Perceived health status as measured by the SF-36 in patients with multiple sclerosis: a review

This review of literature gives an overview of recent studies about perceived health status as measured by the Short-Form-36 (SF-36) Health Survey in patients with multiple sclerosis (MS). The SF-36 is one of the tools measuring health status in patients used in international research and clinical practice. It measures two main health concepts – physical and mental. The SF-36 represents a valid instrument able to detect differences in perceived health status in patients. A computer-aided search in Medline and PsycINFO resulted in 504 articles in English published from 1996 to August 2006. After the screening process on the basis of abstracts, eight articles consisting of empirical studies remained in which perceived health status was evaluated using the SF-36 Health Survey. Seven studies focused on disability and perceived health status in the SF-36. Two studies focused on the relationship between depression and perceived health status. These studies showed that MS patients with low disability and minor depression scored significantly better than patients with high disability and major depression in the SF-36 health dimensions. Gender seems to have no influence on perceived health status in MS patients. The longer the disease duration and the more severe the disease, the lower the patients scored in perceived health status. The more disabled, the more depressive and the older the patients, the poorer their perceived health status was. Health providers supporting appropriate treatment might pay more attention to more disabled and more depressive patients, with longer disease duration. Perceived health status can be a predictor of prognosis and intervention outcomes. The study shows the importance of measuring perceived health status in MS patients with implications for their quality of life and provision of care.     

Staying in the here‐and‐now: A pilot study on the use of dialectical behaviour therapy group skills training for forensic clients with intellectual disability

Background Dialectic behaviour therapy (DBT) has been widely used with individuals diagnosed with borderline personality disorder who exhibit severe emotional and behavioural dysregulation. There is a paucity of research in assessing the effectiveness of DBT with forensic clients with intellectual disability (ID). Methods This pilot study aims to evaluate the effectiveness of the DBT group skills training programme adapted particularly for offenders with ID. Six participants completed the 13‐week adapted DBT group skills training programme. All participants exhibited challenging behaviours and have a history of prior charges or convictions for violent crimes. The study conducted pre‐ and post‐tests using instruments that measured dynamic risks, relative strengths, coping skills and global functioning. Results The study result showed improvement across all measures. A decrease in the level of risks, increase in relative strengths and general improvement in overall functioning were found significant. The results were promising particularly as a stand‐alone adapted DBT group skills training programme for this client group.     

Economic Incentives in Disability Insurance and Behavioral Responses

This paper reviews evidence that economic incentives affect the behavior of workers and their health care providers. Prior models of disability behavior have been incomplete either because these incentive responses were ignored (as in the biomedical model of disability), or they focused exclusively on the workers' incentives (the insurance model) or the providers' incentives (the managed-care model). This paper calls for the use of the more expansive, integrated approach to disability management.     

Health screening for people with learning disabilities by a community learning disability nursing service in Northern Ireland

Over the last 30 years there has been a considerable increase in the life expectancy of people with learning disabilities. This has resulted in changing patterns of morbidity and mortality and an increasing recognition of the health needs of people with learning disabilities. Major strides forward have been made in the reduction of preventable illnesses among the general population. However, among people with learning disabilities such illnesses have received only limited health promotion attention until recently. In the last decade major gaps have been identified in the ability of current primary health services to respond to the needs of people with learning disabilities. The need to respond effectively to this situation has been identified as a priority by the current United Kingdom Government. Following an overview of the literature in relation to the changing health profile of people with learning disabilities and the need for health screening, consideration is given to some of the key difficulties which may be encountered when attempting to utilize current primary health services. The analysis of data derived from the health screening of 373 people with learning disabilities by a community nursing service in Down and Lisburn Health and Social Services Trust reveals the need for further action in relation to cardiovascular status, sensory deficits, mobility and aspects of sexual health.     

Dyslexia: a review of two theories

Optometrists will frequently see patients, who may have a diagnosis or a suspected diagnosis of dyslexia (specific reading disorder) and will need to manage and counsel such patients. There are many propounded theories on the cause(s) of dyslexia. Although most professionals in this area consider that dyslexia is chiefly a linguistic disorder, the possibility of a visual component is contentious. This article is a selective review of two commonly discussed theories that suggest a visual component in dyslexia; the magnocellular deficit theory and Meares‐Irlen syndrome.     

Communication Supports in Congregate Residential Care Settings in Ohio

Background Communication skills are important to the pursuit of increased self‐determination in individuals with disabilities. The aim of this investigation was to gather information about communication supports in state‐run residential care facilities in Ohio, and to compare findings with a previous investigation on this topic examining such perceptions in group home environments. Methods An online survey was adapted from DeSimone & Cascella [Journal of Developmental and Physical Disabilities, 17 , 2005 , 1] to examine perceptions of habilitation managers regarding the quality of communication supports in their settings. Perceptions of communication supports by program manager‐level staff in larger group residential facilities had not been previously investigated. Results Respondents reported a generally high quality of communication supports provided in their settings. Despite this general level of perceived quality, certain quality indicators related to supports for communication were relatively lower across respondents and were consistent with DeSimone & Cascella.     

Measuring the Personal Burden of Eye Disease and Vision Impairment

Purpose: To describe research methods for assessing the personal burden of eye disease and vision impairment on health and functional well-being. Methods: Three methods are described, which are largely complementary of each other. (1) Questionnaires are patient-centered in that they provide the person's own self-reported perspective on difficulty in engaging in everyday activities, psychological well-being, and/or health status. Examples are generic and vision-targeted health-related quality of life instruments, domain-specific questionnaires, and instruments that screen for psychological comorbidities. (2) Direct assessment of actual behavior provides information about the functional competences the patient has. Examples are mobility performance and reading speed. (3) Administrative records maintained by government, healthcare, and other agencies provide information relevant to the existence of adverse or detrimental circumstances that engender decreased health and well-being. Examples are healthcare utilization, employment history, and motor vehicle collision involvement. Discussion: Measures of eye disease severity should not be used in research as surrogates for the personal burden of eye disease and vision impairment. Individuals personally respond to and cope with the presence of eye disease and vision impairment in very wide ranging ways. There are several ways to measure the personal burden of eye disease and vision impairment that provide information about the person's own perspective on his/her health and well-being and functional competences.     

Using assistive technology for schoolwork: the experience of children with physical disabilities

Aim.?This study explored the experience of children with physical disabilities using assistive technology for participation with schoolwork to gain a greater understanding of their perspectives and subjective experiences.

Method.?A qualitative study involving thematic analysis of in-depth interviews of the child with a parent or significant adult. Purposeful sampling from a larger study recruited five children aged between 10 and 14 years, with differing physical disabilities who attended mainstream schools. All children used computer-based assistive technology.

Results.?All of the children recognised that assistive technology enabled them to participate and reduced the impact of their physical disability, allowing independent participation, and facilitated higher learning outcomes. Issues related to ease of use, social implications and assistive technology systems are discussed.