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Biomedical subjects

E M Badley

Publications and source records attributed to E M Badley.

68 records · Page 4Linked to original sources

Patterns of disability related to joint involvement in rheumatoid arthritis.

The relationship between particular disabilities and specific impairments of which these disabilities could be the consequence has been explored. Assessments of performance of activities of daily living (ADL) have been simplified by factor analysis, and the resultant factors have been related to the sites of joint involvement in patients with rheumatoid arthritis. Our preliminary findings on the grouping together of various ADL activities are meaningful in terms of underlying impairments, and at the same time indicate an approach for simplification of ADL assessments so as to enhance their value for research and the evaluation of outcome. The results are entirely consistent with a comprehensive model of disablement.

Activities of Daily Living↗

Attitudes of the public to arthritis.

A survey of the public's attitude to arthritis was commissioned by the Arthritis and Rheumatism Council (ARC) in 1974. The survey was carried out by National Opinion Polls (NOP) Market Research Ltd. The ARC were interested to find out whether people underestimated arthritis and what they thought about the consequences. Respondents were asked to rank a number of illnesses in terms of their seriousness and the loss of work to which they give rise. They were also shown a series of statements about arthritis and rheumatism in order to elicit the extent of their agreement with the views these represented. The public appear to have fairly realistic ideas about the magnitude of the problem and of its nature and associations. However, although the pain of arthritis and rheumatism was appreciated, their possible impact in terms of disturbance of the normal pattern of daily life tended to be underestimated. The findings reflect the climate of opinion from which present and potential arthritis sufferers come and may therefore reveal part of their attitudes to their disease.

Adolescent↗

The prevalence and severity of major disabling conditions--a reappraisal of the government social survey on the handicapped and impaired in Great Britain.

This paper re-examines the data gathered for the Government Social Survey on the Handicapped and Impaired in Great Britain. The underlying cause of disablement is considered in conjunction with severity and prevalence. When these are taken together a picture emerges in which stroke, arthritis, and circulatory disorders are the most frequent cause of severe disability in the community. An attempt is also made to examine the way in which the survey might be biased by the non-inclusion of those in institutions.

Adult↗

The relationship between impairment and disability in arthritis: an application of the theory of generalized linear models to the ICIDH.

We investigated the relationship between impairment, as represented by limitation in range of movement and pain in the knee joint, and disability as measured by a series of activities of daily living in 123 patients with either rheumatoid arthritis or osteoarthrosis. A log-linear modelling technique found there was a positive association between functional limitation, as measured by reduction in angle of flexion, and disability. However, there was only a marginal relationship between pain in the knee joint and disability, and no association between pain and range of movement, which suggests that conventional beliefs that pain is a key factor in assessing health outcomes may need to be reassessed.

Adolescent↗

The assessment of physical independence handicap: experience in a community disablement survey.

Two approaches to the ascertainment of physical independence handicap have been explored using data from a survey of disablement in the population. The survey used a two-stage methodology with an initial postal shift to ascertain those with selected disabilities, a stratified random sample of whom were followed-up with an in-depth interview. The first approach to handicap was direct ascertainment of the scale categories by means of a question in the interview schedule. The second approach was to synthesize the scale categories from the answers to interview questions about disabilities in activities of daily living and other relevant factors. The final synthesized algorithm gave a 75% match within one scale point with the direct question and 85% agreement with receipt of attendance allowance, a state benefit paid to those meeting certain criteria for dependence on others. The lessons learned from the work have been incorporated in a revised and expanded scale, which is suggested as a starting point for revision of physical independence dimension of handicap.

Activities of Daily Living↗

A survey of disablement in a British population using an action-orientated measure, physical independence handicap: problems with activities of daily living and level of support.

A population survey with the aim of obtaining information to facilitate the planning of services for younger physically disabled people provided the opportunity to explore the use of physical independence handicap in this context. A Phase 1 sift questionnaire was sent to one in three (25,167) occupied households in Calderdale, a district in Yorkshire, England, with a final 87% response rate. A Phase 2 in-depth interview was carried out on a stratified random sample of those identified as disabled in Phase 1. Interviews were obtained with 570 individuals aged 16-64 years, 93% of those available. The measure of physical independence handicap was derived from data obtained in the interview indicating need for help at infrequent or short intervals and immediate-needs dependence. The estimated prevalence of dependent people aged 16-64 in Calderdale is 26.6 per 1000 population (95% CI: 24.9-28.3). Rates were higher in females, and both prevalence and level of dependence increased with age. Disability in activities of daily living and locomotion was linked to the level of physical independence handicap. Problems with housework and collecting (including shopping) were most frequent for those who needed help on an infrequent basis, while self-care needs were substantial for the short and immediate-needs dependence groups. Only a small proportion reported receiving services in their home during the previous 12 months; 20% received services from a nurse and 10% the services of a local authority home help. Overall, 91% reported contact with the primary health care team within the previous 12 months and 68% with hospital and rehabilitation services.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

An introduction to the concepts and classifications of the international classification of impairments, disabilities, and handicaps.

This paper aims to introduce the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) and to set the scene for the forthcoming revision process. The consequences of diseases and disorders at the level of the body (impairment), the person (disability), and the person as a social being (handicap) are defined and described. Bearing in mind some of the controversies and confusions which have become apparent in attempts to apply the ICIDH since its publication in 1980, the distinctions between the different concepts are explored: namely, impairment--disability; impairment--functional limitation--disability; and between disability--handicap. The nature of the classification schemes for these concepts is described, together with some implications for methods of assessment. Finally, the contribution the ICIDH has made, and its potential uses are briefly reviewed.

Persons with Disabilities↗

The genesis of handicap: definition, models of disablement, and role of external factors.

Handicap has proved to be the most contentious and arguably most misunderstood concept of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH). This paper reviews the definition and characteristics of handicap as presented in the original introduction to the ICIDH, and presents some of the alternative suggested definitions. Limitations in the way the original conceptual model for the consequences of disease was depicted have led to the development of alternative models which draw attention to the importance of external factors, particularly for the genesis of handicap. The nature of these external factors and the implications of alternative models for the testing of the conceptual framework are discussed. The expression of handicap as a product of an interaction of a person with impairment and disability and the environment draws attention to the options available for the decrease of handicap through the modification of the environment, and not only by attempting to ameliorate the impairment or disability.

Persons with Disabilities↗

Disability, resources, role demands and mobility handicap.

Research on disablement highlights a wide variability in the impact of disabling conditions on individuals' lives. However, in most of this work, the relationships between impairment/disability and features of individuals' social and physical environments are not specified conceptually. Recent conceptual work in the context of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) suggests that the impact of impairment/disability on individuals' lives is contingent on levels of resources and other aspects of social context. The research question addressed in this paper is whether selected social factors affect the impact of impairment/disability on mobility handicap, defined as 'the individual's ability to move about effectively in his/her surroundings'. Two types of social factors are considered: resources such as help from others or having a car available; and social role obligations such as having a job or visiting relatives. Data are derived from a 1986 probability sample of 570 individuals with disabilities living in communities in Calderdale, Yorkshire, England. Multiple-regression models indicate that the impact of walking disability on mobility handicap was reduced by availability of a car in the household and school or job obligations. Other impairments/disabilities, resources and social role demands examined did not act on mobility outcomes in this manner. Implications for conceptualizing and testing relationships between impairment, disability, handicap and social and physical environments are discussed. A critical task for future research is the investigation of personal and social resources and barriers that may moderate the impact of disability on individuals' lives.

Activities of Daily Living↗

The nature of increased hospital use in poor neighbourhoods: findings from a Canadian inner city.

The relationship between socioeconomic factors and hospital use is not well understood in the Canadian context. We used the 1991 Canada census and 1990-92 Ontario hospital discharge abstracts for residents of southeast Toronto to calculate crude and age-sex adjusted rates of hospital admission, bed days, and costs by quintile of low-income households. Population-based rates of admission to hospital, bed days and costs were all significantly related to census tract income (p < 0.01 for males and females). The number of admissions per person admitted was significantly associated with census tract income (p < 0.01 for males and females), but length of stay and resource intensity weight were not. Hospital costs were 50.0% higher for the poorest quintile of neighbourhoods than for the wealthiest and 35.8% higher than for the middle-income quintile. Poor urban neighbourhoods may require more resources than previously anticipated, related to higher hospital admission and readmission rates.

Adolescent↗