Risks of Daily Living Activities on Related Disability

Indonesian lost 6 days productive time in average because the disability of daily activities, that must be dealt with seriously because the effect of this problem is the declining quality of life of a person and will also cause a burden for country. This research is expected to be the key to understand and overcome the problems of disability in daily activities. The research used cross sectional design with a secondary data based of Indonesian Family Life Survey (IFLS) 5. The analysis in this study was logistic regression with samples aged >40 years who participated in data collection conducted by RAND with a total of 8185 respondents. Almost all variables examined in this study were statistically significant with disabilities, there were age (p = 0.000, OR = 2.996, 95%CI = 2.726 – 3.294), gender (p = 0.000, OR = 1.858, 95%CI = 1.693 – 2.039), marital status (p = 0.000, OR = 2.211, 95%CI = 1.997 – 2.448), employment status (p = 0.000, OR = 2.540, 95%CI = 2.321 – 2.780), arthritis status (p = 0.000, OR = 1.687, 95%CI = 1.482 – 1.919) and obesity (p = 0.000, OR = 1.345, 95%CI = 1.177 – 1.538). Only variable educational level that is not significant with disability (p=0,198). The target of disability management is prioritized at an older age by providing health education and assistance so that they can withstand the threat of daily disability and lead to an improvement in their quality of life

Effect of Influenza Vaccination on Mortality and Risk of Hospitalization in Elderly Individuals with and without Disabilities: A Nationwide, Population-Based Cohort Study

Purpose: The effects of influenza vaccines are unclear for elderly individuals with disabilities. We use a population-based cohort study to estimate the effects of influenza vaccines in elderly individuals with and without disabilities. Methods: Data were taken from the National Health Insurance Research Database and Disabled Population Profile of Taiwan. A total of 2,741,403 adults aged 65 or older were identified and 394,490 were people with a disability. These two groups were further divided into those who had or had not received an influenza vaccine. Generalized estimating equations (GEE) were used to compare the relative risks (RRs) of death and hospitalization across the four groups. Results: 30.78% elderly individuals without a disability and 34.59% elderly individuals with a disability had vaccinated for influenza. Compared to the unvaccinated elderly without a disability, the vaccinated elderly without a disability had significantly lower risks in all-cause mortality (RR = 0.64) and hospitalization for any of the influenza-related diseases (RR = 0.91). Both the unvaccinated and vaccinated elderly with a disability had significantly higher risks in all-cause mortality (RR = 1.81 and 1.18, respectively) and hospitalization for any of the influenza-related diseases (RR = 1.73 and 1.59, respectively). Conclusions: The elderly with a disability had higher risks in mortality and hospitalization than those without a disability; however, receiving influenza vaccinations could still generate more protection to the disabled elderl

Innovations in risk insurance models

Smallholder farmers face a range of risks related to production, transactions and human resources which often impact on their farming operations as well as their livelihoods. Farm output may vary from season to season because of the vagaries of the weather, especially in countries where agriculture is predominantly rain-fed. Crop production can also be affected by diseases, pests and other natural factors. They face human resource risks associated with death, disease and disability affecting the farmer and his/her family members. They may incur losses as a result of inability to enforce contracts and may themselves be vulnerable to legal risks arising from farm legislations or regulatory standards. Smallholder farmers are also exposed to uncertain access to markets and high price risks which may sometimes occur, or are accentuated by inefficiencies in markets or policy interventions. This policy brief provides an overview of different insurance tools that can be used by farmers to manage risks

Nonlinear Associations Between Working Hours and Overwork-Related Cerebrovascular and Cardiovascular Diseases (CCVD)

Long working hours are recognized as a risk factor for cerebrovascular and cardiovascular diseases (CCVD). We investigated the relationship between working hours and different CCVD severity outcomes—death, disability, and illness—across industries in Taiwan from 2006 to 2016. We applied a generalized additive mixed model to estimate the association between working hours and the rate of each severity outcome, adjusted for salary, unemployment rate, time, and a random intercept. Industry-average working hours were significantly associated with each outcome level of overwork-related CCVD, especially when monthly working hours increased from 169 (relative risk [RR] = 1.46, 95% confidence interval [CI] 1.002–2.12) to 187 (RR = 5.73, 95% CI 3.61–9.08). Although RR trends declined after monthly working hours exceeded 187, excess risks remained statistically significant. Each 1-hour increase in working hours had a stronger effect on the RR increase in death and disability than on illness. Variations in CCVD risks existed across industries, with the highest risk in transportation and information. Reducing working hours is essential to preventing overwork-related CCVD, especially the more severe outcomes. We recommend further research to address possible underreporting of less severe cases, and to explore actions to narrow the gaps in risk across industries

Frailty as a predictor of disabilities among community-dwelling older people: a systematic review and meta-analysis

BACKGROUND: Frailty has been shown to be associated with disability in the previous studies. However, it is not clear how consistently or to how much degree frailty is actually associated with the future disability risks. METHODS: A systematic review of the literature was conducted using Embase, MEDLINE, CINAHL, PsycINFO, and the Cochrane Library for any prospective studies published from 2010 to September 2015 examining associations between baseline frailty status and subsequent risk of developing or worsening disabilities among community-dwelling older people. A meta-analysis was performed to synthesize pooled estimates. RESULTS: Of 7012 studies identified through the systematic review, 20 studies were included in the meta-analysis. Twelve studies examined activities of daily living (ADL) disability risks, two studies examined instrumental activities of daily living (IADL) disability risks, and six studies examined both ADL and IADL disability risks. Overall, frail older people were more likely to develop or worsen disabilities in ADL (12 studies, pooled OR = 2.76, 95% CI = 2.23-3.44, p < 0.00001; 5 studies, pooled HR = 2.23, 95% CI = 1.42-3.49, p < 0.00001) and IADL (6 studies, pooled OR = 3.62, 95% CI = 2.32-5.64, p < 0.00001; 2 studies, pooled HR = 4.24, 95% CI = 0.85-21.28, p = 0.08). Prefrailty was also associated with incident or worsening disability risks to a lesser degree in most pooled analyses. High heterogeneity observed among 12 studies with OR of ADL disability risks for frailty was explored using subgroup analyses, which suggested methodological quality and mean age of the cohort were the possible causes. CONCLUSION: This systematic review meta-analysis quantitatively showed that frail older people are at higher risks of disabilities. These results are important for all related parties given population aging worldwide. Interventions for frailty are important to prevent disability and preserve physical functions, autonomy, and quality of life. Implications for Rehabilitation Although frailty has been shown to be associated with disability and considered as a precursor of disability, it is not clear how consistently or to how much degree frailty is actually associated with the future disability risks. This systematic review and meta-analysis quantitatively shows frailty is a significant predictor of incident and worsening ADL and IADL disabilities. It is a pressing priority to develop interventions for frailty to prevent disability and preserve older people's physical functions, autonomy, and quality of life

First Transit v. Chernikoff, 135 Nev. Adv. Op. 32 (Aug. 1, 2019)

The Court clarified that (1) the heightened duty of care by common carriers only applies to transportation-related risks, and (2) when a common carrier is aware of a passenger’s disability, reasonable care includes providing safe transport that the circumstances reasonably require based on the disability

A multifactorial approach for understanding fall risk in older people

OBJECTIVE: To identify the interrelationships and discriminatory value of a broad range of objectively measured explanatory risk factors for falls. DESIGN: Prospective cohort study with 12-month follow-up period. SETTING: Community sample. PARTICIPANTS: Five hundred community-dwelling people aged 70 to 90. MEASUREMENTS: All participants underwent assessments on medical, disability, physical, cognitive, and psychological measures. Fallers were defined as people who had at least one injurious fall or at least two noninjurious falls during a 12-month follow-up period. RESULTS: Univariate regression analyses identified the following fall risk factors: disability, poor performance on physical tests, depressive symptoms, poor executive function, concern about falling, and previous falls. Classification and regression tree analysis revealed that balance-related impairments were critical predictors of falls. In those with good balance, disability and exercise levels influenced future fall risk-people in the lowest and the highest exercise tertiles were at greater risk. In those with impaired balance, different risk factors predicted greater fall risk-poor executive function, poor dynamic balance, and low exercise levels. Absolute risks for falls ranged from 11% in those with no risk factors to 54% in the highest-risk group. CONCLUSIONS: A classification and regression tree approach highlighted interrelationships and discriminatory value of important explanatory fall risk factors. The information may prove useful in clinical settings to assist in tailoring interventions to maximize the potential benefit of falls prevention strategies

Emergency plans in schools: Individualised disaster planning for students with impaired vision

In light of recent disasters, families, schools and communities are developing plans to manage school response. Few students have individualised safety plans built into their IEPs and most schools do not have inclusive plans for safety in the event of disaster. Carefully considered emergency plans, which address the needs of all students, could bring peace of mind to families and school personnel, could prevent the exacerbation of disability and could save lives. Disabled children are at great risk for displacement during rapid evacuations and slowed reunification with families following a disaster, among other disaster related risks. The objective of this research is to provide literature based recommendations for research and practice for safety planning in schools for children with impaired vision. - See more at: http://mro.massey.ac.nz/handle/10179/7516?show=full#sthash.B2F75Q1f.dpuffalsePublishe

Teaching & learning guide for disability and climate justice

Disability is widespread: nearly one in four Americans has a disability (Taylor, 2018) and disability cuts across demographic categories. Among individuals aged 15 and over, 12.6% had some type of mobility disability; above age 65, it is nearly 40% (Brault, 2012). Mobility disabilities heighten vulnerability to climate change and climate-related disasters (UNHCHR, 2020). Reduced information resources and mobility, increased health risks, and a lack of visibility in climate change discourse put people with disabilities in a more vulnerable position in the climate crisis. However, this vulnerability can be mitigated through relevant and sufficient access to information, risk mitigation strategies, and policy-shaping power. However, when these resilience-building resources are not accessible to disabled people, it exacerbates their vulnerability to climate change and becomes an issue of climate (in)justice. This guide and the accompanying article explore ways to teach the intersection of disability and climate justice for a better understanding of each

The Michigan Disability Prevention Study: Research Highlights

This 3-year collaborative research project was designed to provide empirical evidence to substantiate the impact of various employer policies and practices on the prevention and management of workplace disability. It studied a random sample of 220 Michigan establishments with more than 100 employees from seven different industries who responded to a mail survey in the first half of 1991. The study correlates differences in employer-reported levels of achievement on policy and practice dimensions with performance on disability outcome measures, while controlling for a set of establishment characteristics in a multivariate regression analysis. There are three sets of policy and practice interventions evaluated here. First is safety intervention, that is, the attempt to prevent injuries from happening at all (measured as Safety Diligence, Ergonomic Solutions, and Safety Training). Second is disability management, the set of strategies to minimize the disability consequences of a given injury or disease arising from the workplace (measured as Disability Case Monitoring and Proactive Return-to-Work Program). Third is health promotion, which represents an attempt to intervene directly with individuals to encourage more healthy lifestyles, in the expectation that this will reduce the likelihood of a workplace accident or disease, or reduce the lost worktime resulting from a given injury or disease (measured as Wellness Orientation). In addition, a fourth dimension was included to capture the general environment of the firm and the orientation of its management in areas relevant to the study (measured as People Oriented Culture and Active Safety Leadership). These interventions and the general environment of the firm were scored on this set of eight variables which represent self-rated firm achievement of the policy and practice dimensions. The marginal effect of these interventions is determined by comparing firm performance on the incidence of work-related disability (Lost Workday Cases and Workers' Compensation Wage-Loss Claims), the duration of disability (Lost Workdays per Case), and overall disability prevention and management performance (Total Lost Workdays). Our results show that a higher self-rating on Safety Diligence is strongly associated with better performance on disability outcomes, varying with the specific measure. Higher self-rating on Proactive Return-to-Work Programs is also strongly associated with better performance outcomes. Safety Training and Active Safety Leadership is shown to have significant effects on the number of Lost Workday Cases. For example, on the summary measure of total Lost Workdays per 100 Employees, 10 percent better self-rating on Safety Diligence translates into 17 percent fewer lost workdays, and 10 percent better self-rating on Proactive Return-to-Work Programs translates into 7 percent fewer lost workdays. Thus, the twin strategies of trying to prevent injuries in the first place, and working to ameliorate their disability effects through disability management techniques, are both shown to be productive in reducing workplace disability in those establishments that have implemented them rigorously. Disability Case Monitoring could not be shown to have significant effects; in fact, Disability Case Monitoring had negative impacts in some cases. This probably reflects the controlling aspects of Disability Case Monitoring, as we speculate that these practices can be viewed by the employees as negative and interfering if they do not emanate from a supportive company human resource climate. Ergonomic Solutions and Wellness Orientation generally do not perform significantly, and this is attributed to their indirect connection to the performance outcomes used here or ineffective measurement of these dimensions in the study. Site visits were made to a subsample of 32 firms selected from the larger, random sample in order to confirm the quantitative survey findings and gain operational understanding of successful policies and practices contributing to low disability rates. Companies were generally found to be most advanced in their safety efforts, very active in injury management, and had implemented at least some form of return-to-work. Health promotion strategies to prevent specific work injuries have not yet been fully developed. The disability prevention efforts of successful firms use data effectively to measure performance, identify problems, guide actions taken, and motivate active support and participation of management, supervisors and line employees. Successful firms rigorously investigate injuries and communicate their commitment by immediately responding to risks when they are identified. In these low-disability firms, safety and disability management are viewed as components of quality, productivity and financial stability. Working relationships have been developed with responsive health care providers to assure effective injury management, but firms also maintain an active role in case management themselves. Their return-to-work process is systematic, yet flexible to respond to individual needs. Innovative firms have also implemented ergonomic principles to prevent risks. Nearly all companies visited reported increasing incidence and costs due to cumulative trauma and repetitive motion disorders. Additional strategies are needed to resolve and prevent these disabilities. This study demonstrates that many employers have moved aggressively to policies and practices designed to reduce the incidence and the costs of disability in their workplace. The project concludes that disability can be prevented and managed; and those who do it well can expect to be rewarded with lower disability costs, more satisfied workers, higher productivity and, ultimately, higher profits.disability, workers', compensation, Michigan, Hunt, Habeck