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This article is from The Open Orthopaedics Journal , volume 8 . Abstract Study Design:: Prospective longitudinal validation study Objective:: To translate and cross-culturally adapt the Oswestry Disability Index (ODI) to the Tamil language (ODI-T), and to evaluate its reliability and construct validity. Summary of Background Data:: ODI is widely used as a disease specific questionnaire in back pain patients to evaluate pain and disability. A thorough literature search revealed that the Tamil version of the ODI has not been previously published. Methods:: The ODI was translated and cross-culturally adapted to the Tamil language according to established guidelines. 30 subjects (16 women and 14 men) with a mean age of 42.7 years (S.D. 13.6; Range 22 - 69) with low back pain were recruited to assess the psychometric properties of the ODI-T Questionnaire. Patients completed the ODI-T, Roland-Morris disability questionnaire (RMDQ), VAS-pain and VAS-disability at baseline and 24-72 hours from the baseline visit. Results:: The ODI-T displayed a high degree of internal consistency, with a Cronbach's alpha of 0.92. The test-retest reliability was high (n=30) with an ICC of 0.92 (95% CI, 0.84 to 0.96) and a mean re-test difference of 2.6 points lower on re-test. The ODI-T scores exhibited a strong correlation with the RMDQ scores (r = 0.82) p

The medical disability evaluation process for Army Soldiers has been a source of significant confusion and frustration for many years. Although the United States Army Physical Disability Agency was not established until 1967, the historical roots contributing to this problem can be traced to the post-Civil War era. The increased number of Soldiers requiring disability consideration as a result of injuries sustained during current contingency operations has brought renewed attention to this long-standing problem. The current process is cobbled together by multiple governing Statutes, Defense Directives, Defense Instructions, and Army Regulations. Reform of the Physical Disability Evaluation System (PDES) that severs disability adjudication from the Army will promote improved process efficiency without decrement in the access or quality of medical care provided to Wounded, Ill, and Injured (WII) Soldiers. It will clarify the delineation of responsibilities that allows the Army to focus on medical treatment and fitness for duty. Further, it will present the opportunity to re-evaluate and potentially revise national compensation and benefits policy for retired disabled veterans.

The medical disability evaluation process for Army Soldiers has been a source of significant confusion and frustration for many years. Although the United States Army Physical Disability Agency was not established until 1967, the historical roots contributing to this problem can be traced to the post-Civil War era. The increased number of Soldiers requiring disability consideration as a result of injuries sustained during current contingency operations has brought renewed attention to this long-standing problem. The current process is cobbled together by multiple governing Statutes, Defense Directives, Defense Instructions, and Army Regulations. Reform of the Physical Disability Evaluation System (PDES) that severs disability adjudication from the Army will promote improved process efficiency without decrement in the access or quality of medical care provided to Wounded, Ill, and Injured (WII) Soldiers. It will clarify the delineation of responsibilities that allows the Army to focus on medical treatment and fitness for duty. Further, it will present the opportunity to re-evaluate and potentially revise national compensation and benefits policy for retired disabled veterans.

Government Publishing Office U.S. Congress House of Representatives Committee on Oversight and Government Reform ONE YEAR AFTER WALTER REED: AN INDEPENDENT ASSESSMENT OF THE CARE, SUPPORT, AND DISABILITY EVALUATION FOR WOUNDED SOLDIERS Date(s) Held: 2008-02-27 110th Congress, 2nd Session GPO Document Source: CHRG-110hhrg50228 Superintendents of Documents ID: Y 4.G 74/7 Related Items: Congressional Serial No. 110-176

Government Publishing Office U.S. Congress Senate Committee on Veterans' Affairs REVIEW OF THE VA AND DOD INTEGRATED DISABILITY EVALUATION SYSTEM Date(s) Held: 2010-11-18 111th Congress, 2nd Session GPO Document Source: CHRG-111shrg65146 Superintendents of Documents ID: Y 4.V 64/4 Witnesses: Bertoni, Daniel, Director of Education, Workforce, and Income Security Issues, U.S. Government Accountability Office Campbell, John R., Deputy Under Secretary, Office of Wounded Warrior Care and Transition Policy, U.S. Department of Defense Medve, John, Executive Director of VA/DOD Collaboration Service, Office of Policy and Planning, U.S. Department of Veterans Affairs Related Items:

Government Publishing Office U.S. Congress Senate Committee on Veterans' Affairs REVIEW OF THE VA AND DOD INTEGRATED DISABILITY EVALUATION SYSTEM Date(s) Held: 2010-11-18 111th Congress, 2nd Session GPO Document Source: CHRG-111shrg65146 Superintendents of Documents ID: Y 4.V 64/4 Witnesses: Bertoni, Daniel, Director of Education, Workforce, and Income Security Issues, U.S. Government Accountability Office Campbell, John R., Deputy Under Secretary, Office of Wounded Warrior Care and Transition Policy, U.S. Department of Defense Medve, John, Executive Director of VA/DOD Collaboration Service, Office of Policy and Planning, U.S. Department of Veterans Affairs Related Items:

ABSTRACT Aims: The aim of this study was to evaluate the incidence and prevalence of pneumoconiosis, pneumoconiosis-related disability-adjusted life years (DALY) score, deaths and risk factors by gender and year in Türkiye. Methods: In this study, the estimation data prepared by the Institute for Health Metrics and Evaluation (IHME) for Türkiye in the global burden of disease study covering the years 1990-2021 were used. Descriptive statistics are given as mean and standard deviation. Comparisons according to gender were made with Independent Samples t test. The relationships between numerical variables were analyzed by Pearson correlation coefficient (r). Results: A total of 1755 pneumoconiosis-related deaths occurred in Türkiye between 1990 and 2021. Of the deaths, 687 (39%) were due to silicosis, 489 (28%) to coal worker pneumoconiosis, 451 (26%) to asbestosis and 128 (7%) to other pneumoconiosis. Of those who died, 1619 (92%) were men. The DALY score, incidence and prevalence are also higher in men. The most common risk factor affecting men is silica exposure, while for women it is asbestos exposure. After 2016, incidence and prevalence are decreasing. Conclusion: Pneumoconiosis is more fatal in men and in the 65-80 age group. The effects of the disease vary across countries and even regions within the same country. It is important to take these differences into account in future research on pneumoconiosis. Regulation of working environments in sectors known to cause the disease will both ensure that people are less affected by an important occupational disease and prevent loss of workforce.

The Micro-TOWER System of Vocational Evaluation includes work samples for assessing vocational skills, presentations of occupational information, behavioral observations, and group discussions focusing on vocational goals and related concerns. It has been field tested on over 1,200 persons at eighteen sites, including rehabilitation facilities, psychiatric hospitals, correctional facilities, and a school for the mentally retarded. Thirteen work sample tests are designed to measure five skill areas: Verbal (Want Ads Comprehension, Message Taking), Numerical (Payroll) Computation, Making Change), Motor (Bottle Capping, Packing, Electronic Connector Assembly, Lamp Assembly), Spatial (Blueprint Reading, Graphics Illustration), and Clerical Perception (Mail Sorting, Filing, Zip Coding, Record Checking). This report presents data comparing the performance of a variety of special disability groups to the performance of the general rehabilitation group, which includes all of the individuals who participated in the field testing. Performance data are summarized for groups of the physically disabled, emotionally disturbed, educable mentally retarded, brain-injured, adult offenders, ex-alcoholics, Spanish-speaking, visually handicapped, and deaf. (Author/BW)

The Micro-TOWER System of Vocational Evaluation includes work samples for assessing vocational skills, presentations of occupational information, behavioral observations, and group discussions focusing on vocational goals and related concerns. It has been field tested on over 1,200 persons at eighteen sites, including rehabilitation facilities, psychiatric hospitals, correctional facilities, and a school for the mentally retarded. Thirteen work sample tests are designed to measure five skill areas: Verbal (Want Ads Comprehension, Message Taking), Numerical (Payroll) Computation, Making Change), Motor (Bottle Capping, Packing, Electronic Connector Assembly, Lamp Assembly), Spatial (Blueprint Reading, Graphics Illustration), and Clerical Perception (Mail Sorting, Filing, Zip Coding, Record Checking). This report presents data comparing the performance of a variety of special disability groups to the performance of the general rehabilitation group, which includes all of the individuals who participated in the field testing. Performance data are summarized for groups of the physically disabled, emotionally disturbed, educable mentally retarded, brain-injured, adult offenders, ex-alcoholics, Spanish-speaking, visually handicapped, and deaf. (Author/BW)

U.S. Army disability records processed in Fiscal Year 1996 were examined for variables affecting processing and adjudication time. The dependent variable examined was days. Independent variables included age, race, gender, grade, component, length of service, retirement eligibility, request for congressional involvement, request for formal physical evaluation board (PEB), compensation award and regional PEB. The research suggests the Physical Disability Evaluation System (PDES) is remarkably fair and unbiased in terms of the process and process duration. Variations in individual disability awards were not examined. Recommendations for improving the PDES center on a systems oriented approach to disability management as a concept of integrated health care delivery.

One focus of the Australian Government's social inclusion agenda is to help people with a disability into work. The government's new National Mental Health and Disability Employment Strategy acknowledges that a considerable barrier to employment for people with a disability is the lack of information for employers. It is therefore timely to examine employer views on employing people with a disability. Based on a series of focus groups with employers from small-to-medium-sized enterprises, this report describes the attitudes of employers towards hiring a person with a disability. It also sets out some strategies that would assist businesses to take on employees with a disability. The research confirmed that, even when employers are open to the idea of employing a person with a disability, they are often not confident that they have the knowledge, understanding and capability to do so. Employers are not looking for formal training in "disability employment." They are looking for assistance in building their capacity to support the productive employment of people with a disability. The vocational education and training (VET) system already helps employers to employ people with disabilities (by providing group training organisation field officers, for example), but this report suggests a broader role could be developed. Inevitably, this would require financial support from governments. (Contains 2 figures.) [For the support document, see ED508545.]

This article is from Trials , volume 15 . Abstract Background: Despite growing interest in the importance of, and challenges associated with the involvement of patient and population (IPP) in the process of developing and adapting clinical practice guidelines (CPGs), there is a lack of knowledge about the best method to use. This is especially problematic in the field of rehabilitation, where individuals with disabilities might face many barriers to their involvement in the guideline development and adaptation process. The goal of this pilot trial is to document the acceptability, feasibility and effectiveness of two methods of involving patients with a disability (traumatic brain injury) in CPG development. Methods/Design: A single-blind, randomized, crossover pragmatic trial will be performed with 20 patients with traumatic brain injury (TBI). They will be randomized into two groups, and each will try two alternative methods of producing recommendations; a discussion group (control intervention) and a Wiki, a webpage that can be modified by those who have access to it (experimental intervention). The participants will rate the acceptability of the two methods, and feasibility will be assessed using indicators such as the number of participants who accessed and completed the two methods, and the number of support interventions required. Twenty experts, blinded to the method of producing the recommendations, will independently rate the recommendations produced by the participants for clarity, accuracy, appropriateness and usefulness. Discussion: Our trial will allow for the use of optimal IPP methods in a larger project of adapting guidelines for the rehabilitation of individuals with TBI. Ultimately the results will inform the science of CPG development and contribute to the growing knowledge about IPP in rehabilitation settings. Trial registration: Clinical trial KT Canada 87776.

This article is from Neuropsychiatric Disease and Treatment , volume 10 . Abstract Inattention and impulsivity symptoms are common among adults with attention-deficit/hyperactivity disorder (ADHD), which can lead to difficulty concentrating, restlessness, difficulty completing tasks, disorganization, impatience, and impulsiveness. Many adults with ADHD find it difficult to focus and prioritize. Resulting outcomes, such as missed deadlines and forgotten engagements, may ultimately impact the ability to function at work, school, home, or in a social environment. The European Medicines Agency guidelines for evaluating medicinal products for ADHD recommend inclusion of both functional outcomes, such as school, social, or work functioning, and outcomes related to symptoms of ADHD in clinical studies of novel medication primary efficacy endpoints. Due to its performance in other disease areas and the relevance of its items as evidenced by content validity analyses, the Sheehan Disability Scale (SDS) was chosen to assess functional impairment in ADHD. The aim of this study was to investigate the psychometric properties of the SDS, used as a brief measure of functional impairment in a number of psychiatric disorders, in adult patients with ADHD. To the authors’ knowledge, this is the first study to evaluate the reliability of the SDS (based on Cronbach’s coefficient alpha and test-retest reliability), its validity (construct and known-groups validity), and its ability to detect change in this patient population. This study also established a preliminary responder definition for the SDS in this study population to determine when change can be considered clinically beneficial in a clinical trial setting. The psychometric results support the use of the SDS subscales (items 1–3) and total score (sum of items 1–3) in an ADHD population. In addition, the evaluation provides evidence for a three-point preliminary responder definition for the SDS and further evidence of its responsiveness in adults with ADHD. Altogether, the results indicate that the SDS is a simple and easy-to-score scale that would have great utility in future clinical trials for monitoring functional impairment in adults with ADHD.

AMSARA has provided the Department of Defense with evidence-based evaluations of accession medical standards since 1996. As part of this ongoing research activity, data are collected from each service's Disability Evaluation System (DES). AMSARA's mission was expanded in fiscal year (FY) 2009 to include audits and studies of existing DES by the request of the Office of Assistant Secretary of Defense, Health Affairs. The Disability Evaluation System Analysis and Research Annual Report includes descriptive statistics on the population presenting for disability evaluation by service and describes pre-accession morbidity in this population. Brief descriptions of ongoing special studies and publications, as well as recommendations for disability evaluation and database management, are also given. This report describes analyses conducted in fiscal year 2014 of existing DES data collected for accessions and disability research through the end of FY 2013.

AMSARA has provided the Department of Defense with evidence-based evaluations of accession medical standards since 1996. As part of this ongoing research activity, data are collected from each service's Disability Evaluation System (DES). AMSARA's mission was expanded in fiscal year (FY) 2009 to include audits and studies of existing DES by the request of the Office of Assistant Secretary of Defense, Health Affairs. The Disability Evaluation System Analysis and Research Annual Report includes descriptive statistics on the population presenting for disability evaluation by service and describes pre-accession morbidity in this population. Brief descriptions of ongoing special studies and publications, as well as recommendations for disability evaluation and database management, are also given. This report describes analyses conducted in fiscal year 2014 of existing DES data collected for accessions and disability research through the end of FY 2013.

This article is from BMC Health Services Research , volume 13 . Abstract Background: Before 2007, the disability evaluation was based on the medical model in Taiwan. According to the People with Disabilities Rights Protection Act, from 2012 the assessment of a person’s eligibility for disability benefits has to be determined based on the International Classification of Functioning, Disability, and Health (ICF) framework nationwide. The purposes of this study were to: 1) design the evaluation tools for disability eligibility system based on the ICF/ICF-Children and Youth; 2) compare the differences of grades of disability between the old and new evaluation systems; 3) analyse the outcome of the new disability evaluation system. Methods: To develop evaluation tools and procedure for disability determination, we formed an implementation taskforce, including 199 professional experts, and conducted a small-scale field trial to examine the feasibility of evaluation tools in Phase I. To refine the evaluation tools and process and to compare the difference of the grades of disability between new and old systems, 7,329 persons with disabilities were randomly recruited in a national population-based study in Phase II. To implement the new system smoothly and understand the impact of the new system, the collaboration mechanism was established and data of 168,052 persons who applied for the disability benefits was extracted from the information system and analysed in Phase III. Results: The measures of the 43 categories for body function/structure components, the Functioning Scale of Disability Evaluation System for activities/participation components, and the needs assessment have been developed and used in the field after several revisions. In Phase II, there was 49.7% agreement of disability grades between the old and new systems. In Phase III, 110,667 persons with a disability received their welfare services through the new system. Among them, 77% received basic social welfare support, 89% financial support, 24% allowance for assistive technology, 7% caregiver support, 8% nursing care and rehabilitation services at home, and 47% were issued parking permits for persons with disability. Conclusion: This study demonstrated that disability evaluation system based on the ICF could provide a common language between disability assessment, needs assessment and welfare services. However, the proposed assessment protocol and tools require additional testing and validation.

This article is from BMC Health Services Research , volume 13 . Abstract Background: Before 2007, the disability evaluation was based on the medical model in Taiwan. According to the People with Disabilities Rights Protection Act, from 2012 the assessment of a person’s eligibility for disability benefits has to be determined based on the International Classification of Functioning, Disability, and Health (ICF) framework nationwide. The purposes of this study were to: 1) design the evaluation tools for disability eligibility system based on the ICF/ICF-Children and Youth; 2) compare the differences of grades of disability between the old and new evaluation systems; 3) analyse the outcome of the new disability evaluation system. Methods: To develop evaluation tools and procedure for disability determination, we formed an implementation taskforce, including 199 professional experts, and conducted a small-scale field trial to examine the feasibility of evaluation tools in Phase I. To refine the evaluation tools and process and to compare the difference of the grades of disability between new and old systems, 7,329 persons with disabilities were randomly recruited in a national population-based study in Phase II. To implement the new system smoothly and understand the impact of the new system, the collaboration mechanism was established and data of 168,052 persons who applied for the disability benefits was extracted from the information system and analysed in Phase III. Results: The measures of the 43 categories for body function/structure components, the Functioning Scale of Disability Evaluation System for activities/participation components, and the needs assessment have been developed and used in the field after several revisions. In Phase II, there was 49.7% agreement of disability grades between the old and new systems. In Phase III, 110,667 persons with a disability received their welfare services through the new system. Among them, 77% received basic social welfare support, 89% financial support, 24% allowance for assistive technology, 7% caregiver support, 8% nursing care and rehabilitation services at home, and 47% were issued parking permits for persons with disability. Conclusion: This study demonstrated that disability evaluation system based on the ICF could provide a common language between disability assessment, needs assessment and welfare services. However, the proposed assessment protocol and tools require additional testing and validation.

"March 1998."

"March 1998."

This document, which is intended for individuals involved in writing and reviewing college disability statements, summarizes the results of a Further Education Development Agency evaluation of the disability statements of 432 further education (FE) colleges throughout England. Chapter 1 examines the extent to which the individual FE colleges' disability statements meet the criteria specified in 1996 regulations governing FE colleges' disability statements. Included throughout Chapter 1 are numerous examples of good practice in 423 (98%) of the policy statements that indicate the institutions' commitment to respond flexibly to all students, including those with disabilities. The examples illustrate policy statements by focusing on the following items: overall policy, admissions arrangements, education facilities and support, other support, examination arrangements, physical access, and complaints and appeals procedures. Chapter 2 evaluates the disability statements in terms of their style, format, and accessibility. Special attention is paid to the following aspects of the statements: title; length and size; presentation (word processed versus printed); and availability in alternate forms. Fifty-one examples/figures are included. Appended are the following: text of "The Education (Disability Statements for Further Education Institutions) Regulations 1996: Guidance for Colleges in the FE Sector in England"; framework for evaluation; and interview schedules. (MN)

Every school system has to deal with children with Learning Disabilities (LD). However, the concepts of LD, the assessment procedures, the diagnostic criteria as well as their interpretation vary widely from country to country. What they usually seem to have in common is that general cognitive abilities, as measured by standardized IQ tests, are seen as an important aspect of the label. In Austrian schools the diagnosis of LD is largely based on expert opinions provided by special education teachers. The diagnostic procedure is quite unregulated and open to individual interpretation. As a rule, standardized tests are not used in this connection. In the present study the characteristics of children with a diagnosis of LD are evaluated in terms of standardized testing. Thirty-seven pupils diagnosed as having LD and 136 regular school children were assessed at the end of the 5th grade in Austrian schools using standardized tests of intelligence, reading, writing and arithmetic skills and questionnaires regarding social integration in class, emotional integration in school and cultural capital of their families. Compared with a group of pupils without LD, matched for IQ and age, the LD children showed significantly worse basic arithmetic and reading skills, inferior social integration in class and lower familial cultural capital. A stepwise logistic regression analysis indicated that poor basic arithmetic and reading skills were the strongest predictors of having a diagnosis of LD. Other variables, including IQ, had significantly less weight. The results are seen as indication of the fact that precise guidelines for diagnosing LD in the school system and a transition to a system of evidence-based allocation of resources are urgently needed.

Includes bibliographies and index

The mission of the Accession Medical Standards Analysis & Research Activity (AMSARA) is to support the development of evidence based medical standards for the Department of Defense (DoD) by guiding improvement of medical and administrative databases and conducting epidemiologic and special studies analyses. AMSARA's mission has recently expanded to include analysis and studies of existing disability tri-service evaluation system by the request of the Office of Assistant Secretary of Defense, Health Affairs. The DES Annual Report includes executive summary, methods, history of medical disqualification, pre-existing conditions, accession medical waiver, and hospitalization among service members evaluated for disability, service disability evaluation databases limitations from FY 07 to FY12, data quality and standardization recommendations.

THE POSSIBILITY OF A CORRELATION BETWEEN HAND-EYE COORDINATION AND READING DISABILITY WAS INVESTIGATED. CHILDREN FROM GRADES 2 TO 12 WERE TESTED TO DETERMINE THEIR HAND-EYE COORDINATION USING A PORTABLE TESTING DEVICE FOR QUANTATIVE MEASURE RECENTLY DEVELOPED. THE SUBJECTS INCLUDED APPROXIMATELY 1,700 NORMAL PUBLIC SCHOOL STUDENTS AND 290 STUDENTS DIAGNOSED AS POOR READERS BY READING CLINICS. THE SUBJECT'S READING ABILITY WAS DETERMINED THROUGH THE USE OF THE STANDARDIZED READING TESTS ADMINISTERED BY SCHOOL PERSONNEL. STATISTICAL ANALYSIS OF THE DATA, AFTER IT WAS NORMALIZED FOR THE EFFECT OF AGE, INDICATED NO CORRELATION BETWEEN HAND-EYE COORDINATION AND READING DISABILITY ABOVE THE SECOND- GRADE LEVEL. HOWEVER, SINCE THIS WAS THE YOUNGEST GROUP TESTED, MORE WORK MUST BE DONE IN THE YOUNGER AGE RANGE BEFORE ANY CONCLUSIONS CAN BE REACHED. REFERENCES ARE LISTED, AND 6 APPENDIXES OF DETAILED DATA ANALYSIS ARE INCLUDED. (AUTHOR/BS)

The Accession Medical Standards Analysis and Research Activity (AMSARA) has provided the Department of Defense (DoD) with evidence-based evaluations of accession medical standards since 1996. As part of this ongoing research activity, data are collected from each service's Disability Evaluation System (DES). Disability evaluation is administered at the service level with each branch of service responsible for the evaluation of disability in its members. Variability exists in the type of disability data available among AMSARA databases for each service as a result of service level data collection on disability evaluations. In fiscal year (FY) 2009, AMSARA's mission was expanded to include audits and studies of existing DES per the request of the Office of Assistant Secretary of Defense, Health Affairs. This report describes analyses conducted in FY 2017 of existing DES data collected for accessions and disability research through the end of FY 2016. Once approved, this report \Viii be distributed to the USD (P and R) Medical Personnel Committee, the Accession Medical Standards Working Group, Disability Advisory Committee, and any other interested parties, then submitted to the Defense Technical Information Center, and posted on the AMSARA website.

Every school system has to deal with children with Learning Disabilities (LD). However, the concepts of LD, the assessment procedures, the diagnostic criteria as well as their interpretation vary widely from country to country. What they usually have in common is that general cognitive abilities, as measured by standardized IQ tests, are seen as an important aspect. In Austrian schools the diagnosis of LD is largely based on expert opinions provided by special education teachers. The diagnostic procedure is quite unregulated and open to individual interpretation. As a rule, standardized tests are not used in this connection. In the present study the characteristics of children with a diagnosis of LD are evaluated in terms of standardized testing. 37 pupils diagnosed as having LD and 136 regular school children were assessed at the end of the 5th grade in Austrian schools using standardized tests of intelligence, reading, writing and arithmetic skills and questionnaires regarding social integration in their class, emotional integration in their school and the cultural capital of their families. Compared with a group of pupils without LD, matched for IQ and age, the LD children showed significantly worse basic arithmetic and reading skills, inferior social integration in class and lower familial cultural capital. A stepwise logistic regression analysis indicated that poor basic arithmetic and reading skills were the strongest predictors of having a diagnosis of LD. Other variables, including IQ, had significantly less weight. The results are seen as indication of the fact that precise guidelines for diagnosing LD in the school system and a transition to a system of evidence-based allocation of resources are urgently needed.

ABSTRACT Aims: It has been suggested that the incidence of low back pain is higher in individuals with respiratory disorders compared to healthy individuals. In this study, it was aimed to calculate the relationship between respiratory muscle strength and low back pain-related disability, fatigue and cardiorespiratory fitness in individuals with chronic low back pain. Methods: The study included 36 individuals (21F, 15M, 46.61±10.19) aged 18-65 years with low back pain. Respiratory muscle strength was measured with Pocket-Spiro MPM100 device. Disability due to low back pain was assessed by Oswestry Function Questionnaire and fatigue was assessed by fatigue severity scale. For cardiorespiratory fitness, a 6-minute walk test was performed. Results: No significant correlation was found between maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) values and disability status due to low back pain and fatigue (p>0.05). There was a significant, positive and moderate correlation between MIP and MEP values and 6 minute walk test (p

ABSTRACT Aims: It has been suggested that the incidence of low back pain is higher in individuals with respiratory disorders compared to healthy individuals. In this study, it was aimed to calculate the relationship between respiratory muscle strength and low back pain-related disability, fatigue and cardiorespiratory fitness in individuals with chronic low back pain. Methods: The study included 36 individuals (21F, 15M, 46.61±10.19) aged 18-65 years with low back pain. Respiratory muscle strength was measured with Pocket-Spiro MPM100 device. Disability due to low back pain was assessed by Oswestry Function Questionnaire and fatigue was assessed by fatigue severity scale. For cardiorespiratory fitness, a 6-minute walk test was performed. Results: No significant correlation was found between maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) values and disability status due to low back pain and fatigue (p>0.05). There was a significant, positive and moderate correlation between MIP and MEP values and 6 minute walk test (p

This article is from Journal of Korean Neurosurgical Society , volume 55 . Abstract Objective: This study explored the relationships among demographic (DVs) and clinical variables (CVs), neurocognitive (NOs) and functional outcome (FO) that could be used as prognostic factors for old aged patients with traumatic brain injury (TBI) undergoing or appointed disability evaluation (DE) after treatment. Methods: A total of 162 subjects with TBI above the age of 55 years undergoing DE or appointed to do so after treatments were selected. The patients were divided into two subgroups according to age : a junior elderly group 55 to 64 years old and a senior elderly group over the age of 65. NOs and FO were evaluated using the Seoul Neuropsychological Screening Battery and Clinical Dementia Rating scale. Results: Gender, age, and education level were shown to significantly impact the recovery of NOs after TBI. Other DVs and CVs such as area of residency, occupation, type of injury, or loss of consciousness were not found to significantly affect the recovery of NOs after TBI. Analysis of the relationships among DVs, CVs and NOs demonstrated that gender, age, and education level contributed to the variance of NOs. In FO, loss of consciousness (LOC) was included to prognostic factor. Conclusion: Gender, age and education level significantly influence the NOs of elderly patients with TBI. LOC may also serve as a meaningful prognostic factor in FO. Unlike younger adult patients with TBI, old aged patients with TBI did not show global faking-bad or malingering attitudes to DE for compensation, but assume that they could faking their performance in a test set available visual feedback.

This article is from Journal of Korean Neurosurgical Society , volume 55 . Abstract Objective: This study explored the relationships among demographic (DVs) and clinical variables (CVs), neurocognitive (NOs) and functional outcome (FO) that could be used as prognostic factors for old aged patients with traumatic brain injury (TBI) undergoing or appointed disability evaluation (DE) after treatment. Methods: A total of 162 subjects with TBI above the age of 55 years undergoing DE or appointed to do so after treatments were selected. The patients were divided into two subgroups according to age : a junior elderly group 55 to 64 years old and a senior elderly group over the age of 65. NOs and FO were evaluated using the Seoul Neuropsychological Screening Battery and Clinical Dementia Rating scale. Results: Gender, age, and education level were shown to significantly impact the recovery of NOs after TBI. Other DVs and CVs such as area of residency, occupation, type of injury, or loss of consciousness were not found to significantly affect the recovery of NOs after TBI. Analysis of the relationships among DVs, CVs and NOs demonstrated that gender, age, and education level contributed to the variance of NOs. In FO, loss of consciousness (LOC) was included to prognostic factor. Conclusion: Gender, age and education level significantly influence the NOs of elderly patients with TBI. LOC may also serve as a meaningful prognostic factor in FO. Unlike younger adult patients with TBI, old aged patients with TBI did not show global faking-bad or malingering attitudes to DE for compensation, but assume that they could faking their performance in a test set available visual feedback.

The Department of Veterans Affairs (VA) and the Department of Defense (DoD) have instituted a jointly managed disability evaluation process. This process began as the Disability Evaluation System Pilot (DES-P), which was initiated in the National Capitol Region (NCR), and it eventually expanded to 27 sites. The pilot was declared a success and is now being rolled out world-wide as the Integrated Disability Evaluation System (IDES). In the departments' joint report to Congress dated August 31, 2010, the data in the report illustrate that processing time has increased consistently since February 2010. Further, while 10,698 Army Soldiers had entered the process by January 2011, only 26% managed to complete the process, and the Army's case processing time for a Soldier in IDES grew from 294 days in October 2010 to 302 days by January 2011. In concert with this growth in processing time, the IDES is planned to increase in size by roughly double during fiscal year 2011. Failure to address the IDES program's declining performance impacts the Army's population of medically nondeployable Soldiers and, as a consequence, it impacts medical readiness and Army Force Generation (ARFORGEN). This paper proposes a more comprehensive, data-driven performance management system for the execution of the IDES program. The paper also presents metrics to monitor work in process as well as completed work, and proposes automation system changes to better monitor performance and respond to surges for both the VA and DoD partners.

The Disability Evaluation System (DES) is a management tool used by the Department of Defense to determine the disposition of a service member who has a medical condition that calls into question the member's ability to perform his or her duties. The DES exists to evaluate service members with such medical conditions, remove those unable to fulfill their duties, and determine a disability rating for those who are removed. This book focuses on four major research tasks related to improving system performance: developing a basis for assessing DES outcomes, identifying issues of variability in DES policy application, conducting a DES training analysis and presenting recommended changes, and developing a method for continuously monitoring DES performance. As part of their findings, the authors constructed a set of desired system outcomes and from that framework suggest comprehensive training and information management interventions to improve overall system performance. The authors also identify groups of primary DES participants and outline the specific bodies of knowledge and skills the participants require to execute disability policy consistently throughout the military departments.

There are 1.5 million people with an intellectual disability (ID) in the UK and over half of these present with ID associated with a co-occurring condition such as autism. Evidence suggests cognitive differences may underpin clinically significant behaviours for children and adults within this population (for example self-injurious behaviour and differences in adaptive functioning). However, thus far, evidence is based solely on informant report measures. One key barrier to the advancement of evidence is the lack of developmentally appropriate, robust and feasible direct cognitive assessments for children and adults with ID. Where measures of cognition have been developed for populations with ID they are often limited in their ability to capture performance across the full range of functioning, especially in those with lower mental age. As such, there are few reliable and valid tools available to detect and track cognitive change in people with ID, particularly those with moderate to severe ID. The current study therefore seeks to advance this position, detailing feasibility data from a robust protocol of direct cognitive assessments designed to be delivered remotely by caregivers with real-time support from a research team. The feasibility of cognitive tasks, as well as their ability to capture change over time when repeated is explored within the current study.

This article is from The Pan African Medical Journal , volume 14 . Abstract Introduction: The current study uses the Language Independent Functional Evaluation (L.I.F.E.) to evaluate disability in a smaller Ghanaian coastal town to characterize the extent and nature of disability. The L.I.F.E. is a video animated, language free equivalent of the standard 10-item verbal/written Barthel Index functional assessment. Methods: Over a four-month period, the L.I.F.E. survey was given to members of the village of Anomabo in a preliminary survey which consisted of recruitment in an un-controlled manner, followed by a systematic, comprehensive survey of three neighborhood clusters. Basic demographics were also collected, along with the observer's assessment of disability. Results: 541 inhabitants (264 in the preliminary survey and 277 in systematic survey) completed the L.I.F.E. Participants ranged from 7-100 years old (mean age 32.88, s.d. 20.64) and were 55.9% female. In the systematic study, 16.6% of participants had a less than perfect score on the L.I.F.E., indicating some degree of impairment. Significant differences were found between age groups, but not between sexes, the preliminary and systematic survey, and study location (a=.05). Conclusion: The L.I.F.E. and this study methodology can be used to measure the prevalence of disability in African communities. Disability in this community was higher than the frequently cited estimate of 10%. African policymakers can use the L.I.F.E. to measure disability and thus more rationally allocate resources for medical rehabilitation.

Translational research inspired by behavioral momentum theory in the area of developmental disabilities has shown effects in individuals over a range of functioning levels. In the current study, behavioral momentum was assessed in 6 children diagnosed with autism and severe intellectual disability. In a repeated measures design, participants were exposed to relatively rich versus lean reinforcement contingencies in a multiple schedule with food reinforcers. This was followed by exposure to each of four disrupting conditions: prefeeding, presentation of a concurrent alternative stimulus, presentation of a movie, and the presence of a researcher dispensing response-independent reinforcers on a variable-time schedule. Consistently greater resistance to disruption in the component with the richer schedule occurred with the alternative stimulus disrupter but not with the other disrupters. These results suggest parameters that may be more (or less) effective if behavioral momentum inspired techniques are to be exploited in therapeutic environments. (Contains 5 tables and 5 figures.)

In their evaluation of the IDES pilot, DOD and VA concluded that, as of February 2010, the pilot had (1) improved servicemember satisfaction relative to the existing legacy system and (2) met their established goal of delivering VA benefits to active duty and reserve component servicemembers within 295 and 305 days, respectively, on average. While these results are promising, average case processing times have since steadily increased - for example, for active duty servicemembers, the average has increased from 274 days in February 2010 to 296 days in August 2010. At 296 days, processing time for the IDES is still an improvement over the 540 days that DOD and VA estimated the legacy process takes to deliver VA benefits to servicemembers. However, the full extent of improvement of the IDES over the legacy system is unknown because (1) the 540-day estimate was based on a small, nonrepresentative sample of cases and (2) limitations in legacy case data prevent a comprehensive comparison of processing times, as well as appeal rates.

To better understand the nature of problems in math learning, a case study was conducted of the specific strengths and weaknesses of a child with a severe math-learning disability. The subject, Adam, was nearly 11 years old when interviews began and had been officially classified as learning disabled due to organic brain dysfunction. A semistructured clinical interview method was employed in the study: tasks or problems, often followed by flexible questioning, were posed to the subject. Interviews lasted from 45 to 90 minutes and were conducted over a 14-month period. Initial clinical interviews revealed that the subject had informal skills and concepts upon which to build, but that his formal math skills were quite deficient. Many weaknesses in formal skills could be traced to a poor grasp of part/whole relationships and base ten notions. Remedial efforts making extensive use of games and activities were implemented. Linking understanding with procedural knowledge, these efforts focused on basic place value and base ten concept skills and resulted in some improvement. Gains made in math ability were perhaps facilitated by affective factors. Over the course of the study, Adam appeared more willing to assert himself, was less defensive, and seemed to have more confidence in his abilities. (RH)

The use of Reserve Component (RC) personnel has increased dramatically since September 11, 2001, and has remained high. Both Active Component (AC) and RC personnel serving on active duty for more than 30 days have comprehensive healthcare coverage, but other RC members are covered only for injuries or illness sustained in the line of duty. For other conditions, they must rely on their civilian healthcare coverage if they have such coverage. A decade of combat, however, has focused the nation s attention on meeting the needs of service members both AC and RC whose military service has led to disability. Legislation passed in 1965 required the President to review military compensation every four years. In light of the critical role the RC has played and is likely to continue to play in the future, the President asked the 11th Quadrennial Review of Military Compensation (QRMC) to examine compensation and benefits for RC personnel. As part of this review, RAND was asked to provide supporting analyses of the healthcare coverage provided for RC members, including participation in the TRS program, the potential effects of national health reform on coverage rates, and disability evaluation outcomes for RC members.

AMSARA has provided the Department of Defense with evidence-based evaluations of accession medical standards since 1996. As part of this ongoing research activity, data are collected from each services Disability Evaluation System (DES). AMSARAs mission was expanded in fiscal year (FY) 2009 to include audits and studies of existing DES by the request of the Office of Assistant Secretary of Defense, Health Affairs. The Disability Evaluation System Analysis and Research Annual Report includes descriptive statistics on the population presenting for disability evaluation by service and describes pre-accession morbidity in this population. Brief descriptions of ongoing special studies and publications, as well as recommendations for disability evaluation and database management, are also given. This report describes analyses conducted in fiscal year 2016 of existing DES data collected for accessions and disability research through the end of FY 2015. Once approved, this report will be distributed to the USD (P and R) Medical Personnel Committee, the Accession Medical Standards Working Group, Disability Advisory Committee, and any other interested parties, then submitted to the Defense Technical Information Center, and posted on the AMSARA website.

The Integrated Disability Evaluation System (IDES) represents a significant interagency collaboration between the Department of Veterans Affairs (VA) and the Department of Defense (DoD). Despite significant work on the part of both agencies, their efforts to get the system to meet its timeliness goals have met with limited success. This thesis seeks to identify and solve the real problems facing the IDES by studying three areas of concern: systems, problem formulation, and organizational culture. The thesis uses both qualitative and quantitative tools to analyze these problem areas. The results suggest that the IDES may have been developed without a full appreciation of the complexity of the disability evaluation problem, and with a process-driven focus that reflects organizational cultures that value stability and order. The thesis concludes with ideas for building adaptability into the IDES by clarifying ownership, adapting systems, and improving performance standards.

Accession Medical Standards Analysis and Research Activity (AMSARA's) mission is to support the development of evidence based medical accession standards for the Department of Defense (DoD) by guiding improvement of medical and administrative databases and conducting epidemiologic and special studies. AMSARA's mission has recently expanded to include analysis and studies of existing disability tri-service evaluation system by the request of the Office of Assistant Secretary of Defense, Health Affairs. The DES Annual Report (AR) includes executive summary, methods, service descriptive analysis by service of DES databases from FY 01 to FY 09, DES database limitations, DES database recommendations, special studies and future research. The special studies presented in this AR included analyses of risk factors for Disability Retirement among the US Army and US Marines enlisted service members. DES database provide a basis for future studies of risk factors for disability processing, separations, and retirement.

Congressional Hearing Committee on Oversight and Government Reform Date: 2008-02-27 Room: 2154 Rayburn HOB

This protocol describes an evaluation of the Replicability Model (RM) project and estimation of the prevalence of disabilities due to leprosy in the district of Janjgir-Champa, state of Chhattisgarh, India. This is funded by National Institute for Health Research (NIHR: 200132) using UK aid from the UK Government to support global health research.

This protocol describes an evaluation of the Replicability Model (RM) project and estimation of the prevalence of disabilities due to leprosy in the district of Janjgir-Champa, state of Chhattisgarh, India. This is funded by National Institute for Health Research (NIHR: 200132) using UK aid from the UK Government to support global health research.

This article is from Iranian Journal of Child Neurology , volume 7 . Abstract Objective: Developmental impairment is a common problem in children health that occurs in approximately 5–10% of the childhood population. The aim of this study was to determine the etiologic yield of subspecialists’ evaluation of young children with developmental disability. Materials & Methods: All children aged between 2 months and 5 years referred over a 15-month period to Hamadan University of Medical Sciences subspecialty services for initial evaluation of a suspected developmental Disability, were enrolled in the present study. Diagnostic yield was determined after the completion of clinical assessments and laboratory tests requested by the evaluating physician. Results: A total of 198 children (129 boys and 69 girls) were eligible for our study. 108 children had global developmental delay and 90 children had isolated developmental delay. Approximately ¼ of all patients did not have any specific etiology for developmental disability. Cerebral palsy (CP) was the most common clinical syndrome in all patients (41.4%). Hypoxic ischemic encephalopathy (13.8%), brain dysgenesis (13%), genetic disorder (13%), and neurodegenerative diseases (11%) were determined in more than one half of all children with global developmental disability. in our study, “developmental speech delay” was the common cause of isolated speech delay. Conclusion: Determination of an underlying etiology is an essential part of specialty evaluation of young children with developmental disability. The results of this study were similar closely to the results of other studies.

The Accession Medical Standards Analysis and Research Activity (AMSARA) has provided the Department of Defense with evidence-based evaluations of accession standards since 1996. As part of this ongoing research activity, data are collected from each service s Disability Evaluation System (DES). Disability evaluation is administered at the service level, with each branch of service responsible for the evaluation of disability in its members. Variability in the type of data available in existing AMSARA databases for each service is present as the result of service level collection of data on disability evaluations and the lack of accession information on many individuals evaluated for disability. AMSARA s mission was expanded in FY 2009 to include audits and studies of existing disability evaluation system by the request of the Office of Assistant Secretary of Defense, Health Affairs. This report describes analyses conducted in fiscal year 2012 of existing DES data collected for accessions and disability research through the end of fiscal year 2011.

There are 1.5 million people with an intellectual disability (ID) in the UK and over half of these present with ID associated with either a rare genetic syndrome or a co-occurring condition such as autism. Within ID and typically-developing (TD) populations, everyday functioning may be evaluated via measures of adaptive functioning, intellectual ability, and executive functioning. Indeed, previous studies of rare genetic syndromes associated with ID have commonly employed informant-report measures of adaptive functioning (e.g. Vineland Adaptive Behavior Scales and Wessex Questionnaire) and executive functioning (e.g. Behavior Rating Inventory of Executive Function (BRIEF) and Childhood Executive Functioning Inventory (CHEXI)). Although these informant-report measures effectively examine unitary constructs, the focus on unitary constructs precludes comprehensive assessment of individuals’ everyday functioning. For example, informant-report measures of adaptive functioning do not capture variation in executive functioning or intellectual ability. Additionally, existing informant-report measures of executive function were predominantly developed for TD samples and thus often lack face validity for individuals with intellectual disabilities. Furthermore, existing informant-report measures are often lengthy, necessitating a shorter measure that is more accessible to parents/caregivers of individuals with intellectual disabilities. Overall, there is a need for a comprehensive and accessible informant-report measure of everyday functioning for individuals with intellectual disabilities.

Approved For Release 2004/02/1 25 -Rr f 8B05703A000400080054-5 '?PC/17_ I39-70 - MAY 1971 `'` % f ,U-1 FOP: Director of Personnel SttRJBCT Annual Pe-Evaluation of , loyees for Participation in the CIA Petiremmt and Disability System 'rE=FFP1 dCF Your memorandum, same subject, dated 4 February 1970 We have thoroughly reviewed the records of the personneq listed in the attachment to the reference m&roranclum. Vte 'have determined that the status of these personnel has not cluant=ed., and they are still ineligible for participation in the CTAPM 25X1 AT3T flJR C. 11t DAHI_, Director 'ational Photographic Interpretation Center Distribution Original E 1 - Addressee 2 - NPIC/ODIR 2 - NPIC/TSSG/SSD/PB NPIC/TSSG/SSD/PB: (29 April 1970) Declass Review by NIMA/DOD GnU Approved For Release 2004/02/.2 ag R78B05703A000400080054-5 1Excluded fromUN automatic t downgrading and declassification

Committee on Oversight and Government Reform - One Year after Walter Reed: An Independent Assessment of the Care, Support, and Disability Evaluation for Wounded Soldiers - Subcommittee on National Security and Foreign Affairs. The Subcommittee on National Security and Foreign Affairs held a hearing at 2:00 PM on Wednesday, February 27th, in room 2154 Rayburn entitled, "One Year after Walter Reed: An Independent Assessment of the Care, Support, and Disability Evaluation for Wounded Soldiers." Video provided by the U.S. House of Representatives.