for public services (Title II), public transportation, major provisions concerning public accommodations operated by private entities (Title III), new construction and alterations, requirements for private transportation providers, telecommunications services for individuals who are hearing impaired and speech impaired (Title IV), miscellaneous provisions (Title V), religious organizations, enforcement and dispute resolution, tax credits for compliance, and tax deductions for compliance. The booklet concludes with a list of videos and publications about disabilities. The booklet includes tables and black and white photographs. 5 tables. •
Americans with Disabilities Act (ADA): Title 1-Employment. Questions and Answers for Employees Source: Washington, DC: American Association of Retired Persons (AARP). 1994. 12 p. Contact: Available from American Association of Retired Persons (AARP). 601 E Street, N.W., Washington, DC 20049. (800) 424-3410 or (202) 434-2477; TTY (202) 434-6554. PRICE: Single copy free; bulk rates available. Summary: This booklet provides answers to commonly asked questions about employment and an employer's requirements as established by the Americans With Disabilities Act (ADA). Title I of the ADA prohibits employers from discriminating against a qualified job applicant or employee with a disability. The ADA prohibits discrimination in all employment practices, including job advertising, recruitment, application procedures, testing, hiring, assignments, promotions, discipline, compensation, benefits, leave, training, layoff and recall, termination, and other terms, conditions, and privileges of employment. The booklet explains how each of these practices and activities are impacted by the requirements of the ADA. Other topics covered include definitions of disability, essential functions, reasonable accommodations, undue hardship, specific disabilities, testing for illegal drugs, the impact of the ADA on older adults, and how to proceed if one believes that he or she was discriminated against by an employer because of a disability. The booklet concludes with a list of information resource organizations and other ADA Title I resources. 6 references. (AA-M).
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Resources You Can Use: Assessing Children for the Presence of a Disability Source: NICHCY (National Information Center for Children and Youth with Disabilities) Resources You Can Use. Bibliography 1 (2nd edition), August 2002. Contact: Available from National Information Center for Children and Youth with Disabilities (NICHCY). P.O. Box 1492, Washington, DC 20013-1492. Voice/TTY (800)
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695-0285 or (202) 884-8200. E-mail:
[email protected]. Website: http://www.nichcy.org. PRICE: Single copy free. Summary: This brief article is from a series that focuses on the assessment process, involving the ways and primary skill areas in which school systems collect information to determine if a child is eligible for special education and related services and make informed decisions about that child's educational placement and instruction. The article outlines methods of gathering information. The author stresses that evaluators need to use a variety of tools and approaches to assess a child, including observation, interviews, and testing. Topics covered include reviewing school records; looking at student work samples or portfolios; pre-referral procedures; observation; interviewing methods; common observational techniques; testing considerations, including selecting an appropriate instrument and the limitations of testing; framing the assessment questions; ecological assessment; direct assessment; dynamic assessment; task analysis; outcome-based assessment; and learning styles. •
Life After Disability : Returning to Work Contact: National AIDS Fund, 1400 Eye St NW Ste 1220, Washington, DC, 20005-2208, (202) 408-4848, http://www.aidsfund.org/. Summary: This brochure answers a number of questions asked by persons with disabling conditions such as the human immunodeficiency virus (HIV) who are considering returning to work. The brochure describes government entitlements for disabled workers such as Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), and Medicare. For each of these entitlements, the brochure explains how they work, what happens to them when the reader returns to work, as well as what happens if a person must leave their job a second time due to the same or a different medical condition. The brochure examines private long term disability (LTD) insurance, how it applies to persons returning to work, and how to apply for a leave of abscence from work if it is necessary due to disability. It provides advice concerning debt management when returning to work after disability leave. The brochure explains how one can avoid salary garnishment by creditors and government agencies in this situation. It explains the readers rights regarding disability disclosure if they apply for new jobs with other businesses or when returning to their original job.
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Americans with Disabilities Act: Questions and Answers Source: Washington, DC: U.S. Equal Employment Opportunity Commission. 199x. 34 p. Contact: Available from U.S. Equal Employment Opportunity Commission. 1801 L Street, N.W., Washington, DC 20507. Voice (800) 669-3362; TTY (800) 800-3302. PRICE: Free. Also available from U.S. Department of Justice. Civil Rights Division, Public Access Section, P.O. Box 66738, Washington, DC 20035-6738. Voice (800) 514-0301; TTY (800) 514-0383. PRICE: Free. Summary: This brochure answers common questions about the Americans With Disabilities Act (ADA), legislation that gives civil rights protection to individuals with disabilities and guarantees equal opportunity for these individuals in public accommodations, employment, transportation, state and local government services, and telecommunications. Topics covered include the employers covered by the ADA, the practices and activities covered, who is protected from employment discrimination, definitions, limitations imposed on medical examinations and inquiries about disability, job descriptions, reasonable accommodations, accessibility, attendance and leave policies, the use of drug tests, Federal and State health and safety laws, workers'
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compensation programs, how the employment provisions are enforced, financial assistance available to employers for reasonable accommodations, recordkeeping requirements, state and local governments, public accommodations, transportation, and telecommunications. The brochure concludes with a list of telephone numbers of federal agencies that are responsible for providing information to the public about the ADA. •
The Americans with Disabilities Act: The Law and Its Impact on Postsecondary Education Source: Washington, DC: HEATH Resource Center, American Council on Education. 1998. [2 p.]. Contact: Available from HEATH Resource Center. American Council on Education, One Dupont Circle, Suite 800, Washington, DC 20036-1193. Voice/TTY (800) 544-3284 or (202) 939-9320. Fax (202) 833-4760. E-mail:
[email protected]. PRICE: Single copy free. Summary: This brochure describes the Americans with Disabilities Act (ADA) and its implications for secondary education. The ADA (1990) is the civil rights legislation that provides protection from discrimination for individuals on the basis of disability. The brochure reviews the ADA's definition of a person with a disability and explores how the ADA affects institutions of higher education. The brochure notes that, because of the public attention given to the passage and implementation of the ADA, renewed attention is being focused on disability access to institutions of higher education, including in areas of facilities, programs, and employment. The brochure specifically discusses employment issues under the ADA, the need to establish a grievance procedure, and the need for a process of self-evaluation. The brochure lists areas that need to be included in the self-evaluation process. Of particular importance in making appropriate accommodations for students with disabilities are the mandates for making modifications as needed in policies, practices, and procedures and for assuring accessibility of examinations and courses. The brochure concludes with a brief description of the HEATH Resource Center and AHEAD (the Association on Higher Education and Disability).
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Free Information About Disability Related Topics and Equipment Source: Springfield, IL: Disability Research Network (DRN). 199x. 2 p. Contact: Available from Disability Research Network (DRN). 426 West Jefferson, Springfield, IL 62702. Voice/TTY (800) 447-4221 or (217) 523-2587; Fax (217) 523-0427. PRICE: Single copy free. Summary: This brochure describes the Disability Research Network (DRN), an information and referral service for disability related topics. The DRN is funded by the Illinois Department of Rehabilitation Services and is located in Springfield, Illinois. DRN provides information on agencies, disabilities and conditions, education, employment, adaptive equipment, funding and financial resources, law, personal care, recreation and travel, standards, and statistics. The DRN personnel perform computer searches in response to requests, then print the information and combine it with information from DRN library files. For information about adaptive equipment, DRN provides a list of manufacturers and a list of used equipment for sale by individuals. The DRN has a tollfree number (800-447-4221) which is both a voice and a TTY number. Out of state requests are charged a fee for DRN's information services.
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NICHCY: National Information Center for Children and Youth with Disabilities Source: Washington, DC: National Information Center for Children and Youth with Disabilities (NICHCY). 199x. [2 p.]. Contact: Available from National Information Center for Children and Youth with Disabilities (NICHCY). P.O. Box 1492, Washington, DC 20013-1492. Voice/TTY (800) 695-0285 or (202) 884-8200; Fax (202) 884-8441; E-mail:
[email protected]; http://www.nichcy.org. PRICE: Single copy free. Summary: This brochure describes the National Information Center for Children and Youth with Disabilities (NICHCY), an information clearinghouse that provides free information on disabilities and disability-related issues, focusing on children and youth (birth to age 22). The brochure briefly describes NICHCY's services, including personal responses to questions on disability issues, referrals to other organizations, information searches of NICHCY's databases and library, free informational publications, technical assistance to parent and professional groups, and materials in Spanish and in alternative formats.
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DECOD (Dental Education in Care of Persons with Disabilities) Distance Learning Unit Source: Seattle, WA: Dental Education in Care of Persons with Disabilities (DECOD), University of Washington. 1996. 8 p. Contact: Available from Dental Education in Care of Persons with Disabilities (DECOD). Continuing Dental Education, Box 357137, University of Washington, Seattle, WA 981956370. (206) 543-5448. Fax (206) 685-3164. PRICE: Single copy free. Summary: This brochure describes two components of the Dental Education in Care of Persons with Disabilities (DECOD) Distance Learning Unit: the video lecture series and the self-instructional modules series. Videos cover wheelchair transfer; organizing a mobile dental practice; oral medicine problems in patients with disabilities; a behavioral perspective on chronic orofacial pain; HIV-AIDS overview; the management of renal dialysis and renal transplant patients; the use of sedation in patients with developmentally disabilities; swallowing and oral-pharyngeal dysphagia; patients with stroke; medical emergencies in the dental office; dental-nutrition concerns of older adults; the aging mouth; the behavioral management of medically compromised children; spinal cord injury and traumatic head injury; the cultural aspects of deafness; oral health issues in rehabilitation, including access to dental care; oral care for persons with psychiatric disorders; adaptive devices; building interdisciplinary communication; oral hygiene for persons with developmental disability; patients with blindness or visual impairments; and the psychological and social issues of disability. The Self-Instructional modules cover the rehabilitation of, dental treatment of, and dental prevention for patients with developmental disabilities; medically compromised patients in dental practice; anxiety and pain control for dental patients with disabilities; clinical assessment of this population; dental treatment of patients with major psychiatric disorders, of patients with chemical dependencies, of patients with CNS and neurologic impairment, and of geriatric patients; the management of medical emergencies in this population; and the oral health care of persons with disabilities.
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A Guide to Social Security and SSI Disability Benefits Contact: CDC Business and Labor Resource Service, PO Box 6003, Rockville, MD, 208496003, (301) 562-1098, http://www.brta-lrta.org.
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Summary: This brochure discusses Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits that may be available to employees with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). The brochure defines the rules of eligibility for SSDI and SSI. It provides the readers with information concerning the Social Security definition of disability and how Social Security evaluates people on their level of disability. It explains the evaluation of HIV infection used for women and children as well as how the readers can file for their disability claims. The brochure examines how Social Security ensures prompt processing of claims and payments, and explains how readers can speed up the process. It discusses Social Security's rules about returning to work and provides important information about Medicaid and Medicare coverage for employees with HIV/AIDS. •
Americans with Disabilities Act in Brief: Focus on Telecommunications Source: Washington, DC: President's Committee on Employment of People with Disabilities. 1993. [2 p.]. Contact: President's Committee on Employment of People with Disabilities. 1331 F Street, N.W., Washington, DC 20004-1107. (202) 376-6200; TTY (202) 376-6205; Fax (202) 376-6219. PRICE: Single copy free. Summary: This brochure focuses on the right to equal access to telephone services, as defined by the Americans With Disabilities Act (ADA). The brochure is one in a series of brochures on the ADA from the President's Committee on Employment of People with Disabilities. The ADA states that 'the Commission shall ensure that interstate and intrastate telecommunications relay services are available, to the extent possible and in the most efficient manner, to hearing impaired and speech impaired individuals in the U.S.' The brochure defines telecommunications relay services as telephone transmission services that enable an individual who has a hearing or speech disability to communicate by wire or radio with a hearing individual in a manner that is functionally equivalent to the ability of someone without a hearing or speech disability. The brochure concludes with the contact information for two resource organizations that can provide more information about the regulations.
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Learning Disabilities and Young Adults Source: Elk Grove Village, IL: American Academy of Pediatrics (AAP). 1992. 6 p. Contact: Available from American Academy of Pediatrics (AAP). 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (800) 433-9016 (members) or (888) 227-1773 (nonmembers). Fax (847) 434-8000. Website: www.aap.org. PRICE: $24.95 per 100 copies for members; $29.95 for non-members. Item Number HE0125. Summary: This brochure from the American Academy of Pediatrics (AAP) provides information for parents interested in knowing more about learning disabilities and young adults. The brochure describes and defines learning disability and then discusses the causes of learning disabilities; outlines the types of learning disabilities; considers problems experienced by young people with learning disabilities, including the importance of developing social skills. Other topics covered include a reminder of the adolescent's strength; looking for opportunities for academic, social, and vocational development; coping on the job; continuing education; and the role of support from friends and family. The brochure concludes with a list of resource organizations that can provide readers with more information on learning disabilities. The brochure includes a blank box for physicians to stamp their name and address.
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How to Comply with the Americans With Disabilities Act: Sources of Federal Guidelines Source: Pittsburgh, PA: United States Government Information, Superintendent of Documents. 199x. [4 p.]. Contact: Available from Superintendent of Documents. P.O. Box 271954, Pittsburgh, PA 15250-7954. Fax (202) 512-2250. PRICE: Single copy free. Summary: This brochure lists publications available from the Federal government that can help readers comply with the requirements of the Americans With Disabilities Act (ADA). The catalog lists brochures and books including: Americans With Disabilities Handbook, Americans With Disabilities Act Accessibility Guidelines Checklist for Buildings and Facilities, The Arts and 504: A Handbook for Accessible Arts Programming, Compliance With The Americans With Disabilities Act, Data from the Survey of Income and Program Participation (ADA 1991-1992), Making History Properties Accessible: Preservation Briefs 32, Public Law 101-336 (ADA 1990), and Public Law 103-218 (Technology Related Assistance for Individual With Disability Act). Also included are periodicals: A Technical Assistance Manual on the Employment Provisions (Title I) of the Americans With Disabilities Act, The Americans With Disabilities Act Title II-Technical Assistance Manual Covering State and Local Government Programs and Services, The Americans With Disabilities Act Title IIITechnical Assistance Manual Covering Public Accommodations and Commercial Facilities, Job Safety and Health Quarterly, and American Rehabilitation. Each item is briefly described, with a black and white photograph of the cover; pricing information is included.
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AIDS As A Disability Contact: American Bar Association, Commission on Mental and Physical Disability Law, 740 15th St NW, Washington, DC, 20005, (202) 662-1570, http://www.abanet.org/disability/. Summary: This brochure notes the problem of children and adolescents with Human immunodeficiency virus (HIV), noting there are special legal issues involved. It describes the American Bar Association's projects on Acquired immunodeficiency syndrome (AIDS) and developmental disability, on legal resources for child advocacy, and on work with the mentally disabled. The Association's publications and services are listed.
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Auxiliary Aids and Services for Postsecondary Students with Disabilities: Higher Education's Obligations Under Section 504 and Title II of the ADA Source: Washington, DC: Office for Civil Rights, U.S. Department of Education. 1998. 13 p. Contact: Available from U.S. Department of Education. Office for Civil Rights. Customer Service Team, Mary E. Switzer Building, 330 C Street, SW, Washington, DC 20202. (800) 421-3481 or (202) 205-5413. TDD (202) 205-5166. Fax (202) 205-9862. Website: www.ed.gov/offices/OCR. PRICE: Single copy free. Summary: This brochure outlines the obligations of postsecondary institutions for providing auxiliary aids and support services for students with disabilities. The brochure begins with a reprint of Section 504 of the Rehabilitation Act of 1973, a law that prohibits discrimination on the basis of physical or mental disability. The brochure also reviews Title II of the Americans with Disabilities Act (ADA), which prohibits state and
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local governments from discriminating on the basis of disability. The Title II regulation states that a public entity shall furnish appropriate auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity to participate in and enjoy the benefits of a service, program, or activity conducted by a public entity. The brochure then reminds readers of the postsecondary student's responsibilities, primarily in the areas of notifying the institution of the disabling condition and assisting in identifying appropriate and effective auxiliary aids. The brochure then lists examples of auxiliary aids and discusses the effectiveness and costs of auxiliary aids. An additional section briefly considers personal aids and services, including help in bathing, dressing, and other personal care (which are not required to be provided by postsecondary institutions). The brochure concludes with a section of common questions and answers. The toll free telephone number of the Office of Civil Rights is provided for readers wishing to receive additional information (800-421-3481). •
Social Security: A Guide to Social Security and SSI Disability Benefits for People with HIV Infection Source: US Department of Health and Human Services. Contact: Social Security Administration, Office of Public Inquiries, 6401 Security Blvd, Rm 4-C-5 Annex, Baltimore, MD, 21235-6401, (410) 965-7700, http://www.ssa.gov. Summary: This brochure provides information on the Social Security disability benefits and Supplemental Security Income (SSI) that are available to employees with the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). It discusses HIV and Social Security; the non-medical rules and eligibility factors for Social Security disability insurance benefits and SSI; how Social Security defines 'disability'; how Social Security evaluates disability claims involving HIV diseases; information on how claims are processed, especially those involving women and children with HIV; how to apply for disability, what steps Social Security takes to ensure that claims are processed accurately, and what can be done to help the process along; special rules designed to help individuals return to work; and the kinds of benefits available from the Medicaid and Medicare programs. It provides information on accessing information and services online at www.ssa.gov, and it provides a phone number, 1-800-772-1213, for individuals to learn more about Social Security.
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Helping young children with learning disabilities achieve independence Source: Pittsburgh, PA: Learning Disabilities Association. n.d. 2 pp. Contact: Available from Learning Disabilities Association of America, 4156 Library Road, Pittsburgh, PA 15234. Telephone: (412) 341-1515 / fax: (412) 344-0224 / e-mail:
[email protected] / Web site: http://www.ldanatl.org. Summary: This brochure, developed for parents of young children with learning disabilities, provides information on helping children with this disability gain confidence. It discusses such topics as building self esteem, activities for preschool children, handling behavior problems, teaching self-help skills, developing communication and thinking skills, and providing social skills training.
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Understanding IDEA and Section 504: A Guide for Parents of Children with Disabilities Source: South Deerfield, MA: Channing L. Bete Co., Inc. 1999. 15 p.
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Contact: Available from Channing L. Bete Co., Inc. 200 State Road, South Deerfield, MA 01373. (800) 628-7733. Fax (800) 499-6464. E-mail:
[email protected]. Website: www.channing-bete.com. PRICE: $1.05 for 1-99 copies; bulk copies available. Item Number 20658A-11-98. Summary: This cartoon booklet helps parents of children with disabilities understand IDEA (Individuals with Disabilities Education Act) and Section 504 of the Rehabilitation Act of 1973. The IDEA provides federal funding to states to help guarantee special education and related services to eligible students. Section 504 prohibits discrimination against any person with a disability by any federally funded agency or organization. It requires states to provide programs for eligible students with disabilities that are equal to those for students without disabilities. The booklet describes how these laws can help children, who can get services under these laws, how to know if a child is eligible, the main principles of each of the laws, parents' rights, and the differences between IDEA and Section 504 (in the areas of individualized education plan or IEP, related services, evaluation consent, available funding, eligibility, age requirements, parent involvement, language requirement, private school placement, and costs). The booklet concludes with a section of answers to common questions on Section 504 and the IDEA. The booklet is illustrated with simple cartoon drawings of parents and children. •
What You Should Know About the Sexual Abuse of Children with Disabilities Source: Lawrence, KS: Beach Center on Families and Disabilities. 1995. 2 p. Contact: Available from Beach Center on Families and Disability. 3111 Haworth, University of Kansas, Lawrence, KS 66045. (913) 864-7600. PRICE: Single copy free. Summary: This fact sheet familiarizes readers with the issue of sexual abuse of children with disabilities. The fact sheet reviews the somewhat limited research in this area, reporting findings that imply a greater need for attention to this problem. The fact sheet also lists why children with disabilities are at additional risk for sexual abuse. One sidebar notes that recognizing signs of abuse can be more difficult among patients with disabilities because symptoms of abuse are sometimes masked by the disability itself or are ascribed to other causes. The fact sheet emphasizes that the support of inclusion and integration of the child and family in the community can prevent abuse. The fact sheet concludes with a list of strategies that could be implemented in the areas of communication, school support services, community health and support services, and communication in the courtroom and other legal settings. The fact sheet provides information about a conference report summarizing key literature in this area.
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Look at Alcohol and Other Drug Abuse Prevention and Americans with Disabilities Source: Washington, D.C.: Resource Center on Substance Abuse Prevention and Disability. 1992. 8 p. Contact: Available from Resource Center on Substance Abuse Prevention and Disability. 1819 L Street, N.W., Suite 300, Washington, D.C. Voice (800) 628-8442 or (202) 638-5862; TTY (202) 638-5862; Fax (202) 628-3812. PRICE: Single copy free. Summary: This fact sheet is designed for those working in the field of alcohol and other drug abuse services, as well as for those involved in the disability and rehabilitation fields. The fact sheet reviews the Americans With Disabilities Act of 1990 and its impact on alcohol and other drug abuse services. The fact sheet provides information on architectural and communication barriers, as well as discrimination and other barriers and provides suggestions to improve access and positive interactions. A list of resource
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organizations and agencies to contact for more information is provided. 19 references. (AA-M). •
Look at Alcohol and Other Drug Abuse Prevention and Learning Disabilities Source: Washington, DC: Resource Center on Substance Abuse Prevention and Disability. 1992. 4 p. Contact: Available from Resource Center on Substance Abuse Prevention and Disability. 1818 L Street, N.W., Suite 300, Washington, DC 20036. Voice (800) 628-8442 or (202) 6288080; TTY (202) 638-5862; Fax (202) 628-3812. PRICE: Single copy free. Summary: This fact sheet on learning disabilities is designed for those working in the field of alcohol and other drug abuse services, as well as for those involved in the disability and rehabilitation fields. The fact sheet describes the implications of alcohol and other drug abuse for a person with a learning disability, focusing on suggestions to improve access and positive interactions. Myths and facts about learning disabilities are included. A list of resource organizations and agencies to contact for more information is provided. 5 references. (AA-M).
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Prevention of Reading Disability Source: in DeFeo, A.B., ed. Parent Articles 2. San Antonio, TX: Communication Skill Builders. 1995. p. 33-34. Contact: Available from Communication Skill Builders. Customer Service, 555 Academic Court, San Antonio, TX 78204-2498. (800) 866-4446; Fax (800) 232-1223. PRICE: $49.00 plus shipping and handling. Order Number 076-163-0732. Summary: This fact sheet, from a communication skills book for parents, discusses the prevention of reading disability. The author defines reading disability, describes its relationship to language disorders, and presents ways to foster reading in children to prevent reading disability. The latter section provides detailed suggestions for parentchild interaction, including recommended activities and role-play, and language to use. The author encourages parents to incorporate these suggestions into everyday activities. 2 references.
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What Do We Know About Adults With Learning Disabilities? Source: Overland Park, KS: Council for Learning Disabilities (CLD). 1994. 2 p. Contact: Available from Council for Learning Disabilities (CLD). P.O. Box 40303, Overland Park, KS 66204. (913) 492-8755. PRICE: Single copy free. Summary: This fact sheet, from the Council for Learning Disabilities (CLD), summarizes the characteristics of adults with learning disabilities. The fact sheet emphasizes the it is virtually impossible to provide a typical profile of individuals with learning disabilities (LDs) because of their unique differences. Topics covered include how LDs in adults are diagnosed; LDs in a non-school setting; whether or not adults with LD should pursue postsecondary education; how a learning disability can affect an individual's career; and factors that can improve an individual's chances for success. The fact sheet concludes with a list of five resource organizations through which readers can obtain more information. 5 references.
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ETC.: Effective Therapies Through Cued Speech. Articulation, Learning Disabilities, Phonics, Down Syndrome, Deaf-Blind, etc Source: Cleveland, OH: National Cued Speech Association. 1996. (Information Package). Contact: Available from Cued Speech Discovery. Bookstore of the National Cued Speech Association, 23970 Hermitage Road, Cleveland, OH 44122-4008. Voice/TTY (800) 4593529 or (216) 292-6213; E-mail:
[email protected]. PRICE: $10.00 plus $3.00 shipping and handling. Summary: This information package contains a variety of information about cued speech and its use with children who have hearing impairments and a disability such as Down syndrome, learning disability, visual impairment, etc. The package is designed for the families of these children, and for professionals who work with them. It combines fact sheets, articles, and commentaries on cued speech. Topics include autism, pervasive developmental disorders, and cued speech; cued speech for children who are deaf-blind; cued speech and phonics; students who have reading difficulties and cued speech; the self-monitoring cue card (SMCC) format; cued speech for articulation therapy; cued speech for persons who have mental retardation; and the views of speechlanguage pathologists on cued speech. The information packet also lists recommended readings and resources for additional materials.
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Information Package: Resource Center on Substance Abuse Prevention and Disability Source: Washington, D.C.: Resource Center on Substance Abuse Prevention and Disability. 1993. (information package). Contact: Available from Resource Center on Substance Abuse Prevention and Disability. 1819 L Street, N.W., Suite 300, Washington, D.C. 20036. Voice (800) 628-8442 or (202) 628-8080; TTY (202) 628-3812; Fax (202) 628-3812. PRICE: Single copy free. Summary: This information packet is designed for those working in the field of alcohol and other drug abuse services, as well as for those involved in the disability and rehabilitation fields. The packet includes fact sheets on alcohol and drug abuse prevention, the Americans With Disabilities Act, attention deficit disorders, blindness and visual impairments, deafness and hearing loss, hidden disabilities, learning disabilities, mental illness, mental retardation, mobility limitations, spinal cord injury, traumatic brain injury, disability and enabling, disability and the family, disability and health implications, and service delivery settings. Each fact sheet lists truths and myths about the subject, provides information about resource organizations and publications, and includes references. An order form for additional copies of the fact sheets is also included.
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Aging with Mental Retardation: Oral Health for Older Individuals with Disabilities Source: Chicago, IL: Rehabilitation Research and Training Center on Aging with Developmental Disabilities. Institute on Disability and Human Development, University of Illinois at Chicago. Silver Spring, MD: The Arc of the United States. 2001. 8 p. Contact: Available from Rehabilitation Research and Training Center on Aging with Developmental Disabilities. Institute on Disability and Human Development, University of Illinois at Chicago. (800) 996-8845. E-mail:
[email protected]. Website: www.uic.edu/orgs/rrtcamr. PRICE: $3.00 for printed copy, or view for free on the Web. Summary: This informational oral health fact sheet is designed to provide family members and caregivers of older individuals with disabilities basic information
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regarding the oral health care needs and requirements of the individuals for whom they care. The authors describe special care dentistry, a term commonly used for addressing the oral health needs of an older person who is medically compromised or an individual with some type of mental, physical, or developmental disability. The authors also discuss common changes in the oral cavity encountered in older adults with disabilities, diagnostic considerations, recommendations for appropriate oral hygiene, choosing a dentist for the care of an individual with disabilities, the prevention of problems and maintenance of the oral cavity, and barriers in treating older adults with disabilities. The authors conclude by reminding readers of the significant relationship between oral health and general health. A list of ten resources for more information is provided at the end of the document. 2 figures. 7 references. •
Adult Aphasia: Understanding the Disability Source: Cambridge, MA: Department of Communication Disorders, Youville Hospital and Rehabilitation Center. 1994. 12 p. Contact: Available from Youville Hospital and Rehabilitation Center. Department of Communication Disorders, 1575 Cambridge Street, Cambridge, MA 02138-4398. (617) 876-4344. PRICE: $4.00 each. Summary: This manual helps family members and caregivers understand adult aphasia, a language disability that is often the result of a stroke (cerebrovascular accident or CVA). The manual reminds readers that each individual's recovery will vary, depending on the severity of the stroke and other factors. The manual provides definitions of related terms and then discusses aphasia and its impact on expression and understanding. The authors then discuss complications, including factors that may affect the communication interaction, sensation loss, and visual field cuts. A lengthy section provides suggestions for helping the patient to remain a person and stay involved in his or her own health care. Additional sections address loss of independence, automatic (non-propositional) speech, emotional lability, the time commitments required for effective communication, perseveration, interpersonal relationships, and medical follow ups. The manual concludes with a question and answer section. Comments from patients and caregivers are included throughout the text. 3 figures. 2 references. (AA-M).
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General Information About Disabilities: Disabilities that Qualify Infants, Toddlers, Children, and Youth for Services Under the IDEA Source: National Information Center for Children and Youth with Disabilities. Contact: National Information Center for Children and Youth with Disabilities. P.O. Box 1492, Washington, DC, 20013-1492. Voice (202) 884-8200. Voice/TTY 1-800-695-0285. Email:
[email protected]. Web site: www.nichcy.org. PRICE: single copy free. Summary: This pamphlet describes the services available under the federal law known as the Individuals with Disabilities Education Act (IDEA), defines the 13 disability categories under which a child will be eligible for a free public education under IDEA, and refers parents to other sources for related information. IDEA guarantees the right to a free and appropriate education to students with disabilities (ages 3 to 21 years). 4pp.
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Graduating to Independence: Information for Young People With Disabilities Contact: US Department of Health and Human Services, Social Security Administration, Office of Programs, Office of Disability, Altmeyer Bldg, 6401 Security Blvd, Baltimore, MD, 21235, (410) 965-3424. Summary: This public information package, produced by the Social Security Administration (SSA), is designed for vocational rehabilitation counselors, teachers, members of disability advocacy organizations, and other people who work with youth with disabilities who are making the transition from school to the workplace. It includes information on social security, working while disabled, and work incentives information. It is divided into five parts: special messages, fact sheets, success stories, a videotape, and computer software with instructions. The special messages and fact sheets can be reproduced for use with the targeted groups. The fact sheets can be used as handouts for students/parents, units for class instruction, or a discussion tool for groups and individuals. The success stories are true stories of young people with disabilities. The videotape is a story of two people who have successfully used the Social Security work incentives to find satisfying and rewarding employment and is accompanied by discussion questions. The computer software program is designed to show the effect work and earnings might have on a person's Social Security disability benefits and health insurance coverage. A list of reference materials is included for people who want more detailed information.
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Resources for Adults with Disabilities Source: National Information Center for Children and Youth with Disabilities. Contact: National Information Center for Children and Youth with Disabilities. P.O. Box 1492, Washington, DC, 20013-1492. Voice (202) 884-8200. Voice/TTY 1-800-695-0285. Email:
[email protected]. Web site: www.nichcy.org. PRICE: single copy free. Summary: This publication helps adults with disabilities identify organizations and agencies designed to assist with their specific concerns and needs, such as employment, postsecondary education, recreation, independent living, and assistive technology. 12pp.
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Diagnosis of Dementia in Individuals With Intellectual Disability. Report of the Working Group for the Establishment of Criteria for the Diagnosis of Dementia in Individuals With Source: Albany, NY: New York State Office of Mental Retardation and Development Disabilities Bureau of Aging Services. 1995. 17 p. Contact: New York State Office of Mental Retardation and Development Disabilities Bureau of Aging Services. 144 Holland Avenue, Albany, NY 12229. (518) 473-7855; FAX (518) 473-0775. PRICE: Free. Summary: This report proposes a set of standardized criteria for the diagnosis of dementia in people with intellectual disabilities (ID's) and a standardized procedure for determining whether or not criteria are met in individual cases. These criteria are designed for use by both clinicians and researchers. A group of clinicians are researchers attending the International Colloquium on Alzheimer's Disease and Mental Retardation identified the need for standardized criteria and diagnostic procedures. Those who attended the International Colloquium endorse the diagnostic criteria and procedures outlined in this report. 1 table, 72 references.
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Job Seeking Skills for People with Disabilities: A Guide to Success Source: Northridge, CA: National Center on Deafness, California State University, Northridge. 2001. Contact: Postsecondary Education Programs Network (PEPNet) consortium. 18111 Nordhoff Street, Northridge, CA 91330-8267. (818) 677-2145. Toll-free: (888) 684-4695. TTY: (818) 677-2665. Fax: (818) 677-7693. Web site: www.pepnet.org. PRICE: Single copy free. Summary: This student handbook was developed to help people with disabilities seek employment. Sections include self-assessment, career choices, resumes, interviews, job searches, marketing oneself, job expectations, and the Americans with Disabilities Act (ADA). A number of checklists, worksheets, and tables are included to help students assess their abilities and career goals. The handbook was developed in collaboration with the Students with Disability Internship Project and Transition Resources and Career Services for Students with Disabilities (TRACS).
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Achieving in Spite of: A Booklet on Learning Disabilities Source: New York, NY: National Neurofibromatosis Foundation, Inc. 1998. 28 p. Contact: Available from National Neurofibromatosis Foundation, Inc. 95 Pine Street, 16th Floor, New York, NY 10005. (800) 323-7938. (212) 344-6633. Fax (212) 747-0004. Email:
[email protected]. Website: www.nf.org. PRICE: $1.00 plus shipping and handling. Summary: While learning disabilities are quite common, people with neurofibromatosis (NF) are five times more likely to have learning disabilities than the general population. Because of this, the National Neurofibromatosis Foundation (NNFF) has created this booklet to explain how the two issues are connected. In addition, the booklet reinforces the belief that a learning disability does not have to be a roadblock to achieving one's full potential. The booklet includes two separate sections; the first defines learning disabilities, explains how they may impact a child or adolescent in the learning setting, and explores the various treatment options. The second section focuses on learning disabilities in children and adolescents with NF1, one of the two types of NF. The author offers suggestions to foster healthy cognitive development in this population. The contact information for the National Neurofibromatosis Foundation (NNFF) is provided (800-323-7938 or www.nf.org).
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Ideas for Accommodating Teachers and other Educational Personnel Who Have Disabilities Source: Morgantown, WV: Job Accommodation Network. February 2000. 27 p. Contact: Available from Job Accommodation Network. West Virginia University, P.O. Box 6080, Morgantown, WV 26506-6080. Voice/TTY (800) 526-7234. E-mail:
[email protected]. Website: www.jan.wvu.edu. PRICE: Single copy free. Summary: With the passage of the Americans with Disabilities Act (ADA), an increasing need has developed to be knowledgeable about reasonable accommodations for people who have disabilities. This document provides ideas for accommodating teachers and other educational personnel who have disabilities. When considering accommodations for teachers or educational personnel who have disabilities, it is important to remember that this process must be conducted on a case by case basis with input from the person with the disability. The person's abilities and limitations should be considered and problematic tasks must be identified. This document defines some of the terminology
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under the ADA; notes some examples of accommodations that may be utilized; lists questions to consider when determining, implementing, and maintaining accommodations; lists different types of issues (motor and mobility, sensory, allergies or multiple chemical sensitivities, psychological or neurological) with possible accommodation strategies noted for each; and describes sample accommodation examples for different types of school employees. This information is provided for informational purposes and should not be construed as legal advice. The document concludes with a list of resources for educators with disabilities (including web site and e-mail addresses where available). •
Pocket Guide to Federal Help for Individuals with Disabilities Source: Washington, DC: U.S. Department of Education, Office of Special Education and Rehabilitative Services, 1993, 29 p. Contact: Available free of charge from the Clearinghouse on Disability Information, Office of Special Education and Rehabilitative Services, U.S. Department of Education, Room 3132, Switzer Building, Washington, DC 20202-2524. (202)205-8241 Voice/TDD/TT. (202)205-8723 Voice/TDD/TT. Summary: Written for people with disabilities, their families, and service providers, this publication contains information on government-wide benefits and services for which individuals with disabilities may be eligible. It describes benefits applicable specifically to those who are deaf and deaf/blind as well as those who are developmentally disabled. Included are the names and addresses of the various federal agencies that can refer individuals to their state and/or local counterpart offices.
The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “disability” (or synonyms). The following was recently posted: •
Assessment of maltreatment of children with disabilities Source: American Academy of Pediatrics - Medical Specialty Society; 2001 August; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3085&nbr=2311&a mp;string=disability Healthfinder™
Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database:
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A Guide to Disability Rights Laws Summary: This guide provides a summary of federal civil rights laws that ensure equal opportunity for people with disabilities. Source: National Council on Disability http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5366
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American Indian and Alaska Natives Information from the Social Security Administration Summary: This page links to information about how to get a social security card and contact the Social Security Administration as well as to information about retirement, disability, survivors, Supplemental Source: Social Security Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6914
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Americans with Disabilities Act Document Center Summary: ADA Statute, Regulations, ADAAG (Americans with Disabilities Act Accessibility Guidelines), Federally Reviewed Tech Sheets, and Other Assistance Documents from many sources, both government and Source: National Institute on Disability and Rehabilitation Research, U.S. Department of Education http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=620
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Caregiving Fact Sheets: Diseases, Disorders and Issues Summary: The fact sheets available at this site provide caregivers with medical information related to diseases and disorders that most commonly result in mental and/or physical disability as well as Source: Family Caregiver Alliance http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2820
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Caring for the Caregiver Summary: Caring for a child with a disability can create stress, depression, and physical problems. Source: American Occupational Therapy Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7294
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Choosing A Caregiver: A Guide for Individuals and Families with Special Needs Summary: If you are a persons with a disability or caring for a person with disabilities. Source: General Government Agency http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5384
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Disability Fact Sheets and Briefing Papers Source: National Information Center for Children and Youth with Disabilities, U.S. Department of Education http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5406
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Disability Related Sites: Sports & Recreation Pages Summary: Links to a selected list of internet websites for information about national and international recreational and athletic activities for persons who are wheelchair-bound. Source: Disabled Sports USA http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2690
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FAQ - About Service/Assistance Dogs Summary: Answers questions about choosing the right type of dog for a specific disability, the training process, selecting dogs for training and cost of training and maintenance. Source: Assistance Dogs International http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4241
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FCC Disabilities Issues Task Force Summary: Information on FCC activities related to developments in the communications field with the focus on people with disabilities and those who care for them. Source: Federal Communications Commission http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=863
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Guide To Social Security And SSI Disability Benefits For People With HIV Infection Summary: If you are disabled because of HIV infection, this booklet will help you understand the kinds of disability benefits you might be eligible for from the Social Security or SSI programs. Source: Social Security Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1195
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Handling your Psychiatric Disability in Work and School Summary: Information about the Americans with Disabilities Act (ADA) and other employment and education issues for people with psychiatric disabilities. Source: Center for Psychiatric Rehabilitation http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5934
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Health Publications and Reports & Proceedings -- National Institute of Child Health and Human Development Summary: NICHD seeks to assure that every individual is born healthy and wanted, and has the opportunity to fulfill his or her potential for a healthy and productive life unhampered by disease or disability. Source: National Institute of Child Health and Human Development, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=554
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Health Topic: Infants and Children Page - Centers for Disease Control and Prevention Summary: An index of health and safety topics that are specific to infants and children including childhood diseases, immunization, injuries, developmental disabilities, child abuse, birth defects and more. Source: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=365
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Information and Websites Related to Disability, Aging and Long-Term Care Summary: Links to federal, private and academic web sites with resources related to issues concerning the elderly, the working disabled, disabled children and those dealing with welfare reform. Source: Office of Disability, Aging, and Long-Term Care Policy http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4157
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Insurance Guides for Consumers Summary: Links to insurance guides on disability, health insurance, long term care, medical savings accounts, and general insurance information. Source: Health Insurance Association of America, Public Affairs Department http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4772
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Journal of the Association for Persons with Severe Handicaps (JASH) Summary: Published by the Association for Persons with Severe Handicaps (TASH), the goal of this quarterly journal is to enhance the quality of lives of people with severe disabilities by providing credible Source: Association for Persons with Severe Handicaps http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5234
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Kids’ Quest on Disability and Health Summary: Answers questions about what it is like to be disabled and the needs and opportunities for disabled children and adults Source: National Center on Birth Defects and Developmental Disabilities http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5785
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Know Your Rights Summary: This fact sheet discusses selected disability rights topics for people with severe mental illness. Source: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5396
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LD Online Summary: This interactive guide allows access to a wide variety of information and resources related to learning disabilities for parents, teachers and children. Source: Nonprofit/Professional Entity--Follow the Resource URL for More Information http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5171
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Learning Disabilities Source: National Information Center for Children and Youth with Disabilities, U.S. Department of Education http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3412
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Learning Disabilities Information Page Summary: A general overview of learning disabilities that includes a description of the disorder, and treatment, prognosis and research information. Source: National Institute of Neurological Disorders and Stroke, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=782
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Learning Disability Online Artist of the Week Contest Summary: Students between the ages of 5 and 18 who have a learning disability are invited to submit art (or writing pieces) to LD Online. Source: Nonprofit/Professional Entity--Follow the Resource URL for More Information http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5816
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Mental Health Publications & Education Programs Summary: Conference proceedings, consumer publications, and public education program materials on anxiety, attention deficit hyperactivity disorder, depression, panic disorder, learning disabilities, bipolar Source: National Institute of Mental Health, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=358
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National Vaccine Injury Compensation Program Vaccine Injury Table Summary: A listing of vaccines covered by the National Vaccine Injury Compensation Program and the related illness, disability, injury, or specific condition. Source: Office of Special Programs, Health Resources and Services Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=900
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NICHCY State Resource Sheet Summary: The National Information Center for Children and Youth with Disabilities has provided this alphabetical listing of state offices where you can locate organizations and agencies within your state that Source: National Information Center for Children and Youth with Disabilities, U.S. Department of Education http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6220
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Providing Medical Evidence To The Social Security Administration For Individuals With Chronic Fatigue Syndrome: A Guide For Health Professionals Summary: When an individual with Chronic Fatigue Syndrome (CFS), also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), applies for Social Security disability benefits, we must decide whether Source: Social Security Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=740
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Sam's Story of Life With Dyslexia Summary: This article is about the learning disability called dyslexia. It tells why what Sam and kids like him see and hear looks different or sounds different than it would to most people. Source: Nemours Foundation http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5860
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Social Security Benefits For People Living With HIV/AIDS Summary: People with HIV/AIDS may qualify for disability benefits from the Social Security Administration under two programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Source: Social Security Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1193
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Social Security Disability Benefits Summary: This booklet provides a general overview of the Social Security disability program. The information it contains is not intended to cover all provisions of the law. Source: Social Security Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1188
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Social Security Disability Programs Summary: When you talk to the Social Security representative, two different disability programs may be discussed--Social Security disability insurance and Supplemental Security Income (SSI) disability. Source: Social Security Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1194
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Social Security: Working While Disabled.How We Can Help Summary: If you are receiving Social Security Disability Insurance or Supplemental Security Income (SSI) disability benefits but still want to work, this booklet provides information to help you treat your Source: Social Security Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1198
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Social Security: What You Need To Know When You Get Disability Benefits Summary: You might think that because the disability application process is over and your benefits are about to start, you no longer have to worry about Social Security. Source: Social Security Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1192
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Targeting Arthritis: The Nation’s Leading Cause of Disability Summary: This site provides statistics about arthritis as the leading cause of disability among persons 15 and older, including state specific data. It also discusses the various known forms of the disease. Source: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2446
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Treatment for MS Summary: Studies indicate that early treatment delays disability, presumably by decreasing the injury to the nervous system caused by the disease. Source: Multiple Sclerosis Foundation, Inc. http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7798
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Understanding Autism Summary: Autism is a developmental disability that affects how the brain functions, specifically those areas of the brain that control social ability and communication skills. Source: American Occupational Therapy Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7292
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Women's Health Initiative, National Heart, Lung, and Blood Institute/NIH Summary: The WHI focus is on the major causes of death, disability and frailty in postmenopausal women. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2812 The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to disability. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMD®Health: http://my.webmd.com/health_topics
News Services and Press Releases One of the simplest ways of tracking press releases on disability is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “disability” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to disability. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “disability” (or synonyms). The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “disability” (or synonyms) into the search box, and click on “Search News.” As this service is technology
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oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “disability” (or synonyms). If you know the name of a company that is relevant to disability, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “disability” (or synonyms).
Newsletters on Disability Find newsletters on disability using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “disability.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “disability” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •
Introducing the Idea Exchange: Home-to-School Communication Source: Disability Solutions. 4(2): 1-15. March-April 2000. Contact: Available from Disability Solutions. PMB 179, 9220 S.W. Barbur Boulevard, Number 119, Portland, OR 97219. Summary: This issue of the Disability Solutions newsletter, a publication for families and others interested in Down syndrome and related disabilities, is the first to introduce the Idea Exchange. The Idea Exchange offers a way for parents and professionals to share practical strategies that are successful. This installment gathers ideas for home to school communication systems parents have designed with their IEP (Individualized Education Plan) teams across the country. The lead story explains the rationale for home to school communication stories, and introduces a notebook style format for the actual communication method. A second article explains methods for families to design home to school communication systems that the child can complete his or her own record keeping. The issue includes photographs and reprints of the communication devices and forms used. The editorial introduction to the issue reminds readers to check the Idea Exchange section of the organization's website for more ideas (www.disabilitysolutions.org/idea.htm). A list of resources and their manufacturers is also included. 18 figures.
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Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “disability” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on disability: •
Internet and Disability-Related Resources Source: Closing The Gap. 14(3): 1, 4, 7, 9. August-September 1995. Contact: Available from Closing the Gap. P.O. Box 68, Henderson, MN 56044. (612) 2483294; Fax (612) 248-3810. Summary: In this article, the author familiarizes readers with the Internet and disabilityrelated resources online. The author stresses that the Internet is emerging as a potentially powerful resource for all individuals interested in special education and disability-related topics. Topics covered include a list of disability-related resources, the Cornucopia of Disability Information (CODI) and how to access it, searching suggestions, resources and directories, data and documents, the Internet newsstand, network resources, and employment information on the Internet. The author provides a number of useful lists of where to find resources on the Internet.
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Memory and Disability: What Is Memory? Source: Wellspring Currents. [Newsletter] Number 1: 1-3, 5, 7. Summer 1991. Contact: Available from Wellspring Currents. 179 West Washington, Suite 360, Chicago, IL. 60602. (312) 201-9696. PRICE: Call for price information. Summary: Memory impairment is a common complaint of patients who have psychological problems such as depression or those who have primary neurologic disorders such as Alzheimer's disease, Parkinson's disease, and traumatic brain injury. This newsletter article discusses what is currently understood about how normal memory operates and the influence of aging on memory. Also discussed are the validity, use, and misuse of memory and mental status tests in guardianship and residential placement of memory impaired individuals.
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Assessing Children for the Presence of a Disability: Section Three: The Parents' Role in the Assessment Process Source: NICHCY (National Information Center for Children and Youth with Disabilities) News Digest. 4(1): 12. 1994. Contact: Available from National Information Center for Children and Youth with Disabilities (NICHCY). P.O. Box 1492, Washington, DC 20013-1492. Voice/TTY (800) 695-0285. Summary: This brief article is from a series that focuses upon the assessment process involving the ways and primary skill areas in which school systems collect information
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in order to determine if a child is eligible for special education and related services and in order to make informed decisions about that child's educational placement and instruction. The article outlines the parents' role in the assessment process. The author provides parents with suggestions for the range of ways in which they might involve themselves in the assessment of their child. Suggestions are outlined for parental involvement before, during, and after the evaluation. •
Chronic Pain and Disability of Whiplash May Be Prevented by Prompt Administration of a Drug Used in Spinal Cord Injury Source: Lifeline: The Newsletter of the National Chronic Pain Outreach Association. p. 15-16. Summer 1999. Contact: Available from National Chronic Pain Outreach Association. P.O. Box 274, Millboro, VA 24460. (540) 862-9437. Fax (540) 862-9485. E-mail:
[email protected]. Summary: This newsletter article for health professionals and people who have chronic pain reports on the use of a drug used in spinal cord injury to prevent chronic pain and disability of whiplash. Whiplash is an extension/flexion injury to the neck that frequently occurs from a rear hit motor vehicle accident. A study has found that methylprednisolone (MPS), a powerful synthetic corticosteroid, may help prevent chronic pain and other symptoms following whiplash. Patients participating in the study received either high-dose MPS or placebo. At 6 month followup there was a significant difference in prevalence of disabling symptoms between the treated and placebo groups. No one in the MPS group was still on sick leave, but four participants in the placebo group were still on sick leave and taking analgesics daily for neck and radiating pain in their arms. Early initiation of treatment with MPS is crucial because posttraumatic decrease in blood flow to the injury site results in decreased MPS uptake. Although high-dose MPS cannot be recommended for whiplash patients until additional studies are conducted, a single 30 milligram per kilogram dose of MPS is virtually without harmful effects.
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Legal Rights of Children With Musculoskeletal Disabilities Source: Bulletin on the Rheumatic Diseases. 45(7):1-5; November 1996. Contact: Arthritis Foundation, 1330 West Peachtree Street, Atlanta, GA 30309. (404) 8727100. (404) 872-9559 (fax). Summary: This newsletter article for individuals who care for children disabled by chronic rheumatic diseases discusses the legal rights of these children. Medical issues facing the families of children with chronic rheumatic diseases and the physicians who care for them are highlighted, including the coordination of health care services and the transition to adult care. The problem of insurance for children with chronic rheumatic diseases is discussed in terms of inadequate insurance, the role of health maintenance organizations, employee insurance, and Social Security Insurance. The educational process and peer environment for children with musculoskeletal disease is explored, focusing on public laws related to disability. Other issues addressed include access to comprehensive services for children with chronic rheumatic diseases. 24 references and 1 table.
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Onychomycosis Patients Report Wide Disability Source: Skin and Allergy News. 27(8):8-9. August 1996.
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Summary: This newsletter article for physicians presents survey results from four countries on the effects of onychomycosis on patient's disability and quality of life. The European study of 532 patients reports an alarming rate of disability present in onychomycosis patients including the inability to walk in 15 percent of respondents, 44 percent could not work with their hands due to the lesions, and 42 percent reported difficulty and pain associated with wearing shoes. About half of the respondents reported the presence of significant pain. A U.S. study found onychomycosis required significant numbers of doctor visits; significant work restrictions, particularly in those who had to work with their hands; and psychological trauma due to embarrassment. •
Eligibility for Social Security and SSI Disability Benefits Based on Acoustic Neuroma Source: ANA Notes. Number 67: 9, 11. September 1998. Contact: Available from Acoustic Neuroma Association (ANA). 600 Peachtree Parkway, Suite 108, Cumming, GA 30041-8211. (770) 205-8211. Fax (770 www.ANAUSA.org. Summary: This newsletter article reviews the issue of eligibility for Social Security and SSI disability benefits based on acoustic neuroma. These two disability benefit programs are administered by the Social Security Administration (SSA). Disability benefits are available to claimants who meet two conditions: they are disabled and cannot work at any job (not just the jobs they held in the past); and through their employment, they have contributed enough FICA tax over the years to be covered. The person's wage history will determine the monthly benefit amount. Eligibility for disability benefits depends on the limitations arising from both physical and mental impairments. Hearing loss, vertigo, and tinnitus, as well as the loss of eye sensation or control (which may be associated with acoustic neuroma) may make it impossible for the person to work at a regular job. Dizziness may make it impossible to take public transportation, carry heavy items, or walk very far. Coping with the effects of the condition, including the change in one's appearance and a loss of control of facial movements, often create a mental strain or depression which can affect the ability to function in the workplace. The author of the article reviews the SSA evaluation process, specific eligibility requirements, how to apply for benefits, the application and appeals process, how long the process takes, and work incentive programs. The article concludes with the tollfree telephone number of the SSA (800-772-1213) for readers wishing to obtain further information.
Associations and Disability The following is a list of associations that provide information on and resources relating to disability: •
American Bar Association Commission on Mental and Physical DisabilityLaw Telephone: (202) 662-1570 Fax: (202) 662-1032 Email:
[email protected] Web Site: http://www.abanet.org/disability Background: The American Bar Association Commission on Mental and Physical Disability Law (CMPDL) is a not-for-profit organization dedicated to fulfilling the American Bar Association s (ABA) commitment to justice and the rule of the law for persons with mental and physical disabilities. Established in 1973, the Commission also promotes research, provides referrals, and engages in professional education. The
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Commission publishes a directory; a registry; the 'Mental and Physical Disability Law Reporter,' the nation's longest running source on disability law; and other materials. •
Center for Research on Women with Disabilities Telephone: (713) 960-0505 Toll-free: (800) 442-7693 Fax: (713) 961-3555 Email:
[email protected] Web Site: www.bcm.tmc.edu/crowd/ Background: The Center for Research on Women with Disabilities (CROWD) is a research organization dedicated to conducting ongoing research and promoting, developing, and disseminating information to expand the life choices of women with disabilities so that they may fully participate in community life. Established in 1993, the Center conducts research and training activities on issues related to the health, independence, and community integration of women and men with physical disabilities, primarily with funding from federal grants. Sources include the National Institutes of Health and the U.S. Department of Education. The Center has established a database on psychosocial behaviors of women with disabilities compared to ablebodied women based upon 900 responses to a comprehensive national survey. The data has provided the first empirical data on a population of women with physical disabilities ages 18 through 85 years. Findings have been introduced to undergraduate and graduate medical training at Baylor College of Medicine and continuing education courses for a broad range of medical practitioners. The Center fulfills requests for information on its research findings and is expanding its efforts to conduct training and disseminate materials targeting a variety of audiences including medical professionals, allied health professionals, counselors, social workers, educators, policy analysts, and consumers. The Center offers a wide variety of materials including its prospectus, audiovisuals, reports, and a listing of the Center s journal articles concerning women with disabilities, the Americans With Disabilities Act, personal assistance services, and independent living.
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Danish Centre for Rare Diseases and Disabilities Telephone: 00 453 3914020 Fax: 00 453 3914019 Email:
[email protected] Web Site: www.chs.dk Background: The Danish Centre for Rare Diseases and Disabilities is a nonprofit government organization that is concerned primarily with severe physical or mental disabilities that affect a population of less than one person in every 10,000. Most of these disorders are congenital or hereditary in nature. Founded in 1990, the Centre's objectives are to offer nationwide support to adults and families who have children with rare disabilities or special needs and to ensure their access to highly qualified information and counseling services; to network affected individuals and family members with other affected families thus promoting mutual support and self-help groups; to network health care professionals; and to promote dialogue and research and thus improve public knowledge and awareness of issues concerning rare diseases and disabilities. A wide range of information and counseling services is offered to all who, either as health professionals or as private persons, need information on rare diseases.
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Target groups are local professionals and authorities involved in the provision and coordination of counseling, treatment, education and support for persons affected by a rare disease and their families. Educational materials include pamphlets, brochures, and books in Danish. •
Disability Information and Resource Centre, Inc., South Australia Telephone: 08 8223 7522 Fax: 08 8223 5082 Email:
[email protected] Web Site: http://www.dircsa.org.au/ Background: The Disability Information and Resource Centre (DIRC), Inc., South Australia, was founded in 1982 to provide a centralized, independent organization capable of providing information relating to any aspect of disability. DIRC is an Incorporated body funded by the State Government. The Management Committee includes people with disabilities and representatives of organizations that provide services to people with disabilities. DIRC's role is to 'point people in the right direction' to end the confusion concerning where to go for information about disability and to refer people to the most appropriate places to meet their special needs. The organization offers information services to affected individuals, disability organizations, professionals, government departments, and any member of the public. DIRC provides a computerized information retrieval system as well as a library of books, videos, newsletters, and journals that offer information on disabilities in easy to understand language.
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Disability Rights Education and Defense Fund, Inc Telephone: (510) 644-2555 Toll-free: (800) 348-4232 Fax: (510) 841-8645 Email:
[email protected] Web Site: www.dredf.org Background: The Disability Rights Education and Defense Fund (DREDF) is a nonprofit national law and policy center dedicated to furthering the civil rights of people with disabilities. Managed and directed by people with disabilities and parents of children with disabilities, DREDF is an advocate for the rights of all people with disabilities. Established in 1979, the organization promotes the full integration of people with disabilities into the mainstream of society. Programs and services provided by DREDF include technical assistance, information, and referrals on disability rights, laws, and policies; training of and legal advocacy for parents of children with disabilities to help them secure the education and services guaranteed to their children by law; and legal representation to adults and children with disabilities in cases involving their rights to employment, education, transportation, housing, and access to public accommodations. Additional services include training and speakers for the disability community, public entities, and private businesses on the provisions of the Americans with Disabilities Act (ADA) and its relationship to other state and federal laws; education for legislators and policy makers on issues affecting the rights of people with disabilities; and a toll-free hot line that provides information concerning the ADA. DREDF also provides a blue book that offers a detailed analysis of the ADA and offers a video entitled 'Open For
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Business,' which depicts the disability and business communities of one small town working together. Relevant area(s) of interest: Disabilities •
ERIC Clearinghouse on Disabilities and Gifted Education Telephone: (703) 264-9475 Toll-free: (800) 328-0272 Fax: (703) 620-4334 Email:
[email protected] Web Site: http://ericec.org Background: The ERIC Clearinghouse on Disabilities and Gifted Education (ERIC EC) is part of the US Department of Education's information network. Founded in 1966, ERIC EC responds to requests for information on special/gifted education, serves as a resource and referral center for the general public, conducts general information searches, and publishes and disseminates free or low-cost information on special/gifted education research, programs, and practices.
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Family Resource Center on Disabilities Telephone: (312) 939-3513 Toll-free: (800) 952-4199 Fax: (312) 939-7297 Email: FRCD
[email protected] Web Site: None Background: The Family Resource Center on Disabilities (FRCD), formerly the Coordinating Council for Handicapped Children, is a not-for-profit advocacy organization. Established in 1969, the Center is dedicated to improving services for all children with disabilities by providing support and services to affected families, informing parents of their rights under the law, and helping parents become advocates for their children. The Center also seeks to educate and train health care professionals and volunteers. In 1976, the Family Resource Center on Disabilities was one of five pilot programs to operate a parent center funded by the U.S. Department of Education s Office of Special Education Programs. There are now more than 65 federally funded Parent Centers in the United States. The Center offers family support services, information and referral services, and transition services that prepare disabled high school students for adulthood. Special education rights training and the Parent-toParent Training Project help parents become effective advocates in their communities. The Center also offers a variety of educational and support materials. These include a regular newsletter, a pamphlet series, and manuals concerning the basics of organizing parent advocacy groups. Other publications distributed by the Center include the provisions of the Federal Rehabilitation Act and its amendments and current federal and state special education rules.
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Health Resource Center for Women with Disabilities Telephone: (312) 238-1000 Toll-free: (800) 354-7342 Fax: (312) 908-1087 Email:
[email protected] Web Site: None
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Background: The Health Resource Center for Women with Disabilities (HRCWD) is a national, not-for-profit, general health and service center that provides accessible medical services for women with disabilities, conducts research into health issues concerning disabled women, and offers educational resources for health care professionals and women with disabilities. Established in 1991 and located at the Rehabilitation Institute of Chicago, the HRCWD uses an interdisciplinary team approach that addresses the wide range of physical, psychosocial, and emotional issues that may affect women with disabilities. Its medical services for women with disabilities include consultative pregnancy services, family planning, mammography referrals, preventive health care counseling, parenting support, peer counseling, psychological and psychosocial services, and peer support groups. •
Institute for Health and Disability Telephone: (612) 624-3939 Toll-free: (800) 276-8642 Fax: (612) 624-2134 Email:
[email protected] Web Site: http://www.peds.umn.edu/Centers/ihd Background: The Institute for Health and Disability is a national organization that is housed in the University of Minnesota's Division of Pediatrics and Adolescent Health. It brings together research, training, and information dissemination projects and centers dedicated to the study and promotion of the psychological and social well-being of children with disabilities and their families. The Center for Children with Chronic Illness and Disability (C3ID) functions as a rehabilitation, research, and training center committed to increasing and applying knowledge that fosters the physical, psychological, and social development and confidence of children and adolescents with chronic illness and disability. Project Resilience is a longitudinal study of factors predicting competence in children with chronic conditions, and Special Ukids is a clinicbased demonstration project that provides care coordination for children with complex medical conditions. The Institute for Health and Disability provides a variety of resources for families, professionals, and agencies including The National Resource Library, a newsletter called 'Health Issues,' special reports, monographs, and a series of annotated bibliographies detailing research and resource information known as 'CYDLINE Reviews.'.
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Learning Disabilities Association of America Telephone: (412) 341-1515 Toll-free: (888) 300-6710 Fax: (412) 344-0224 Email:
[email protected] Web Site: http://www.ldaamerica.org Background: The Learning Disabilities Association of America (LDA) is a national notfor-profit voluntary and advocacy organization that was established in 1964 by a group of concerned parents. The only organization of its kind, the Association is dedicated to defining and finding solutions for the broad spectrum of learning disabilities (e.g., visual, auditory, motor, communication, and logical thinking problems). The Association has 50 state affiliates and more than 550 local chapters. Members include parents, professionals from many different disciplines, and other concerned citizens. The Association works directly with school systems in planning and implementing
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programs for the early identification and diagnosis of children with learning disabilities. The Learning Disabilities Association s Governmental Affairs Committee provides information and recommends action on pending legislation that may affect children with learning disabilities and/or their families. Educational materials produced by the Association include a newsletter published six times a year and numerous brochures, pamphlets, and books related to a variety of topics including adolescents with learning disabilities, LD assessment, and Attention Deficit Hyperactivity Disorder. LDA also publishes a biannual professional journal. •
Learning Disabilities Association of Canada Telephone: (613) 238-5721 Fax: (613) 235-5391 Email:
[email protected] Web Site: http://educ.queensu.ca/~lda Background: The Learning Disabilities Association of Canada (LDAC) is a not-forprofit organization dedicated to advancing the education, employment, social development, legal rights, and general well-being of people with learning disabilities. Established in 1963, LDAC consists of 10,000 members and 140 chapters. Educational materials include a quarterly newsletter entitled 'LDAC,' which features articles for parents, teachers, other professionals, and individuals with learning disabilities; a chapter development manual, which is a useful guide for groups interested in setting up local LDAC chapters in their area; and a video entitled 'About Us: Adults With Learning Disabilities' that consists of four adults with learning disabilities who speak about the difficulties, challenges, and achievements they have experienced. Program activities include patient advocacy, government legislation, and a database.
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National Arts and Disability Center Telephone: (310) 794-1141 Fax: (310) 794-1143 Email:
[email protected] Web Site: http://nadc.ucla.edu Background: The National Arts and Disability Center (NADC) is a federally funded project of the University of California, Los Angeles. Established in 1984, the NADC is an information and resource center focusing on promoting the full inclusion of children and adults with disabilities into the art community. NADC disseminates information and training to artists, families with a child with a disability, the art community, and community support personnel. Major activities of NADC are developing a database that contains listings of art centers, organizations, associations, art schools, programs, museums, libraries, foundations, and city, state, and federal departments concerned with the arts and disability; writing a curriculum for the provision of outreach training; and developing a reference library and database of books, videos, products, and other relevant literature.
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National Center for Learning Disabilities Telephone: (212) 545-7510 Toll-free: (888) 575-7373 Fax: (212) 545-9665
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Email: None. Web Site: http://www.ncld.org Background: The National Center for Learning Disabilities (NCLD) is a national voluntary not-for-profit organization dedicated to improving the lives of millions of Americans affected by learning disabilities. Established in 1977, NCLD works toward several goals: advocating for increased research in learning disabilities; providing information and support to teaching professionals so that they are better equipped to assist individuals with learning disabilities; advocating in Washington, DC on behalf of individuals with learning disabilities; and raising public awareness and understanding of learning disabilities throughout the lifespan. In addition, NCLD disseminates information to the public, medical professionals, and individuals with learning disabilities and offers local and regional referrals through an information and referral service. The Center for Learning Disabilities produces a wide variety of educational and support materials including brochures, pamphlets, videotapes, a newsletter, an annual magazine entitled 'Their World,' and assorted reports. •
National Dissemination Center for Children with Disabilities Telephone: (202) 884-8200 Toll-free: (800) 695-0285 Fax: (202) 884-8441 Email:
[email protected] Web Site: http://www.nichcy.org Background: The National Dissemination Center for Children with Disabilities (NICHCY) is an information clearinghouse that provides information on disabilities in children, education rights, and disability-related issues. Children and youth from birth to 22 are our special focus. NICHCY provides personal responses to questions on early intervention, special education, individualized education programs, as well as family and transitional issues. At NICHCY's website, www.nichcy.org., one can access all of our publications, as well as our online listing of national organizations, conferences, and library. Free and low-cost publications include resource sheets, fact sheets, briefing papers, and parent guides. Relevant area(s) of interest: Disabilities
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National Organization on Disability Telephone: (202) 293-5960 Fax: (202) 293-7999 Email:
[email protected] Web Site: http://www.nod.org Background: The National Organization on Disability (NOD) is a not-for-profit organization dedicated to promoting the full and equal participation of America s 49 million men, women, and children with disabilities in all aspects of life. NOD was founded in 1982 at the conclusion of the United Nations International Year of Disabled Persons. NOD is the only national disability network organization concerned with all disabilities, all age groups, and all disability issues. Consisting of 4,500 members and 250 chapters, NOD produces educational materials including fact sheets, brochures, a directory, and various booklets including 'From Barriers To Bridges' and 'Loving Justice.' Program activities include the Community Partnership Program, a nationwide
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network of towns, cities, and counties that promote the replication of effective local disability programs; the National Organization Partnership Program, which assists 35 national non-disability associations in promoting disability action programs among their local affiliates; the CEO Council, which promotes expanded employment of people with disabilities through recognition of corporate leaders and their companies; the Religion and Disability program, which helps congregations of all faiths become more accessible and welcoming to people with disabilities; the Start On Success (S.O.S) student internship program, which provides paid internships to high school students with disabilities to give them first time work experience and to increase their chances for future self-sufficiency; the Attitude Surveying Program, which provides reliable disability data on attitudes and stereotypes so that public acceptance will be more readily achieved; and the World Committee on Disability, NOD s international arm, which promotes commitment and action by international organizations and leaders of nations in furtherance of the United Nations World Programme Of Action Concerning Disabled Persons. Relevant area(s) of interest: Disabilities •
New Directions for People with Disabilities, Inc Telephone: (805) 967-2841 Toll-free: (888) 967-2841 Fax: (805) 964-7344 Email:
[email protected] Web Site: NewDirectionsTravel.com Background: New Directions for People with Disabilities, Inc., a not-for-profit organization established in 1985, is dedicated to providing local, national, and international travel and foreign exchange programs for people with disabilities. The purpose of the programs is to promote the understanding, acceptance, and appreciation of people with disabilities as important and contributing members of our society as well as to promote a sense of accomplishment, belonging, and self-worth for participants by providing a wide range of challenging activities. Such activities include skiing, river rafting, biking tours, and hot air ballooning. The Tour Guides/Chaperones are special educational instructors, recreation therapists, residential counselors, nurses, nurses aides, vocational and independent living skill counselors, and other professional staff who have been trained to work with people with disabilities. Each year, New Directions serves over 350 children, adults, and seniors who have developmental, emotional, and physical disabilities such as cerebral palsy, Down Syndrome, autism, schizophrenia, blindness, hearing impairment, and mental retardation. Participants live in state hospitals, board and care homes, residential treatment centers, and nursing homes. Most have not previously had a vacation, and many have not been away from their facilities or treatment centers for 10 or more years. New Directions annually sponsors trips in the United States and abroad to locations including Hawaii, Washington D.C., New York City, Las Vegas, Disneyland, the Grand Canyon, Australia, Ireland, Japan, and Mexico.
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University of Connecticut A.J. Pappanikou Center for DevelopmentalDisabilities Telephone: (860) 679-1500 Toll-free: (866) 623-1315 Fax: (860) 679-1571 Email:
[email protected]
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Web Site: www.uconnced.org Background: The University of Connecticut A.J. Pappanikou Center for Developmental Disabilities' mission is to work collaboratively to promote evidence-based practice and system change, and to provide information and support to benefit persons with disabilities and their families.
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to disability. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with disability. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about disability. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “disability” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “disability”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For
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publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “disability” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “disability” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.23
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
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Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)24: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
24
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries
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Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
251
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
252
DISABILITY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [EU] Absenteeism: Chronic absence from work or other duty. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acculturation: Process of cultural change in which one group or members of a group assimilates various cultural patterns from another. [NIH] ACE: Angiotensin-coverting enzyme. A drug used to decrease pressure inside blood vessels. [NIH]
Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue.
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Fat is usually stored in the form of tryglycerides. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Akinesia: 1. Absence or poverty of movements. 2. The temporary paralysis of a muscle by the injection of procaine. [EU] Alexia: The inability to recognize or comprehend written or printed words. [NIH]
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Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaemia: A reduction below normal in the number of erythrocytes per cu. mm., in the quantity of haemoglobin, or in the volume of packed red cells per 100 ml. of blood which
Dictionary 255
occurs when the equilibrium between blood loss (through bleeding or destruction) and blood production is disturbed. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analeptic: A drug which acts as a restorative, such as caffeine, amphetamine, pentylenetetrazol, etc. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Ankle Joint: The joint that is formed by the inferior articular and malleolar articular surfaces of the tibia, the malleolar articular surface of the fibula, and the medial malleolar, lateral malleolar, and superior surfaces of the talus. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anterior Cruciate Ligament: A strong ligament of the knee that originates from the posteromedial portion of the lateral condyle of the femur, passes anteriorly and inferiorly between the condyles, and attaches to the depression in front of the intercondylar eminence of the tibia. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH]
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Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticonvulsants: Drugs used to prevent seizures or reduce their severity. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antispasmodic: An agent that relieves spasm. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Aphasia: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Approximate: Approximal [EU] Apraxia: Loss of ability to perform purposeful movements, in the absence of paralysis or sensory disturbance, caused by lesions in the cortex. [NIH] Aqueous: Having to do with water. [NIH]
Dictionary 257
Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthropathy: Any joint disease. [EU] Arthroplasty: Surgical reconstruction of a joint to relieve pain or restore motion. [NIH] Articular: Of or pertaining to a joint. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-amino-acids is obtained by the hydrolysis of proteins. [NIH] Aspartic Acid: One of the non-essential amino acids commonly occurring in the L-form. It is found in animals and plants, especially in sugar cane and sugar beets. It may be a neurotransmitter. [NIH] Astringents: Agents, usually topical, that cause the contraction of tissues for the control of bleeding or secretions. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Audiometry: The testing of the acuity of the sense of hearing to determine the thresholds of the lowest intensity levels at which an individual can hear a set of tones. The frequencies between 125 and 8000 Hz are used to test air conduction thresholds, and the frequencies between 250 and 4000 Hz are used to test bone conduction thresholds. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Aural: Pertaining to or perceived by the ear, as an aural stimulus. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here)
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considered to be part of the autonomic nervous system itself. [NIH] Autopsy: Postmortem examination of the body. [NIH] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Back Injuries: General or unspecified injuries to the posterior part of the trunk. It includes injuries to the muscles of the back. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Barbiturate: A drug with sedative and hypnotic effects. Barbiturates have been used as sedatives and anesthetics, and they have been used to treat the convulsions associated with epilepsy. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Beta-pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Bifida: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived
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constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Conduction: Sound transmission through the bones of the skull to the inner ear. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brace: Any form of splint or appliance used to support the limbs or trunk. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Brain Ischemia: Localized reduction of blood flow to brain tissue due to arterial obtruction or systemic hypoperfusion. This frequently occurs in conjuction with brain hypoxia. Prolonged ischemia is associated with brain infarction. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
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Breakdown: A physical, metal, or nervous collapse. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bronchoconstriction: Diminution of the caliber of a bronchus physiologically or as a result of pharmacological intervention. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calibration: Determination, by measurement or comparison with a standard, of the correct value of each scale reading on a meter or other measuring instrument; or determination of the settings of a control device that correspond to particular values of voltage, current, frequency, or other output. [NIH] Cannabis: The hemp plant Cannabis sativa. Products prepared from the dried flowering tops of the plant include marijuana, hashish, bhang, and ganja. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carbon Disulfide: A colorless, flammable, poisonous liquid, CS2. It is used as a solvent, and is a counterirritant and has local anesthetic properties but is not used as such. It is highly toxic with pronounced CNS, hematologic, and dermatologic effects. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiology: The study of the heart, its physiology, and its functions. [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high
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blood pressure). [NIH] Career Choice: Selection of a type of occupation or profession. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catalogs: Ordered compilations of item descriptions and sufficient information to afford access to them. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Cellular metabolism: The sum of all chemical changes that take place in a cell through which energy and basic components are provided for essential processes, including the synthesis of new molecules and the breakdown and removal of others. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH]
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Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebral Hemorrhage: Bleeding into a cerebral hemisphere of the brain, including lobar, subcortical white matter, and basal ganglia hemorrhages. Commonly associated conditions include hypertension; intracranial arteriosclerosis; intracranial aneurysm; craniocerebral trauma; intracranial arteriovenous malformations; cerebral amyloid angiopathy; and cerebral infarction. [NIH] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]
Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrovascular Disorders: A broad category of disorders characterized by impairment of blood flow in the arteries and veins which supply the brain. These include cerebral infarction; brain ischemia; hypoxia, brain; intracranial embolism and thrombosis; intracranial arteriovenous malformations; and vasculitis, central nervous system. In common usage, the term cerebrovascular disorders is not limited to conditions that affect the cerebrum, but refers to vascular disorders of the entire brain including the diencephalon; brain stem; and cerebellum. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Child Advocacy: Promotion and protection of the rights of children; frequently through a legal process. [NIH] Child Care: Care of children in the home or institution. [NIH] Child Development: The continuous sequential physiological and psychological maturing of the child from birth up to but not including adolescence. It includes healthy responses to situations, but does not include growth in stature or size (= growth). [NIH]
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Child Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in children. [NIH] Child Welfare: Organized efforts by communities or organizations to improve the health and well-being of the child. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chiropractic: A system of treating bodily disorders by manipulation of the spine and other parts, based on the belief that the cause is the abnormal functioning of a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Ciliary Body: A ring of tissue extending from the scleral spur to the ora serrata of the retina. It consists of the uveal portion and the epithelial portion. The ciliary muscle is in the uveal portion and the ciliary processes are in the epithelial portion. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Civil Rights: Legal guarantee protecting the individual from attack on personal liberties, right to fair trial, right to vote, and freedom from discrimination on the basis of race, religion, national origin, age, or gender. [NIH] Cleft Lip: Congenital defect in the upper lip where the maxillary prominence fails to merge with the merged medial nasal prominences. It is thought to be caused by faulty migration of the mesoderm in the head region. [NIH] Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other
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medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Cohort Effect: Variation in health status arising from different causal factors to which each birth cohort in a population is exposed as environment and society change. [NIH] Colitis: Inflammation of the colon. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Communication Barriers: Those factors, such as language or sociocultural relationships, which interfere in the meaningful interpretation and transmission of ideas between individuals or groups. [NIH] Communication Disorders: Disorders of verbal and nonverbal communication caused by receptive or expressive language disorders, cognitive dysfunction (e.g., mental retardation), psychiatric conditions, and hearing disorders. [NIH] Community Mental Health Centers: Facilities which administer the delivery of psychologic and psychiatric services to people living in a neighborhood or community. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity
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may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Competency: The capacity of the bacterium to take up DNA from its surroundings. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray
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machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cones: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide sharp central vision and color vision. [NIH] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. The act of joining together or the state of being conjugated. 2. A sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. In chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with some substance in the body to form a detoxified product, which is then eliminated. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a
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pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Craniotomy: An operation in which an opening is made in the skull. [NIH] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]
Creatine Kinase: A transferase that catalyzes formation of phosphocreatine from ATP + creatine. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic isoenzymes have been identified in human tissues: MM from skeletal muscle, MB from myocardial tissue, and BB from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins. EC 2.7.3.2. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Criterion: A standard by which something may be judged. [EU] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH]
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Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cystitis: Inflammation of the urinary bladder. [EU] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Day Care: Institutional health care of patients during the day. The patients return home at night. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deinstitutionalization: The practice of caring for individuals in the community, rather than in an institutional environment with resultant effects on the individual, the individual's family, the community, and the health care system. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH]
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Dentists: Individuals licensed to practice dentistry. [NIH] Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Dexterity: Ability to move the hands easily and skillfully. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Foot: Ulcers of the foot as a complication of diabetes. Diabetic foot, often with infection, is a common serious complication of diabetes and may require hospitalization and disfiguring surgery. The foot ulcers are probably secondary to neuropathies and vascular problems. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disabled Persons: Persons with physical or mental disabilities that affect or limit their activities of daily living and that may require special accommodations. [NIH] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH]
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Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Dreams: A series of thoughts, images, or emotions occurring during sleep which are dissociated from the usual stream of consciousness of the waking state. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Dwarfism: The condition of being undersized as a result of premature arrest of skeletal growth. It may be caused by insufficient secretion of growth hormone (pituitary dwarfism). [NIH]
Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysarthria: Imperfect articulation of speech due to disturbances of muscular control which result from damage to the central or peripheral nervous system. [EU] Dyslexia: Partial alexia in which letters but not words may be read, or in which words may be read but not understood. [NIH] Dysphagia: Difficulty in swallowing. [EU]
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Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Echolalia: The pathological repetition by imitation of the speech of another. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Electroacupuncture: A form of acupuncture using low frequency electrically stimulated needles to produce analgesia and anesthesia and to treat disease. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH]
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Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Equinus Deformity: Plantar declination of the foot. [NIH] ERV: The expiratory reserve volume is the largest volume of gas that can be expired from the end-expiratory level. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrone: 3-Hydroxyestra-1,3,5(10)-trien-17-one. A metabolite of estradiol but possessing less biological activity. It is found in the urine of pregnant women and mares, in the human placenta, and in the urine of bulls and stallions. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), estrone may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of
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energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exercise Tolerance: The exercise capacity of an individual as measured by endurance (maximal exercise duration and/or maximal attained work load) during an exercise test. [NIH]
Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Expiratory Reserve Volume: The extra volume of air that can be expired with maximum effort beyond the level reached at the end of a normal, quiet expiration. Common abbreviation is ERV. [NIH] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]
External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] F Factor: A plasmid whose presence in the cell, either extrachromosomal or integrated into the bacterial chromosome, determines the "sex" of the bacterium, host chromosome mobilization, transfer via conjugation of genetic material, and the formation of sex pili. [NIH] Facial: Of or pertaining to the face. [EU] Facial Paralysis: Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. Facial nerve diseases generally results in generalized hemifacial weakness. Neuromuscular junction diseases and muscular diseases may also cause facial paralysis or paresis. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fathers: Male parents, human or animal. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
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Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibula: The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [NIH] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Flexor: Muscles which flex a joint. [NIH] Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Foetal: Of or pertaining to a fetus; pertaining to in utero development after the embryonic period. [EU] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH]
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Foot Ulcer: Lesion on the surface of the skin of the foot, usually accompanied by inflammation. The lesion may become infected or necrotic and is frequently associated with diabetes or leprosy. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Functional magnetic resonance imaging: A noninvasive tool used to observe functioning in the brain or other organs by detecting changes in chemical composition, blood flow, or both. [NIH]
Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Gait: Manner or style of walking. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetic Screening: Searching a population or individuals for persons possessing certain genotypes or karyotypes that: (1) are already associated with disease or predispose to disease; (2) may lead to disease in their descendants; or (3) produce other variations not known to be associated with disease. Genetic screening may be directed toward identifying phenotypic expression of genetic traits. It includes prenatal genetic screening. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of
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heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestures: Movement of a part of the body for the purpose of communication. [NIH] Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [NIH] Gifted: As used in child psychiatry, this term is meant to refer to a child whose intelligence is in the upper 2 per cent of the total population of his age. [NIH] Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Ginseng: An araliaceous genus of plants that contains a number of pharmacologically active agents used as stimulants, sedatives, and tonics, especially in traditional medicine. [NIH] Glare: Scatter from bright light that decreases vision. [NIH] Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Gonadorelin: A decapeptide hormone released by the hypothalamus. It stimulates the synthesis and secretion of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. [NIH] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Government Agencies: Administrative units of government responsible for policy making
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and management of governmental activities in the U.S. and abroad. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]
Group Homes: Housing for groups of patients, children, or others who need or desire emotional or physical support. They are usually established as planned, single housekeeping units in residential dwellings that provide care and supervision for small groups of residents, who, although unrelated, live together as a family. [NIH] Group Practice: Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Habituation: Decline in response of an organism to environmental or other stimuli with repeated or maintained exposure. [NIH] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Halitosis: An offensive, foul breath odor resulting from a variety of causes such as poor oral hygiene, dental or oral infections, or the ingestion of certain foods. [NIH] Handicap: A handicap occurs as a result of disability, but disability does not always constitute a handicap. A handicap may be said to exist when a disability causes a substantial and continuing reduction in a person's capacity to function socially and vocationally. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH]
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Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area. [NIH] Hearing aid: A miniature, portable sound amplifier for persons with impaired hearing, consisting of a microphone, audio amplifier, earphone, and battery. [NIH] Hearing Disorders: Conditions that impair the transmission or perception of auditory impulses and information from the level of the ear to the temporal cortices, including the sensorineural pathways. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemiparesis: The weakness or paralysis affecting one side of the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemophilia: Refers to a group of hereditary disorders in which affected individuals fail to make enough of certain proteins needed to form blood clots. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH]
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Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes virus: A member of the herpes family of viruses. [NIH] Herpes Zoster: Acute vesicular inflammation. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Home Care Services: Community health and nursing services providing coordinated multiple service home care to the patient. It includes home-offered services provided by a visiting nurse, home health agencies, hospitals, or organized community groups using professional staff for care delivery. It differs from home nursing which is provided by nonprofessionals. [NIH] Home Nursing: Nursing care given to an individual in the home. The care may be provided by a family member or a friend. Home nursing as care by a non-professional is differentiated from home care services provided by professionals: visiting nurse, home health agencies, hospital, or other organized community group. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hospice: Institution dedicated to caring for the terminally ill. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Housekeeping: The care and management of property. [NIH] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH]
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Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypotension: Abnormally low blood pressure. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hypoxic: Having too little oxygen. [NIH] Hysteria: Historical term for a chronic, but fluctuating, disorder beginning in early life and characterized by recurrent and multiple somatic complaints not apparently due to physical illness. This diagnosis is not used in contemporary practice. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]
Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Impulse Control Disorders: Disorders whose essential features are the failure to resist an impulse, drive, or temptation to perform an act that is harmful to the individual or to others. Individuals experience an increased sense of tension prior to the act and pleasure, gratification, or release of tension at the time of committing the act. [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU]
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Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Inguinal Hernia: A small part of the large or small intestine or bladder that pushes into the groin. May cause pain and feelings of pressure or burning in the groin. Often requires surgery. [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insecticides: Pesticides designed to control insects that are harmful to man. The insects may be directly harmful, as those acting as disease vectors, or indirectly harmful, as destroyers of crops, food products, or textile fabrics. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own
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psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Institutionalization: The caring for individuals in institutions and their adaptation to routines characteristic of the institutional environment, and/or their loss of adaptation to life outside the institution. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insurance Benefits: Payments or services provided under stated circumstances under the terms of an insurance policy. In prepayment programs, benefits are the services the programs will provide at defined locations and to the extent needed. [NIH] Insurance Pools: An organization of insurers or reinsurers through which particular types of risk are shared or pooled. The risk of high loss by a particular insurance company is transferred to the group as a whole (the insurance pool) with premiums, losses, and expenses shared in agreed amounts. [NIH] Insurance, Life: Insurance providing for payment of a stipulated sum to a designated beneficiary upon death of the insured. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interpersonal Relations: The reciprocal interaction of two or more persons. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervention Studies: Epidemiologic investigations designed to test a hypothesized causeeffect relation by modifying the supposed causal factor(s) in the study population. [NIH] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH]
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Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Aneurysm: A saclike dilatation of the walls of a blood vessel, usually an artery. [NIH]
Intracranial Embolism: The sudden obstruction of a blood vessel by an embolus. [NIH] Intracranial Embolism and Thrombosis: Embolism or thrombosis involving blood vessels which supply intracranial structures. Emboli may originate from extracranial or intracranial sources. Thrombosis may occur in arterial or venous structures. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intracranial Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Ischemic stroke: A condition in which the blood supply to part of the brain is cut off. Also called "plug-type" strokes. Blocked arteries starve areas of the brain controlling sight, speech, sensation, and movement so that these functions are partially or completely lost. Ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes. Most ischemic strokes are caused by a blood clot called a thrombus, which blocks blood flow in the arteries feeding the brain, usually the carotid artery in the neck, the major vessel bringing blood to the brain. When it becomes blocked, the risk of stroke is very high. [NIH] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH]
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Job Description: Statement of the position requirements, qualifications for the position, wage range, and any special conditions expected of the employee. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Juvenile Delinquency: The antisocial acts of children or persons under age which are illegal or lawfully interpreted as constituting delinquency. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] Language Development: The gradual expansion in complexity and meaning of symbols and sounds as perceived and interpreted by the individual through a maturational and learning process. Stages in development include babbling, cooing, word imitation with cognition, and use of short sentences. [NIH] Language Disorders: Conditions characterized by deficiencies of comprehension or expression of written and spoken forms of language. These include acquired and developmental disorders. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Learning Disorders: Conditions characterized by a significant discrepancy between an individual's perceived level of intellect and their ability to acquire new language and other cognitive skills. These disorders may result from organic or psychological conditions. Relatively common subtypes include dyslexia, dyscalculia, and dysgraphia. [NIH] Length of Stay: The period of confinement of a patient to a hospital or other health facility. [NIH]
Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Leukoencephalopathy: A condition with spongy holes in the brain's white matter. [NIH] Leuprolide: A potent and long acting analog of naturally occurring gonadotropin-releasing hormone (gonadorelin). Its action is similar to gonadorelin, which regulates the synthesis and release of pituitary gonadotropins. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to
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dopamine outside of the central nervous system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Life Cycle Stages: The continuous sequence of changes undergone by metamorphosing insects and other animals during the post-embryonic development process. [NIH] Life Expectancy: A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipolysis: The hydrolysis of lipids. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Local Government: Smallest political subdivisions within a country at which general governmental functions are carried-out. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH]
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Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]
Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Macula Lutea: An oval area in the retina, 3 to 5 mm in diameter, usually located temporal to the superior pole of the eye and slightly below the level of the optic disk. [NIH] Macular Degeneration: Degenerative changes in the macula lutea of the retina. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mammogram: An x-ray of the breast. [NIH] Mammography: Radiographic examination of the breast. [NIH] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked
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by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Marital Status: A demographic parameter indicating a person's status with respect to marriage, divorce, widowhood, singleness, etc. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medical Savings Accounts: Tax-exempt trusts or custodial accounts established by individuals with financial institutions for saving money for future medical expenses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Health Services: Organized services to provide mental health care. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior.
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[NIH]
Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Mesoderm: The middle germ layer of the embryo. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methylprednisolone: (6 alpha,11 beta)-11,17,21-Trihydroxy-6-methylpregna-1,4-diene-3,2dione. A prednisolone derivative which has pharmacological actions similar to prednisolone. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Milligram: A measure of weight. A milligram is approximately 450,000-times smaller than a pound and 28,000-times smaller than an ounce. [NIH] Mime: Facial expression. (NOT: mimicry = adaptation for survival in which an organism takes on the semblance another organism or a non-living object.) [EU] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of
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water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Minority Groups: A subgroup having special characteristics within a larger group, often bound together by special ties which distinguish it from the larger group. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH]
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Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Cortex: Area of the frontal lobe concerned with primary motor control. It lies anterior to the central sulcus. [NIH] Motor Neurons: Neurons which activate muscle cells. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multicenter Studies: Controlled studies which are planned and carried out by several cooperating institutions to assess certain variables and outcomes in specific patient populations, for example, a multicenter study of congenital anomalies in children. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]
Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myoglobin: A conjugated protein which is the oxygen-transporting pigment of muscle. It is made up of one globin polypeptide chain and one heme group. [NIH] Myositis: Inflammation of a voluntary muscle. [EU] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Neck dissection: Surgery to remove lymph nodes and other tissues in the neck. [NIH] Neck Pain: Discomfort or more intense forms of pain that are localized to the cervical
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region. This term generally refers to pain in the posterior or lateral regions of the neck. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]
Neurologic: Having to do with nerves or the nervous system. [NIH] Neurology: A medical specialty concerned with the study of the structures, functions, and diseases of the nervous system. [NIH] Neuroma: A tumor that arises in nerve cells. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropsychological Tests: Tests designed to assess neurological function associated with certain behaviors. They are used in diagnosing brain dysfunction or damage and central nervous system disorders or injury. [NIH] Neuropsychology: A branch of psychology which investigates the correlation between experience or behavior and the basic neurophysiological processes. The term neuropsychology stresses the dominant role of the nervous system. It is a more narrowly defined field than physiological psychology or psychophysiology. [NIH] Neurosurgeon: A doctor who specializes in surgery on the brain, spine, and other parts of the nervous system. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier
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nuclei during their decay. [NIH] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonmalignant: Not cancerous. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Assessment: Evaluation of the nature and extent of nursing problems presented by a patient for the purpose of patient care planning. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Nursing Services: A general concept referring to the organization and administration of nursing activities. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Occupational Exposure: The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation. [NIH] Occupational Health: The promotion and maintenance of physical and mental health in the work environment. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] On-line: A sexually-reproducing population derived from a common parentage. [NIH]
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Onychomycosis: Mycosis of the nails, possibly due to some extent to humidity. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Ossification: The formation of bone or of a bony substance; the conversion of fibrous tissue or of cartilage into bone or a bony substance. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteogenesis: The histogenesis of bone including ossification. It occurs continuously but particularly in the embryo and child and during fracture repair. [NIH] Osteomalacia: A condition marked by softening of the bones (due to impaired mineralization, with excess accumulation of osteoid), with pain, tenderness, muscular weakness, anorexia, and loss of weight, resulting from deficiency of vitamin D and calcium. [EU]
Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Otolaryngology: A surgical specialty concerned with the study and treatment of disorders of the ear, nose, and throat. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidants: Oxidizing agents or electron-accepting molecules in chemical reactions in which electrons are transferred from one molecule to another (oxidation-reduction). In vivo, it appears that phagocyte-generated oxidants function as tumor promoters or cocarcinogens rather than as complete carcinogens perhaps because of the high levels of endogenous antioxidant defenses. It is also thought that oxidative damage in joints may trigger the autoimmune response that characterizes the persistence of the rheumatoid disease process. [NIH]
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Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Oxygenase: Enzyme which breaks down heme, the iron-containing oxygen-carrying constituent of the red blood cells. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH]
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Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Advocacy: Promotion and protection of the rights of patients, frequently through a legal process. [NIH] Patient Care Planning: Usually a written medical and nursing care program designed for a particular patient. [NIH] Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Pentoxifylline: A methylxanthine derivative that inhibits phosphodiesterase and affects blood rheology. It improves blood flow by increasing erythrocyte and leukocyte flexibility. It also inhibits platelet aggregation. Pentoxifylline modulates immunologic activity by stimulating cytokine production. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perimetry: Determination of the extent of the visual field for various types and intensities of stimuli. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU]
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Perindopril: An angiotensin-converting enzyme inhibitor. It is used in patients with hypertension and heart failure. [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]
Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peripheral vision: Side vision; ability to see objects and movement outside of the direct line of vision. [NIH] Pernicious: Tending to a fatal issue. [EU] Pesticides: Chemicals used to destroy pests of any sort. The concept includes fungicides (industrial fungicides), insecticides, rodenticides, etc. [NIH] Phagocyte: An immune system cell that can surround and kill microorganisms and remove dead cells. Phagocytes include macrophages. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phonation: The process of producing vocal sounds by means of vocal cords vibrating in an expiratory blast of air. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorylated: Attached to a phosphate group. [NIH] Physical Medicine: A medical specialty concerned with the use of physical agents, mechanical apparatus, and manipulation in rehabilitating physically diseased or injured patients. [NIH] Physical Therapy: The restoration of function and the prevention of disability following
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disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]
Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]
Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plana: The radiographic term applied to a vertebral body crushed to a thin plate. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Platelet Activating Factor: A phospholipid derivative formed by platelets, basophils, neutrophils, monocytes, and macrophages. It is a potent platelet aggregating agent and inducer of systemic anaphylactic symptoms, including hypotension, thrombocytopenia, neutropenia, and bronchoconstriction. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form.
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Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures. [NIH] Polyneuropathies: Diseases of multiple peripheral nerves. The various forms are categorized by the type of nerve affected (e.g., sensory, motor, or autonomic), by the distribution of nerve injury (e.g., distal vs. proximal), by nerve component primarily affected (e.g., demyelinating vs. axonal), by etiology, or by pattern of inheritance. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Post-traumatic: Occurring as a result of or after injury. [EU] Post-traumatic stress disorder: A psychological disorder that develops in some individuals after a major traumatic experience such as war, rape, domestic violence, or accident. [NIH] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prejudice: A preconceived judgment made without adequate evidence and not easily alterable by presentation of contrary evidence. [NIH] Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or
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surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prescription drug abuse: Using two or more drugs interchangeably in an attempt to counteract the adverse effects of one with the other or to potentiate the effects of one with the other, so that an interdependent habit requiring both is formed. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] Prion: Small proteinaceous infectious particles that resist inactivation by procedures modifying nucleic acids and contain an abnormal isoform of a cellular protein which is a major and necessary component. [NIH] Private Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Progressive disease: Cancer that is increasing in scope or severity. [NIH] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Proprioception: The mechanism involved in the self-regulation of posture and movement through stimuli originating in the receptors imbedded in the joints, tendons, muscles, and labyrinth. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed
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and unexposed groups. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Proxy: A person authorized to decide or act for another person, for example, a person having durable power of attorney. [NIH] Pseudotumor Cerebri: A condition marked by raised intracranial pressure and characterized clinically by headaches; nausea; papilledema, peripheral constriction of the visual fields, transient visual obscurations, and pulsatile tinnitus. Obesity is frequently associated with this condition, which primarily affects women between 20 and 44 years of age. Chronic papilledema may lead to optic nerve injury (optic nerve diseases) and visual loss (blindness). [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychophysiology: The study of the physiological basis of human and animal behavior. [NIH]
Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the
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incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Opinion: The attitude of a significant portion of a population toward any given proposition, based upon a measurable amount of factual evidence, and involving some degree of reflection, analysis, and reasoning. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and
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interventional radiology or other planning and guiding medical radiology. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Radius: The lateral bone of the forearm. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU]
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Rehabilitation Centers: Facilities which provide programs for rehabilitating the mentally or physically disabled individuals. [NIH] Rehabilitative: Instruction of incapacitated individuals or of those affected with some mental disorder, so that some or all of their lost ability may be regained. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal Dialysis: Removal of certain elements from the blood based on the difference in their rates of diffusion through a semipermeable membrane. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Resident physician: A physician who lives in a hospital and is constantly available, as an intern. [NIH] Residential Facilities: Long-term care facilities which provide supervision and assistance in activities of daily living with medical and nursing services when required. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respirator: A mechanical device that helps a patient breathe; a mechanical ventilator. [NIH] Respite Care: Patient care provided in the home or institution intermittently in order to provide temporary relief to the family home care giver. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retrospective: Looking back at events that have already taken place. [NIH]
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Rheology: The study of the deformation and flow of matter, usually liquids or fluids, and of the plastic flow of solids. The concept covers consistency, dilatancy, liquefaction, resistance to flow, shearing, thixotrophy, and viscosity. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rheumatology: A subspecialty of internal medicine concerned with the study of inflammatory or degenerative processes and metabolic derangement of connective tissue structures which pertain to a variety of musculoskeletal disorders, such as arthritis. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Rickets: A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. [EU] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Rodenticides: Substances used to destroy or inhibit the action of rats, mice, or other rodents. [NIH]
Role-play: In this method, a conflict is artificially constructed, and the trainee is given a strategic position in it. [NIH] Root Caries: Dental caries involving the tooth root, cementum, or cervical area of the tooth. [NIH]
Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponin: A substance found in soybeans and many other plants. Saponins may help lower cholesterol and may have anticancer effects. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the
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bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Scopolamine: An alkaloid from Solanaceae, especially Datura metel L. and Scopola carniolica. Scopolamine and its quaternary derivatives act as antimuscarinics like atropine, but may have more central nervous system effects. Among the many uses are as an anesthetic premedication, in urinary incontinence, in motion sickness, as an antispasmodic, and as a mydriatic and cycloplegic. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selegiline: A selective, irreversible inhibitor of Type B monoamine oxidase. It is used in newly diagnosed patients with Parkinson's disease. It may slow progression of the clinical disease and delay the requirement for levodopa therapy. It also may be given with levodopa upon onset of disability. (From AMA Drug Evaluations Annual, 1994, p385) The compound without isomeric designation is Deprenyl. [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Self-Help Groups: Organizations which provide an environment encouraging social interactions through group activities or individual relationships especially for the purpose of rehabilitating or supporting patients, individuals with common health problems, or the elderly. They include therapeutic social clubs. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of
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old age. [NIH] Senility: Old age; the physical and mental deterioration associated with old age. [EU] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Sequence Analysis: A multistage process that includes the determination of a sequence (protein, carbohydrate, etc.), its fragmentation and analysis, and the interpretation of the resulting sequence information. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serrata: The serrated anterior border of the retina located approximately 8.5 mm from the limbus and adjacent to the pars plana of the ciliary body. [NIH] Serrated: Having notches or teeth on the edge as a saw has. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sharpness: The apparent blurring of the border between two adjacent areas of a radiograph having different optical densities. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sign Language: A system of hand gestures used for communication by the deaf or by people speaking different languages. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH]
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Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skilled Nursing Facilities: Extended care facilities which provide skilled nursing care or rehabilitation services for inpatients on a daily basis. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Isolation: The separation of individuals or groups resulting in the lack of or minimizing of social contact and/or communication. This separation may be accomplished by physical separation, by social barriers and by psychological mechanisms. In the latter, there may be interaction but no real communication. [NIH] Social Problems: Situations affecting a significant number of people, that are believed to be sources of difficulty or threaten the stability of the community, and that require programs of amelioration. [NIH] Social Security: Government sponsored social insurance programs. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure. [NIH] Software Design: Specifications and instructions applied to the software. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU]
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Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Speech Disorders: Acquired or developmental conditions marked by an impaired ability to comprehend or generate spoken forms of language. [NIH] Speech Perception: The process whereby an utterance is decoded into a representation in terms of linguistic units (sequences of phonetic segments which combine to form lexical and grammatical morphemes). [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spina bifida: A defect in development of the vertebral column in which there is a central deficiency of the vertebral lamina. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Injuries: Injuries involving the vertebral column. [NIH] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splint: A rigid appliance used for the immobilization of a part or for the correction of deformity. [NIH] Spondylitis: Inflammation of the vertebrae. [EU] Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Steady state: Dynamic equilibrium. [EU] Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Stereotactic: Radiotherapy that treats brain tumors by using a special frame affixed directly
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to the patient's cranium. By aiming the X-ray source with respect to the rigid frame, technicians can position the beam extremely precisely during each treatment. [NIH] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Steroids: Drugs used to relieve swelling and inflammation. [NIH] Stimulants: Any drug or agent which causes stimulation. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Strychnine: An alkaloid found in the seeds of nux vomica. It is a competitive antagonist at glycine receptors and thus a convulsant. It has been used as an analeptic, in the treatment of nonketotic hyperglycinemia and sleep apnea, and as a rat poison. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Substrate: A substance upon which an enzyme acts. [EU] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between
310
Disability
neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Talus: The second largest of the tarsal bones and occupies the middle and upper part of the tarsus. [NIH] Teaching Materials: Instructional materials used in teaching. [NIH] Telecommunications: Transmission of information over distances via electronic means. [NIH]
Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temperament: Predisposition to react to one's environment in a certain way; usually refers to mood changes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Thalidomide: A pharmaceutical agent originally introduced as a non-barbiturate hypnotic, but withdrawn from the market because of its known tetratogenic effects. It has been reintroduced and used for a number of immunological and inflammatory disorders. Thalidomide displays immunosuppresive and anti-angiogenic activity. It inhibits release of tumor necrosis factor alpha from monocytes, and modulates other cytokine action. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH]
Dictionary 311
Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tibia: The second longest bone of the skeleton. It is located on the medial side of the lower leg, articulating with the fibula laterally, the talus distally, and the femur proximally. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Plasminogen Activator: A proteolytic enzyme in the serine protease family found in many tissues which converts plasminogen to plasmin. It has fibrin-binding activity and is immunologically different from urinary plasminogen activator. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases. EC 3.4.21.68. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Tooth Loss: The failure to retain teeth as a result of disease or injury. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU]
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Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Plasminogen Activator: A proteolytic enzyme that converts plasminogen to plasmin where the preferential cleavage is between arginine and valine. It was isolated originally from human urine, but is found in most tissues of most vertebrates. EC 3.4.21.73. [NIH]
Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in
Dictionary 313
which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Ventilator: A breathing machine that is used to treat respiratory failure by promoting ventilation; also called a respirator. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is dependent mainly on the sharpness of the retinal focus. [NIH] Visual field: The entire area that can be seen when the eye is forward, including peripheral
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vision. [NIH] Visually Impaired Persons: Persons with loss of vision such that there is an impact on activities of daily living. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vocal cord: The vocal folds of the larynx. [NIH] Voice Disorders: Disorders of voice pitch, loudness, or quality. Dysphonia refers to impaired utterance of sounds by the vocal folds. [NIH] Void: To urinate, empty the bladder. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Vomica: The profuse and sudden expectoration of pus and putrescent matter. An abnormal cavity in an organ especially in the lung, caused by suppuration and the breaking down of tissue. [NIH] Walkers: Walking aids generally having two handgrips and four legs. [NIH] War: Hostile conflict between organized groups of people. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Infection: Invasion of the site of trauma by pathogenic microorganisms. [NIH] Xerostomia: Decreased salivary flow. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH]
315
INDEX A Abdominal, 252, 294, 312 Abdominal Pain, 252, 312 Aberrant, 142, 252 Abortion, 98, 252 Absenteeism, 165, 252 Accommodation, 136, 141, 192, 207, 209, 221, 222, 252 Acculturation, 15, 21, 29, 252 ACE, 207, 211, 252 Acetylcholine, 252, 291 Acoustic, 234, 252, 313 Acquired Immunodeficiency Syndrome, 215, 252 Activities of Daily Living, 4, 6, 7, 8, 10, 15, 16, 29, 106, 206, 252, 269, 303, 314 Acuity, 252, 257 Adaptation, 12, 73, 107, 150, 252, 282, 288 Adenine, 114, 252 Adipocytes, 252, 284 Adjustment, 5, 58, 61, 107, 108, 151, 252, 253 Adjuvant, 48, 253, 275 Adolescence, 75, 98, 253, 262 Adrenal Cortex, 253, 267, 272, 299 Adrenal Glands, 253, 254 Adrenal Medulla, 253, 261, 272, 292 Adrenergic, 253, 270, 272, 309 Adverse Effect, 253, 299, 306 Aerobic, 36, 253, 273 Aerobic Exercise, 36, 253 Afferent, 253, 284 Affinity, 253 Age Groups, 22, 29, 63, 240, 253 Aged, 80 and Over, 253 Agonist, 32, 253, 270 Akinesia, 113, 253 Alexia, 253, 270 Algorithms, 22, 23, 254, 259 Alkaloid, 254, 257, 264, 289, 305, 309 Alleles, 12, 69, 254 Allergen, 254, 306 Alternative medicine, 36, 230, 254 Amebiasis, 254, 288 Amino acid, 254, 255, 257, 267, 270, 276, 295, 296, 300, 306, 311, 312 Amino Acid Sequence, 254, 255 Amphetamines, 254, 264
Amplification, 166, 254 Amputation, 12, 30, 47, 48, 151, 160, 254 Amyloid, 142, 254, 262 Amyloidosis, 45, 142, 254 Anaemia, 254, 287 Anal, 16, 39, 40, 57, 59, 255, 274, 285 Analeptic, 255, 309 Analgesic, 36, 255, 289, 293 Analog, 255, 284 Anaphylatoxins, 255, 265 Anatomical, 255, 263, 280, 305 Androgens, 253, 255, 267 Anemia, 5, 255, 274 Anesthesia, 255, 271, 299 Anesthetics, 255, 258, 272 Ankle, 12, 19, 50, 161, 255 Ankle Joint, 19, 255 Anomalies, 151, 161, 162, 255, 290 Anorexia, 74, 254, 255, 293 Anterior Cruciate Ligament, 92, 255 Antibacterial, 255, 308 Antibiotic, 255, 299, 308 Antibodies, 154, 191, 197, 255, 256, 280, 286, 297 Antibody, 253, 256, 265, 279, 280, 281, 283, 289, 301, 302, 306, 314 Anticonvulsants, 48, 256 Antidepressant, 55, 57, 256 Antigen, 253, 255, 256, 265, 279, 280, 281, 306 Antigen-Antibody Complex, 256, 265 Anti-inflammatory, 256, 267, 276 Anti-Inflammatory Agents, 256, 267 Antineoplastic, 256, 267 Antioxidant, 48, 256, 293 Antispasmodic, 256, 293, 305 Anus, 255, 256, 259, 264, 283, 302 Anxiety, 43, 63, 66, 71, 74, 101, 117, 212, 227, 256, 294, 299 Anxiety Disorders, 256, 294 Aphasia, 162, 164, 219, 256 Apoptosis, 69, 256 Approximate, 24, 256 Apraxia, 162, 164, 256 Aqueous, 256, 258, 268, 271 Arterial, 64, 130, 257, 259, 262, 276, 280, 283, 300, 310 Arteries, 257, 259, 262, 266, 267, 283, 288
316
Disability
Arterioles, 257, 259 Arteriosclerosis, 257, 262 Arteriovenous, 257, 262 Artery, 131, 161, 257, 262, 267, 271, 283, 301, 304 Arthropathy, 161, 257 Arthroplasty, 81, 257 Articular, 28, 255, 257, 293 Articulation, 218, 257, 270 Aspartic, 143, 257 Aspartic Acid, 143, 257 Astringents, 257, 288 Atrophy, 45, 99, 100, 105, 113, 142, 257 Atropine, 257, 305 Atypical, 26, 163, 257 Audiometry, 4, 257 Auditory, 97, 238, 257, 278 Aural, 41, 257 Autoimmune disease, 257, 290 Autonomic, 252, 257, 292, 296, 298 Autonomic Nervous System, 257, 296 Autopsy, 25, 258 Axonal, 258, 298 Axons, 48, 258, 268 B Back Injuries, 58, 258 Back Pain, 46, 70, 79, 81, 94, 102, 119, 121, 124, 258 Bacteria, 255, 256, 258, 266, 271, 288, 297, 308, 311, 313 Bacterial Physiology, 252, 258 Bacterium, 258, 265, 266, 273 Barbiturate, 258, 310 Basal Ganglia, 258, 262 Base, 36, 59, 252, 258, 268, 284, 310 Basophils, 258, 297 Benign, 8, 112, 258, 277, 291, 302 Beta-pleated, 254, 258 Bifida, 258 Bilateral, 54, 258, 295 Bile, 258, 275, 285 Bile Acids, 258, 275 Biochemical, 254, 258, 293, 306 Biological response modifier, 258, 282 Biopsy, 258, 295 Biotechnology, 68, 71, 187, 230, 258 Bladder, 144, 162, 259, 265, 268, 275, 281, 290, 312, 314 Blood Glucose, 259, 278, 282 Blood pressure, 83, 150, 259, 261, 276, 280, 289, 296
Blood vessel, 138, 252, 259, 260, 262, 263, 283, 285, 296, 307, 309, 310, 313 Blood-Brain Barrier, 259, 284 Body Fluids, 259, 274, 292 Bone Conduction, 257, 259 Bone Marrow, 259, 280, 286, 289, 308 Bone scan, 259, 304 Bowel, 166, 255, 259, 269, 281, 309, 312 Bowel Movement, 259, 269, 309 Brace, 161, 259 Brachial, 259, 287 Brachial Plexus, 259, 287 Brachytherapy, 259, 282, 283, 301, 314 Brain Ischemia, 259, 262 Brain Stem, 143, 259, 261, 262 Branch, 205, 249, 259, 268, 275, 291, 295, 301, 308, 309, 310 Breakdown, 260, 261, 269, 275, 293 Bronchi, 260, 272 Bronchitis, 260, 263 Bronchoconstriction, 260, 297 Buccal, 260, 286 C Calcification, 64, 257, 260 Calcium, 260, 265, 288, 293, 294 Calibration, 27, 33, 260 Cannabis, 17, 260 Carbohydrate, 260, 267, 276, 306 Carbon Dioxide, 260, 274, 297, 303 Carbon Disulfide, 48, 260 Carcinogen, 260, 272, 288 Carcinogenic, 260, 281, 299 Cardiac, 260, 272, 290 Cardiology, 130, 260 Cardiopulmonary, 50, 260 Cardiorespiratory, 77, 253, 260 Cardiovascular, 16, 50, 63, 130, 151, 260, 273, 306 Cardiovascular disease, 63, 260 Career Choice, 221, 261 Carotene, 261, 303 Carpal Tunnel Syndrome, 136, 161, 261 Case report, 113, 261, 264 Catalogs, 191, 261 Catecholamine, 261, 270 Catheter, 138, 261 Caudal, 261, 269, 298 Causal, 22, 43, 61, 63, 261, 264, 282 Cause of Death, 29, 261 Cell Death, 256, 261 Cell Division, 258, 261, 268, 287, 289, 297, 299, 305
Index 317
Cell Transplantation, 261 Cellular metabolism, 48, 261 Central Nervous System, 252, 254, 257, 261, 262, 264, 275, 276, 277, 285, 289, 290, 291, 298, 305, 306 Central Nervous System Infections, 261, 277 Cerebellar, 261, 312 Cerebellar Diseases, 261, 312 Cerebellum, 261, 262, 298 Cerebral Cortex, 143, 262, 273, 274, 301 Cerebral hemispheres, 258, 259, 262, 310 Cerebral Hemorrhage, 142, 262 Cerebral Infarction, 262 Cerebral Palsy, 18, 48, 150, 151, 154, 162, 164, 168, 175, 198, 241, 262, 307 Cerebrovascular, 10, 29, 83, 143, 168, 219, 260, 262 Cerebrovascular Disorders, 143, 262 Cerebrum, 30, 262, 310 Cervical, 69, 87, 103, 117, 259, 262, 287, 290, 304 Cervix, 252, 262, 274 Character, 48, 262, 268 Chemotactic Factors, 262, 265 Child Advocacy, 214, 262 Child Care, 153, 156, 171, 262 Child Development, 153, 167, 262 Child Psychiatry, 263, 276 Child Welfare, 197, 263 Chin, 263, 287 Chiropractic, 122, 263 Cholesterol, 126, 258, 263, 267, 304 Chromatin, 256, 263, 292 Chromosomal, 161, 254, 263, 297, 304 Chromosome, 263, 266, 273, 285, 304, 305 Chronic Disease, 12, 26, 32, 39, 50, 60, 63, 64, 151, 228, 263 Chronic Obstructive Pulmonary Disease, 73, 263 Ciliary, 263, 306 Ciliary Body, 263, 306 Circadian, 114, 123, 263 Circulatory system, 263, 283 CIS, 263, 303 Civil Rights, 77, 192, 207, 209, 210, 211, 214, 215, 223, 236, 263 Cleft Lip, 161, 168, 263 Cleft Palate, 160, 263 Clinical Medicine, 263, 298 Clinical study, 263, 266
Clinical trial, 11, 17, 18, 24, 33, 45, 54, 65, 129, 132, 187, 264, 266, 270, 290, 300, 302 Cloning, 259, 264 Coca, 264 Cocaine, 17, 264 Cochlear, 264, 311, 313 Cochlear Diseases, 264, 311 Coenzyme, 114, 264 Cofactor, 48, 264, 300 Cognition, 21, 46, 60, 64, 66, 75, 264, 284 Cognitive restructuring, 43, 61, 264 Cohort Effect, 35, 264 Colitis, 264 Colon, 264, 281, 284, 312 Combination Therapy, 17, 264 Communication Barriers, 216, 264 Communication Disorders, 133, 158, 164, 167, 168, 175, 186, 219, 264 Community Mental Health Centers, 17, 264 Comorbidity, 40, 42, 76, 264 Competency, 9, 189, 265 Complement, 157, 255, 265, 306 Complementary and alternative medicine, 117, 118, 127, 265 Complementary medicine, 117, 265 Complete remission, 265, 303 Compliance, 5, 29, 39, 161, 171, 174, 209, 214, 265 Compress, 144, 265 Computational Biology, 187, 265 Computed tomography, 265, 304 Computer Simulation, 49, 266 Conception, 252, 266, 274 Conduction, 257, 266 Cones, 266, 303 Confounding, 23, 32, 58, 266 Conjugated, 266, 290 Conjugation, 266, 273 Connective Tissue, 259, 266, 274, 275, 276, 286, 304, 310 Consciousness, 255, 266, 268, 270, 300 Constitutional, 266, 290 Constriction, 266, 283, 300, 304, 313 Consultation, 59, 266 Consumption, 266, 269, 273, 292, 303 Contraindications, ii, 266 Control group, 48, 57, 71, 266 Controlled clinical trial, 36, 54, 55, 84, 266, 302 Coordination, 44, 91, 137, 233, 236, 238, 261, 266, 290
318
Disability
Coronary, 160, 260, 266, 267, 288 Coronary heart disease, 260, 267 Coronary Thrombosis, 267, 288 Corpus, 267, 299 Corpus Luteum, 267, 299 Cortex, 24, 46, 256, 267, 272 Cortical, 119, 267, 273, 305 Corticosteroid, 233, 267, 298 Cost Savings, 36, 267 Cranial, 261, 267, 277, 283, 296, 313 Craniocerebral Trauma, 262, 267, 277, 311 Craniotomy, 31, 267 Creatine, 142, 267 Creatine Kinase, 142, 267 Creatinine, 267 Criterion, 79, 267 Cues, 58, 162, 267 Curative, 268, 304, 310 Cutaneous, 268, 286 Cyclic, 66, 268, 296 Cystitis, 206, 268 Cytogenetics, 268, 304 Cytokine, 268, 295, 310 Cytoplasm, 256, 258, 268, 272, 289, 292 D Data Collection, 22, 34, 35, 44, 56, 268, 274 Day Care, 197, 268 Decision Making, 7, 55, 76, 176, 268 Degenerative, 142, 143, 268, 278, 286, 293, 304 Dehydration, 5, 90, 268 Deinstitutionalization, 96, 109, 196, 197, 268 Deletion, 256, 268 Delusions, 268, 300 Dementia, 4, 5, 6, 7, 8, 35, 44, 59, 66, 72, 142, 143, 189, 220, 252, 268 Dendrites, 268, 291 Density, 138, 268, 293 Dental Care, 158, 163, 212, 268 Dentate Gyrus, 268, 279 Dentists, 82, 269 Depersonalization, 269, 294, 305 Depressive Disorder, 53, 269, 285 Deprivation, 61, 269 Derealization, 269, 294 Developing Countries, 92, 269 Dexterity, 29, 168, 269 Diabetes Mellitus, 12, 151, 269, 276, 278 Diabetic Foot, 113, 269 Diagnostic procedure, 135, 220, 231, 269 Diastolic, 269, 280
Diencephalon, 262, 269, 310 Digestion, 258, 259, 269, 285, 309 Digestive system, 133, 269 Dilatation, 252, 269, 283 Direct, iii, 18, 24, 32, 44, 65, 152, 162, 210, 263, 269, 270, 276, 296, 302, 309 Disabled Persons, 13, 37, 50, 166, 240, 269 Discrete, 137, 269, 310 Discrimination, 9, 21, 49, 150, 155, 190, 193, 197, 207, 209, 210, 211, 214, 216, 263, 269 Disease Progression, 38, 39, 87, 100, 269 Disorientation, 5, 270 Dissection, 270 Distal, 47, 70, 142, 258, 270, 275, 296, 298, 300 Dizziness, 234, 270, 294, 313 Dopa, 270, 284 Dopamine, 137, 264, 270, 284, 289, 291, 296 Dorsal, 48, 136, 270, 298, 308 Double-blind, 17, 66, 84, 270 Dreams, 151, 270 Drive, ii, vi, 45, 111, 150, 153, 165, 166, 168, 169, 270, 280 Drug Interactions, 180, 270 Drug Tolerance, 270, 311 Dwarfism, 151, 270 Dyes, 254, 258, 270, 292 Dysarthria, 162, 270 Dyslexia, 162, 163, 165, 167, 227, 270, 284 Dysphagia, 157, 212, 270 Dysphoric, 269, 271 Dyspnea, 271, 294 E Echolalia, 176, 271 Edema, 30, 271, 283 Effector, 252, 265, 271, 296 Efficacy, 12, 14, 17, 26, 29, 31, 36, 43, 53, 54, 55, 61, 65, 66, 86, 137, 271 Elastic, 144, 271 Electroacupuncture, 36, 271 Electrolyte, 267, 271, 274, 289, 292 Elementary Particles, 271, 286, 291, 300 Emaciation, 252, 271 Embolus, 271, 281, 283 Embryo, 252, 271, 288, 293 Emphysema, 263, 271 Empirical, 4, 13, 45, 55, 61, 65, 68, 235, 271 Emulsion, 271, 274 Endogenous, 13, 270, 271, 272, 293 Endometrium, 271, 287 Endorphins, 271, 291
Index 319
Endotoxins, 265, 272 Energy balance, 272, 284 Enkephalins, 272, 291 Entorhinal Cortex, 272, 279 Environmental Exposure, 12, 272 Environmental Health, 130, 186, 188, 272 Enzymatic, 48, 254, 260, 261, 265, 272, 303 Enzyme, 252, 264, 271, 272, 276, 283, 289, 294, 296, 297, 300, 309, 311, 312 Epidemic, 63, 193, 272 Epidemiological, 27, 28, 63, 272 Epinephrine, 32, 253, 270, 272, 291, 292, 312 Equinus Deformity, 12, 272 ERV, 199, 272, 273 Erythrocytes, 254, 255, 259, 272, 302, 306 Esophagus, 269, 272, 275, 286, 296, 309 Estradiol, 272 Estrogen, 13, 272 Estrone, 18, 272 Ethnic Groups, 15, 36, 272 Evacuation, 30, 144, 154, 272 Excitation, 254, 272, 291 Excitatory, 143, 273, 276 Exercise Test, 273 Exercise Tolerance, 60, 273 Exogenous, 271, 273 Expiratory, 272, 273, 296 Expiratory Reserve Volume, 272, 273 Extensor, 273, 300 External-beam radiation, 273, 283, 301, 314 Extracellular, 254, 266, 273 Extrapyramidal, 137, 270, 273 Extravasation, 273, 278 Extremity, 10, 12, 34, 40, 46, 47, 62, 112, 161, 259, 273, 287, 295 Eye Movements, 59, 273 F F Factor, 238, 273 Facial, 93, 94, 99, 122, 234, 273, 288 Facial Paralysis, 94, 122, 273 Family Planning, 82, 187, 238, 273 Fat, 32, 115, 252, 259, 261, 267, 271, 273, 276, 284, 285, 290, 304 Fathers, 80, 85, 86, 205, 273 Fatigue, 107, 114, 138, 227, 273, 278 Femur, 255, 274, 311 Fetus, 252, 274, 297, 299, 313 Fibrin, 274, 297, 310, 311 Fibrosis, 132, 144, 274, 305 Fibula, 255, 274, 311
Fissure, 263, 268, 274 Fixation, 58, 274, 306 Flatus, 274, 275 Flexion, 136, 233, 274 Flexor, 12, 273, 274 Fluid Therapy, 274, 292 Focus Groups, 130, 274 Foetal, 101, 274 Folate, 274 Fold, 30, 59, 274 Folic Acid, 5, 274 Foot Ulcer, 269, 275 Forearm, 259, 275, 287, 302 Fovea, 274, 275 Free Radicals, 256, 275 Frontal Lobe, 262, 275, 290 Functional magnetic resonance imaging, 46, 275 Fundus, 274, 275 G Gait, 18, 19, 27, 49, 137, 261, 275 Gallbladder, 252, 269, 275 Ganglia, 48, 252, 275, 291, 296 Gas, 7, 260, 272, 274, 275, 279, 292, 313 Gastric, 275 Gastrin, 275, 279 Gastroesophageal Reflux, 158, 275 Gastrointestinal, 157, 272, 275, 306 Gelatin, 275, 276 Gene, 12, 35, 142, 205, 254, 259, 275, 305 General practitioner, 56, 275 Genetic Screening, 76, 275 Genetics, 33, 42, 76, 119, 266, 268, 275 Genotype, 14, 29, 276 Gestation, 276, 295, 297 Gestures, 159, 276, 306 Giardiasis, 276, 288 Gifted, 237, 276 Gingivitis, 163, 276 Ginseng, 113, 121, 276 Glare, 92, 276 Glucocorticoids, 253, 267, 276 Glucose, 32, 259, 269, 276, 278, 282 Glucose Intolerance, 269, 276 Glutamate, 143, 276 Glutamic Acid, 274, 276, 291 Glutathione Peroxidase, 276, 305 Glycine, 100, 143, 254, 276, 291, 306, 309 Gonadorelin, 276, 284 Gonadotropin, 32, 276, 284 Governing Board, 276, 298 Government Agencies, 171, 210, 276, 298
320
Disability
Grade, 23, 35, 46, 66, 93, 277 Graft, 277, 279 Grasses, 274, 277 Gravis, 168, 277 Groin, 277, 281 Group Homes, 6, 7, 277 Group Practice, 62, 277 H Habitual, 87, 262, 277 Habituation, 12, 277 Haemorrhage, 252, 277 Halitosis, 163, 277 Handicap, 3, 33, 41, 44, 78, 97, 109, 121, 129, 162, 167, 277 Headache, 85, 91, 105, 120, 277 Headache Disorders, 277 Health Care Costs, 277, 278 Health Education, 191, 194, 278 Health Expenditures, 45, 277, 278 Health Policy, 30, 44, 47, 90, 194, 196, 278 Health Promotion, 118, 228, 278 Health Services, 16, 45, 53, 77, 91, 96, 118, 226, 278 Health Status, 9, 10, 38, 61, 91, 166, 195, 264, 278 Health Surveys, 63, 278 Hearing aid, 41, 129, 278 Hearing Disorders, 264, 278 Heart attack, 260, 278 Heart failure, 278, 296 Hematoma, 31, 278 Heme, 278, 290, 294 Hemiparesis, 161, 278 Hemoglobin, 50, 255, 272, 278 Hemophilia, 161, 165, 278 Hemorrhage, 14, 267, 277, 278, 309 Hepatitis, 168, 278 Hepatocytes, 278 Hereditary, 142, 235, 278, 279 Heredity, 275, 276, 279 Herpes, 13, 279 Herpes virus, 13, 279 Herpes Zoster, 279 Heterogeneity, 64, 253, 279 Hippocampus, 143, 268, 279, 309 Home Care Services, 11, 279 Home Nursing, 279 Homologous, 254, 279, 305, 306, 309, 310 Hormonal, 12, 257, 267, 279 Hormone, 18, 32, 267, 270, 272, 275, 276, 279, 282, 284, 294, 299, 304, 311 Hospice, 5, 279
Host, 38, 175, 273, 279, 280, 313 Housekeeping, 277, 279 Hydration, 5, 279 Hydrogen, 258, 260, 276, 279, 289, 291, 294, 300 Hydrolysis, 257, 279, 285, 300 Hyperglycemia, 32, 279 Hypersensitivity, 254, 279, 304, 306 Hypertension, 31, 260, 262, 280, 283, 296 Hypnotic, 258, 280, 310 Hypotension, 280, 297 Hypoxia, 259, 262, 280 Hypoxic, 280, 288 Hysteria, 193, 280 I Id, 115, 125, 222, 229, 248, 250, 280 Idiopathic, 95, 280 Illusion, 280, 313 Immune response, 253, 256, 257, 267, 280, 306, 313 Immune Sera, 280 Immune system, 280, 286, 290, 296, 313 Immunity, 252, 280, 312 Immunization, 225, 280, 299, 306 Immunodeficiency syndrome, 154, 155, 156, 188, 191, 192, 193, 194, 195, 196, 197, 214, 280 Immunologic, 262, 280, 295, 302 Immunology, 253, 280 Implant radiation, 280, 282, 283, 301, 314 Impulse Control Disorders, 63, 280 Incision, 280, 283 Incompetence, 275, 280 Incontinence, 62, 144, 162, 281, 305 Indicative, 47, 281, 295, 313 Infancy, 281, 304 Infant, Newborn, 253, 281 Infarction, 30, 259, 262, 267, 281, 288 Inflammation, 136, 142, 256, 260, 263, 264, 268, 274, 275, 276, 278, 279, 281, 290, 296, 298, 304, 308, 309, 312, 313 Inflammatory bowel disease, 166, 281 Informed Consent, 14, 197, 281 Infusion, 54, 131, 281 Ingestion, 277, 281, 298 Inguinal, 81, 281 Inguinal Hernia, 81, 281 Initiation, 29, 32, 62, 233, 281 Inlay, 281, 303 Innervation, 259, 281, 287 Inotropic, 270, 281 Inpatients, 11, 46, 74, 281, 307
Index 321
Insecticides, 281, 296 Insight, 34, 60, 80, 281 Insomnia, 64, 282 Institutionalization, 8, 38, 282 Insulator, 282, 290 Insulin, 32, 165, 282 Insulin-dependent diabetes mellitus, 282 Insurance Benefits, 215, 282 Insurance Pools, 166, 282 Insurance, Life, 97, 282 Interferon, 100, 282 Interferon-alpha, 282 Intermittent, 48, 274, 282, 285 Internal Medicine, 18, 37, 59, 62, 282, 304 Internal radiation, 282, 283, 301, 314 Interpersonal Relations, 219, 282 Interstitial, 206, 259, 282, 283, 314 Intervention Studies, 95, 282 Intervertebral, 10, 282, 286 Intervertebral Disk Displacement, 282, 286 Intestines, 252, 275, 283 Intoxication, 283, 314 Intracellular, 142, 281, 283, 305 Intracranial Aneurysm, 14, 262, 283 Intracranial Embolism, 262, 283 Intracranial Embolism and Thrombosis, 262, 283 Intracranial Hypertension, 30, 277, 283, 311 Intracranial Pressure, 30, 283, 300 Intravenous, 10, 54, 113, 131, 281, 283 Intrinsic, 48, 253, 283 Invasive, 35, 280, 283, 286 Involuntary, 197, 283, 290, 302, 307 Ionizing, 272, 283, 302 Ions, 258, 271, 279, 283, 289 Irradiation, 87, 283, 314 Ischemia, 113, 257, 259, 283 Ischemic stroke, 131, 283 Isoenzyme, 267, 283 J Job Description, 210, 284 Joint, 19, 29, 45, 65, 77, 92, 97, 255, 257, 274, 284, 293, 308 Juvenile Delinquency, 161, 284 K Kb, 186, 284 L Labile, 265, 284 Labyrinth, 284, 299 Lag, 29, 284
Language Development, 163, 284 Language Disorders, 217, 264, 284 Large Intestine, 269, 283, 284, 302, 307 Latent, 23, 284, 298 Learning Disorders, 23, 202, 284 Length of Stay, 31, 284 Leprosy, 75, 114, 275, 284 Leptin, 18, 284 Leukoencephalopathy, 98, 284 Leuprolide, 32, 284 Levodopa, 112, 114, 270, 284, 305 Library Services, 248, 285 Life cycle, 17, 155, 189, 285 Life Cycle Stages, 155, 285 Life Expectancy, 28, 29, 35, 285 Ligament, 255, 285, 308 Linkage, 38, 140, 285 Lip, 94, 122, 138, 263, 285 Lipid, 257, 282, 285, 290 Lipolysis, 32, 285 Lithium, 17, 285 Liver, 168, 252, 254, 258, 269, 271, 274, 275, 276, 278, 285, 289, 304 Liver scan, 285, 304 Local Government, 40, 152, 155, 190, 192, 207, 209, 210, 214, 215, 285 Localized, 254, 259, 274, 278, 281, 285, 289, 290, 297, 312 Locomotion, 285, 297 Locomotor, 75, 99, 285 Longitudinal Studies, 23, 285 Longitudinal study, 17, 28, 43, 48, 61, 64, 65, 97, 238, 285 Long-Term Care, 15, 34, 37, 53, 112, 163, 225, 285 Loop, 141, 285 Low Back Pain, 35, 45, 58, 86, 102, 104, 122, 126, 286 Lower Esophageal Sphincter, 275, 286 Lumbar, 258, 282, 286 Lupus, 108, 131, 153, 286 Luteal Phase, 32, 286 Lymph, 262, 263, 286, 290 Lymph node, 262, 286, 290 Lymphatic, 281, 286, 308, 310 Lymphocyte, 252, 256, 286 Lymphocyte Count, 252, 286 Lymphoid, 255, 286 M Macula, 275, 286 Macula Lutea, 286 Macular Degeneration, 54, 286
322
Disability
Magnetic Resonance Imaging, 45, 286, 304 Magnetic Resonance Spectroscopy, 24, 286 Malignant, 252, 256, 286, 291, 302 Malnutrition, 113, 257, 286 Mammogram, 260, 286, 288 Mammography, 238, 286 Manic, 285, 286, 301 Manic-depressive psychosis, 286, 301 Manifest, 20, 46, 258, 287 Marital Status, 38, 287 Maxillary, 263, 287 Medial, 255, 257, 263, 287, 311 Median Nerve, 136, 261, 287 Mediate, 26, 44, 47, 61, 270, 287 Medical Records, 12, 25, 30, 287 Medical Savings Accounts, 225, 287 MEDLINE, 187, 287 Megaloblastic, 5, 274, 287 Meiosis, 287, 309, 310 Melanin, 287, 296, 312 Membrane, 265, 287, 290, 296, 303 Memory, 24, 27, 121, 162, 167, 171, 232, 255, 268, 287 Menopause, 32, 287, 298, 299 Menstrual Cycle, 32, 286, 287, 299 Menstruation, 286, 287 Mental Disorders, 45, 49, 63, 86, 133, 263, 287, 299, 300, 301 Mental Health Services, iv, 11, 40, 194, 199, 226, 287 Mental Processes, 287, 300 Mercury, 65, 288 Mesoderm, 263, 288 Meta-Analysis, 16, 75, 84, 288 Metabolite, 272, 288 Metastasis, 288, 291 Metastatic, 96, 288 Methylprednisolone, 233, 288 Metronidazole, 74, 288 MI, 86, 251, 288 Microbe, 288, 311 Microbiology, 80, 252, 257, 288 Microcalcifications, 260, 288 Microorganism, 264, 288 Migration, 21, 38, 263, 288 Milligram, 233, 288 Mime, 94, 122, 288 Mineralization, 288, 293 Mineralocorticoids, 253, 267, 288 Minority Groups, 165, 289 Mitosis, 256, 289
Mobility, 10, 13, 16, 18, 27, 34, 51, 52, 60, 62, 94, 118, 122, 137, 157, 163, 168, 171, 218, 222, 289 Mobilization, 273, 289 Modeling, 23, 25, 30, 39, 40, 41, 45, 48, 49, 289 Modification, 254, 289, 301 Molecular, 5, 142, 187, 200, 259, 265, 268, 289, 297, 311, 312 Molecular Structure, 289, 312 Molecule, 256, 258, 264, 265, 271, 273, 279, 289, 293, 294, 297, 302 Monitor, 20, 54, 267, 289 Monoamine, 289, 305 Monoamine Oxidase, 289, 305 Monoclonal, 283, 289, 301, 314 Monocytes, 289, 297, 310 Mood Disorders, 43, 289 Morphine, 112, 289, 290, 293 Morphological, 46, 68, 271, 289 Morphology, 68, 290 Motion Sickness, 290, 305 Motor Cortex, 24, 290 Motor Neurons, 24, 290 Mucosa, 286, 290 Mucus, 290, 312 Multicenter Studies, 55, 290 Multicenter study, 290 Multiple sclerosis, 12, 74, 84, 87, 99, 100, 103, 105, 112, 151, 168, 290 Muscular Diseases, 273, 290 Muscular Dystrophies, 151, 161, 168, 290 Myasthenia, 168, 290 Mydriatic, 290, 305 Myelin, 13, 290, 306 Myocardium, 288, 290 Myoglobin, 143, 290 Myositis, 141, 142, 290 N Narcotic, 289, 290 Nausea, 290, 294, 300 NCI, 1, 132, 133, 185, 263, 290 Neck dissection, 99, 290 Neck Pain, 87, 124, 290 Neoplasms, 252, 256, 291, 302 Networks, 21, 39, 291 Neural, 21, 46, 91, 114, 253, 254, 289, 291 Neuroanatomy, 44, 167, 291 Neurologic, 69, 85, 137, 198, 212, 232, 291 Neurology, 14, 15, 24, 30, 44, 47, 76, 84, 89, 93, 96, 99, 100, 105, 113, 114, 291 Neuroma, 234, 291
Index 323
Neuromuscular, 26, 140, 151, 252, 273, 291 Neuronal, 113, 291 Neurons, 143, 264, 268, 273, 275, 284, 290, 291, 309, 310, 313 Neuropathy, 12, 48, 160, 291, 296 Neuropsychological Tests, 14, 291 Neuropsychology, 44, 75, 291 Neurosurgeon, 31, 291 Neurotransmitter, 137, 143, 252, 254, 257, 270, 276, 291, 292 Neutrons, 283, 291, 301 Neutrophils, 292, 297 Nitrogen, 254, 255, 274, 292 Nonmalignant, 75, 292 Nonverbal Communication, 176, 264, 292, 301 Norepinephrine, 253, 270, 291, 292 Nuclei, 142, 266, 273, 286, 289, 291, 292, 300, 313 Nucleic acid, 292, 299 Nucleus, 256, 257, 258, 263, 268, 271, 282, 287, 289, 291, 292, 299, 300, 313 Nursing Assessment, 158, 292 Nursing Care, 191, 292, 295, 307 Nursing Services, 279, 292, 303 Nutritional Status, 21, 292 Nutritional Support, 157, 292 O Observational study, 14, 292 Occupational Exposure, 99, 292 Occupational Health, 38, 58, 99, 100, 292 Ocular, 92, 292 On-line, 59, 251, 292 Onychomycosis, 233, 234, 293 Opacity, 268, 293 Ophthalmology, 58, 88, 274, 293 Opiate, 289, 293 Opium, 289, 293 Opportunistic Infections, 252, 293 Opsin, 293, 303, 304 Oral Health, 161, 162, 168, 212, 218, 293 Oral Hygiene, 163, 212, 219, 277, 293 Orofacial, 212, 293 Ossification, 293, 304 Osteoarthritis, 10, 34, 45, 65, 70, 87, 89, 97, 101, 123, 126, 131, 163, 293 Osteogenesis, 168, 293 Osteomalacia, 168, 293 Osteoporosis, 64, 126, 168, 293 Otolaryngology, 7, 157, 293 Outpatient, 17, 60, 84, 189, 293 Ovulation, 286, 293
Ovum, 267, 276, 285, 293, 299 Oxidants, 48, 293 Oxidation, 256, 276, 293, 294 Oxidation-Reduction, 293, 294 Oxygenase, 104, 294 P Palate, 161, 168, 263, 294 Palliative, 5, 294, 310 Palpation, 136, 294 Palsy, 162, 164, 168, 294 Pancreas, 252, 269, 282, 294 Pancreatic, 275, 294 Pancreatic Juice, 275, 294 Panic, 193, 227, 294 Panic Disorder, 227, 294 Paralysis, 151, 253, 256, 273, 278, 294, 295, 307 Parathyroid, 294, 304 Parathyroid Glands, 294, 304 Paresis, 273, 295 Paresthesias, 294, 295 Parkinsonism, 105, 113, 284, 295 Partial remission, 295, 303 Pathogenesis, 24, 45, 142, 295 Pathologic, 256, 258, 267, 279, 295, 300, 313 Pathologic Processes, 256, 295 Pathophysiology, 18, 295 Patient Advocacy, 239, 295 Patient Care Planning, 292, 295 Patient Care Team, 176, 295 Patient Education, 206, 246, 248, 251, 295 Pelvic, 144, 295 Pelvis, 10, 286, 295, 312 Pentoxifylline, 132, 295 Peptide, 142, 254, 284, 295, 300 Perception, 42, 107, 108, 110, 269, 278, 295, 305 Percutaneous, 12, 36, 295 Perimetry, 88, 295 Perinatal, 76, 295 Perindopril, 83, 296 Periodontitis, 276, 296 Peripheral Nervous System, 143, 270, 272, 291, 294, 296 Peripheral Neuropathy, 12, 296 Peripheral Vascular Disease, 30, 130, 296 Peripheral vision, 296, 314 Pernicious, 287, 296 Pesticides, 65, 281, 296 Phagocyte, 293, 296 Phallic, 274, 296 Pharmacologic, 36, 46, 255, 296, 311
324
Disability
Pharynx, 275, 296 Phenylalanine, 127, 296, 312 Phonation, 167, 296 Phosphodiesterase, 295, 296 Phospholipids, 273, 296 Phosphorylated, 264, 296 Physical Medicine, 49, 72, 77, 97, 119, 296 Physical Therapy, 12, 35, 84, 90, 136, 151, 296 Physiologic, 21, 32, 38, 43, 50, 253, 270, 287, 297, 302, 312 Physiology, 260, 297 Pigmentation, 92, 297 Pigments, 261, 297, 303 Pilot Projects, 17, 297 Pilot study, 31, 54, 58, 65, 77, 99, 105, 297 Pitch, 297, 314 Pituitary Gland, 267, 276, 297 Placenta, 272, 297, 299 Plana, 297, 306 Plants, 254, 257, 260, 264, 276, 290, 292, 297, 304, 311 Plasma, 255, 275, 276, 278, 289, 297 Plasma cells, 255, 297 Plasmid, 273, 297 Plasmin, 297, 311, 312 Plasminogen, 297, 311, 312 Platelet Activating Factor, 45, 297 Platelet Aggregation, 255, 295, 297 Platelets, 297, 306, 310 Platinum, 285, 298 Pneumonia, 266, 298 Poisoning, 283, 288, 290, 298 Policy Making, 276, 298 Polyneuropathies, 78, 298 Pons, 259, 273, 298 Posterior, 141, 255, 258, 261, 270, 291, 294, 298 Postmenopausal, 229, 293, 298 Postprandial, 32, 298 Post-traumatic, 104, 277, 298 Post-traumatic stress disorder, 104, 298 Potentiate, 298, 299 Practice Guidelines, 199, 222, 298 Preclinical, 44, 60, 298 Precursor, 44, 142, 270, 271, 272, 284, 292, 296, 297, 298, 312 Predisposition, 161, 298, 310 Prednisolone, 288, 298 Prejudice, 49, 298 Premedication, 298, 305 Premenopausal, 32, 299
Prenatal, 271, 275, 299 Prescription drug abuse, 20, 299 Presynaptic, 291, 299 Primary Prevention, 4, 299 Prion, 142, 261, 299 Private Sector, 156, 209, 299 Problem Solving, 53, 55, 66, 299 Procaine, 253, 299 Progesterone, 54, 299 Progression, 7, 9, 12, 16, 21, 28, 37, 46, 50, 51, 60, 65, 95, 113, 137, 195, 208, 299, 305 Progressive, 21, 26, 48, 60, 87, 95, 105, 112, 137, 142, 268, 270, 277, 290, 293, 299 Progressive disease, 60, 299 Projection, 137, 292, 299 Promoter, 142, 299 Prophase, 299, 309, 310 Proprioception, 97, 299 Prospective study, 46, 47, 285, 299 Protease, 264, 300, 311 Protein S, 259, 300 Proteins, 142, 254, 256, 257, 263, 265, 267, 278, 289, 292, 295, 297, 300, 306 Proteolytic, 142, 265, 297, 300, 311, 312 Protocol, 31, 36, 83, 104, 168, 300 Protons, 279, 283, 286, 300, 301 Proximal, 140, 142, 270, 298, 299, 300 Proxy, 8, 300 Pseudotumor Cerebri, 283, 300 Psoriasis, 93, 300 Psychiatric, 6, 10, 25, 26, 40, 43, 65, 70, 74, 77, 80, 89, 95, 103, 154, 212, 224, 264, 287, 300 Psychic, 287, 300, 305 Psychoactive, 108, 300, 314 Psychology, 11, 22, 77, 78, 81, 82, 83, 100, 160, 291, 300 Psychopathology, 42, 96, 120, 121, 300 Psychophysiology, 291, 300 Psychosis, 10, 56, 300 Psychotherapy, 53, 55, 57, 301 Public Health, 4, 16, 18, 27, 28, 33, 34, 42, 53, 75, 79, 84, 90, 114, 163, 199, 301 Public Opinion, 25, 301 Public Policy, 63, 187, 189, 198, 301 Pulmonary, 130, 131, 151, 198, 259, 266, 273, 301, 313 Pulmonary Artery, 259, 301, 313 Pulse, 289, 301 Pyramidal Tracts, 273, 301 Q Quaternary, 301, 305
Index 325
R Race, 10, 25, 36, 58, 91, 207, 263, 270, 288, 301 Radiation, 132, 271, 272, 273, 275, 282, 283, 288, 301, 302, 305, 314 Radiation therapy, 273, 282, 283, 301, 314 Radioactive, 259, 279, 280, 282, 283, 285, 301, 304, 314 Radioisotope, 301, 312 Radiolabeled, 283, 301, 314 Radiological, 295, 301 Radiotherapy, 259, 283, 301, 302, 308, 314 Radius, 70, 302 Randomized, 12, 14, 18, 21, 26, 30, 32, 36, 43, 53, 54, 55, 61, 66, 83, 84, 87, 104, 112, 271, 302 Randomized clinical trial, 14, 43, 61, 302 Randomized Controlled Trials, 66, 302 Rape, 298, 302 Reality Testing, 300, 302 Receptor, 45, 143, 252, 256, 270, 302, 306 Rectal, 83, 302 Rectum, 256, 259, 264, 269, 274, 275, 281, 284, 302 Recurrence, 12, 57, 287, 302 Red blood cells, 272, 294, 302 Refer, 1, 222, 236, 260, 265, 270, 271, 274, 276, 279, 285, 286, 291, 301, 302, 311 Reflex, 273, 302 Refraction, 302, 308 Refractory, 30, 302 Regimen, 83, 87, 271, 302 Regurgitation, 163, 275, 302 Rehabilitation Centers, 172, 303 Rehabilitative, 5, 25, 30, 130, 151, 152, 191, 195, 222, 303 Relapse, 83, 84, 303 Reliability, 3, 8, 97, 107, 303 Remission, 48, 287, 302, 303 Renal Dialysis, 212, 303 Research Design, 44, 303 Resident physician, 49, 303 Residential Facilities, 170, 197, 303 Respiration, 260, 289, 303 Respirator, 175, 303, 313 Respite Care, 150, 303 Restoration, 87, 296, 303 Retina, 263, 266, 286, 303, 306 Retinal, 58, 303, 304, 313 Retinol, 303, 304 Retrospective, 7, 38, 303 Rheology, 295, 304
Rheumatic Diseases, 39, 81, 118, 122, 233, 304 Rheumatism, 75, 79, 87, 88, 95, 304 Rheumatoid, 9, 10, 28, 39, 69, 83, 87, 94, 97, 114, 126, 131, 293, 304 Rheumatoid arthritis, 10, 28, 69, 83, 87, 94, 97, 114, 304 Rheumatology, 9, 39, 70, 85, 94, 122, 304 Rhodopsin, 293, 303, 304 Rickets, 168, 304 Rigidity, 283, 295, 297, 304 Risk patient, 12, 304 Rodenticides, 296, 304 Role-play, 217, 304 Root Caries, 163, 304 S Salivary, 269, 304, 314 Salivary glands, 269, 304 Saponin, 121, 304 Satellite, 173, 304 Scans, 31, 304 Schizoid, 305, 314 Schizophrenia, 17, 68, 103, 143, 241, 305, 314 Schizotypal Personality Disorder, 269, 305, 314 Sclerosis, 12, 24, 74, 84, 85, 126, 164, 229, 257, 290, 305 Scopolamine, 121, 305 Screening, 7, 13, 26, 34, 60, 64, 69, 88, 98, 149, 205, 264, 275, 305 Scrotum, 144, 305, 310 Secretion, 267, 270, 276, 282, 289, 290, 305 Segregation, 69, 193, 197, 305 Seizures, 256, 305 Selegiline, 112, 114, 305 Selenium, 65, 305 Self Care, 121, 252, 305 Self-Help Groups, 197, 235, 305 Senile, 293, 305 Senility, 10, 306 Sensitization, 12, 306 Sensor, 139, 306 Sensory loss, 48, 306 Sequence Analysis, 50, 306 Serine, 306, 311 Serotonin, 289, 291, 306 Serrata, 127, 263, 306 Serrated, 306 Serum, 18, 29, 48, 54, 64, 255, 265, 267, 276, 280, 289, 306, 312 Sex Characteristics, 253, 255, 306
326
Disability
Sharpness, 306, 313 Shock, 48, 306, 312 Side effect, 10, 46, 48, 179, 181, 190, 206, 253, 306, 311 Sign Language, 158, 163, 174, 176, 306 Signs and Symptoms, 29, 303, 306 Skeletal, 142, 255, 267, 270, 290, 307 Skeleton, 274, 284, 307, 311 Skilled Nursing Facilities, 30, 307 Skull, 259, 267, 283, 307, 310 Sleep apnea, 307, 309 Small intestine, 276, 279, 281, 283, 307 Smooth muscle, 254, 255, 289, 290, 307 Social Environment, 5, 301, 307 Social Isolation, 21, 33, 305, 307 Social Problems, 7, 161, 307 Social Support, 21, 29, 51, 62, 101, 109, 307 Social Work, 5, 6, 53, 91, 118, 120, 235, 307 Socioeconomic Factors, 15, 307 Software Design, 163, 307 Solvent, 260, 307 Somatic, 253, 280, 287, 289, 296, 307 Spasm, 143, 256, 307 Spastic, 18, 307 Spasticity, 18, 151, 307 Specialist, 157, 159, 173, 242, 308 Species, 261, 272, 287, 288, 289, 301, 308, 312, 313 Spectrum, 5, 34, 44, 76, 164, 238, 308 Speech Disorders, 162, 164, 308 Speech Perception, 78, 308 Sphincter, 144, 308 Spina bifida, 48, 168, 308 Spinal Injuries, 168, 308 Spinal Nerves, 296, 308 Spleen, 254, 286, 308 Splint, 259, 308 Spondylitis, 85, 118, 131, 308 Sprains and Strains, 126, 286, 308 Staging, 304, 308 Steady state, 54, 308 Stem cell transplantation, 87, 308 Stem Cells, 308 Stereotactic, 86, 308 Sterilization, 77, 309 Steroids, 267, 309 Stimulants, 276, 309 Stimulus, 257, 270, 272, 281, 284, 295, 302, 309, 310 Stomach, 252, 269, 272, 275, 279, 283, 286, 290, 296, 307, 308, 309 Stool, 264, 281, 284, 309
Strychnine, 143, 309 Subacute, 281, 309 Subarachnoid, 14, 277, 309 Subclinical, 281, 305, 309 Subcutaneous, 136, 252, 271, 309 Subiculum, 279, 309 Substrate, 32, 309 Support group, 124, 150, 171, 238, 309 Suppression, 32, 120, 267, 309 Sympathomimetic, 270, 272, 292, 309 Symptomatic, 56, 65, 309 Symptomatology, 157, 309 Synapse, 253, 299, 309, 312 Synapsis, 309, 310 Synaptic, 143, 291, 309 Systemic, 85, 88, 131, 254, 259, 272, 281, 283, 297, 298, 301, 310, 312, 314 Systolic, 280, 310 T Talus, 255, 310, 311 Teaching Materials, 52, 310 Telecommunications, 152, 190, 207, 209, 210, 213, 310 Telencephalon, 258, 262, 310 Temperament, 27, 310 Temporal, 28, 35, 277, 278, 279, 286, 310 Tendon, 136, 307, 310 Testicles, 305, 310 Thalidomide, 161, 310 Therapeutics, 17, 122, 180, 289, 310 Thigh, 141, 277, 310 Thoracic, 258, 259, 287, 310 Threshold, 50, 280, 310 Thrombocytopenia, 297, 310 Thrombosis, 283, 300, 309, 310 Thrombus, 267, 281, 283, 297, 310 Thymus, 280, 286, 310 Thyroid, 294, 311, 312 Tibia, 255, 274, 311 Tin, 261, 296, 298, 311 Tinnitus, 234, 300, 311, 313 Tissue Plasminogen Activator, 131, 311 Tolerance, 50, 60, 276, 311 Tomography, 31, 266, 286, 304, 311 Tone, 4, 293, 307, 311 Tonus, 144, 311 Tooth Loss, 163, 311 Tooth Preparation, 252, 311 Torsion, 281, 311 Toxic, iv, 36, 257, 260, 266, 272, 277, 280, 291, 305, 311 Toxicity, 39, 110, 270, 288, 311
Index 327
Toxicology, 188, 311 Toxin, 18, 311 Tracer, 32, 312 Transfection, 259, 312 Transfer Factor, 280, 312 Transmitter, 252, 270, 292, 312 Transplantation, 280, 312 Trauma, 25, 29, 43, 47, 54, 69, 78, 85, 93, 94, 98, 121, 168, 234, 312, 314 Tremor, 105, 123, 295, 312 Triage, 43, 312 Trichomoniasis, 288, 312 Tricyclic, 48, 312 Tumor Necrosis Factor, 310, 312 Tyrosine, 127, 270, 312 U Ulcer, 12, 312 Ulcerative colitis, 166, 281, 312 Unconscious, 255, 280, 312 Urethra, 144, 312 Urinary, 144, 162, 268, 281, 305, 311, 312 Urinary Plasminogen Activator, 311, 312 Urinate, 144, 312, 314 Urine, 64, 144, 259, 267, 272, 281, 312 Uterine Contraction, 252, 312 Uterus, 252, 262, 267, 271, 274, 275, 287, 299, 312 V Vaccine, 168, 227, 253, 300, 313 Vascular, 5, 262, 269, 277, 281, 297, 310, 313 Vasculitis, 88, 262, 313 Vasoconstriction, 272, 313
Vasodilator, 270, 313 VE, 25, 86, 130, 171, 313 Vein, 257, 283, 304, 313 Ventilator, 303, 313 Ventricle, 279, 301, 310, 313 Venules, 259, 313 Vertebrae, 282, 308, 313 Vertebral, 258, 297, 308, 313 Vertigo, 234, 313 Vestibulocochlear Nerve, 311, 313 Vestibulocochlear Nerve Diseases, 311, 313 Veterinary Medicine, 187, 313 Virulence, 311, 313 Visual Acuity, 59, 313 Visual field, 58, 219, 295, 300, 313 Visually Impaired Persons, 58, 314 Vivo, 293, 314 Vocal cord, 296, 314 Voice Disorders, 167, 314 Void, 22, 314 Volition, 283, 314 Vomica, 309, 314 W Walkers, 10, 314 War, 101, 298, 314 Withdrawal, 26, 314 Wound Infection, 12, 314 X Xerostomia, 163, 314 X-ray, 18, 93, 265, 283, 286, 301, 302, 305, 309, 314 X-ray therapy, 283, 314
328
Disability
