Zeitschriftenartikel: „Capacity and disability – england“

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Shah, Ajit, Chris Heginbotham, Bill Fulford, Natalie Banner, Karen Newbigging und Mat Kinton. „A Pilot Study of the Early Experience of Consultant Psychiatrists in the Implementation of the Mental Capacity Act 2005: Local Policy and Training, Assessment of Capacity and Determination of Best Interests“. International Journal of Mental Health and Capacity Law, Nr. 19 (08.09.2014): 149. http://dx.doi.org/10.19164/ijmhcl.v0i19.251.

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The Mental Capacity Act 2005 (MCA) was partially implemented in April 2007 and fully implemented in October 2007 in England and Wales (with the exception of the Deprivation of Liberty Safeguards which were implemented in April 2009). The government estimated that up to 2 million adults in England and Wales may have issues concerning their decision-making capacity (henceforth ‘capacity’), and these will included 840,000 people with dementia, 145,000 people with severe learning disability, 1.2 million people with mild to moderate learning disability and 120,000 people with severe brain injury. Additionally, the prevalence of schizophrenia, mania and serious depression are 1%, 1% and 5% respectively, and some of these individuals may also lack capacity. Moreover, up to 6 million family and unpaid carers are estimated to provide care or treatment for individuals lacking capacity. Furthermore, many other people who do not lack capacity may use aspects of the MCA for future planning.

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Bearden, Elizabeth B. „Before Normal, There Was Natural: John Bulwer, Disability, and Natural Signing in Early Modern England and Beyond“. PMLA/Publications of the Modern Language Association of America 132, Nr. 1 (Januar 2017): 33–50. http://dx.doi.org/10.1632/pmla.2017.132.1.33.

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Disability studies scholars and Renaissance scholars have much to learn from early modern schemata of disability. Early modern people used nature and the natural to discriminate against and to include people with atypical bodies and minds. In his writings, the English physician John Bulwer (1606–56) considers Deafness a natural human variation with definite advantages, anticipating current concepts of biolinguistic diversity and Deaf-gain, while acknowledging his society's biases. He refutes the exclusion of sign language and other forms of what he calls “ocular audition” from natural law, which made capacity for speech the benchmark for natural rights. Instead of using Deaf people as exceptions that prove the rule of nature or as limit cases for humanity, Bulwer makes deafness part of a plastic understanding of the senses, and he promotes the sociability of signed languages as a conduit to a universal language that might be encouraged and taught in England.

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Le Gallez, Isabelle, Keith J. B. Rix, Kartina A. Choong und Helen Dewson. „Sexual rights, mental disorder and intellectual disability: principles and law“. BJPsych Advances 24, Nr. 5 (20.07.2018): 334–45. http://dx.doi.org/10.1192/bja.2018.32.

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SUMMARYPeople with mental disorder and intellectual disability have the same rights to sexual expression as other people, albeit that in some cases a lack of capacity may require curtailment of those rights and regard must be had to protecting the vulnerable. Furthermore, the formation or maintenance of sexual relations, or the attainment of sexual fulfilment, may assist in the maintenance or restoration of mental health or well-being. This article demonstrates how the courts in England and Wales, applying statute law and judicial precedent, are largely supportive of the rights of people with mental disorder or intellectual disability to make decisions about sexual expression, sexual relationships and related matters, notwithstanding some societal and staff attitudes that act to prevent them fulfilling their sexual needs and making decisions about sexual and reproductive matters.LEARNING OBJECTIVES•Understand the underlying principles that apply to the exercise of their sexual rights by people with mental disorder or intellectual disability•Understand some of the obstacles to the exercise of sexual rights by people with mental disorder or intellectual disability•Understand the statute and case law that apply to the exercise of sexual rights by people with mental disorder or intellectual disabilityDECLARATION OF INTERESTNone.

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Soifer, Aviam. „The Paradox of Paternalism and Laissez-Faire Constitutionalism: United States Supreme Court, 1888–1921“. Law and History Review 5, Nr. 1 (1987): 249–79. http://dx.doi.org/10.2307/743942.

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In 1898, the year Americans first sailed forth to fight in other countries to protect purported victims of imperialism, A. V. Dicey steamed into Harvard University to deliver his lectures on Law and Public Opinion in England. Like William Blackstone, Vinerian Professor before him, Dicey deployed a number of memorable epigrams to capture what seemed basic truths of his day. Dicey's assertion that ‘protection invariably involves disability’ appeared to state the obvious to Americans at the turn of the century.In this essay I will consider how the United States Supreme Court embraced Dicey's epigram and translated it into decisions during the tenures of Chief Justices Fuller and White about the capacity of the individual in the United States to contract and care for himself.

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Series, Lucy. „On Detaining 300,000 People: the Liberty Protection Safeguards“. International Journal of Mental Health and Capacity Law 2019, Nr. 25 (30.06.2020): 82. http://dx.doi.org/10.19164/ijmhcl.v2019i25.952.

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The Mental Capacity (Amendment) Act 2019 will introduce a new framework––the Liberty Protection Safeguards (LPS)––for authorising arrangements giving rise to a deprivation of liberty to enable the care and treatment of people who lack capacity to consent to them in England and Wales. The LPS will replace the heavily criticised Mental Capacity Act 2005 deprivation of liberty safeguards (MCA DoLS). The new scheme must provide detention safeguards on an unprecedented scale and across a much more diverse range of settings than traditional detention frameworks linked to mental disability. Accordingly, the LPS are highly flexible, and grant detaining authorities considerable discretion in how they perform this safeguarding function. This review outlines the background to the 2019 amendments to the MCA, and contrasts the LPS with the DoLS. It argues that although the DoLS were in need of reform, the new scheme also fails to deliver adequate detention safeguards, and fails to engage with the pivotal question: what are these safeguards for?Keywords: Mental Capacity (Amendment) Act 2019; Mental Capacity Act 2005; deprivation of liberty safeguards; liberty protection safeguards; article 5 European Convention on Human Rights; P v Cheshire West and Chester Council and another; P and Q v Surrey County Council [2014] UKSC 19; [2014] A.C. 896; [2014] H.R.L.R. 13

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Flynn, Eilionóir. „Disability, Deprivation of Liberty and Human Rights Norms: Reconciling European and International Approaches“. International Journal of Mental Health and Capacity Law 2016, Nr. 22 (23.02.2017): 76. http://dx.doi.org/10.19164/ijmhcl.v22i2.503.

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<span style="font-family: 'Helvetica',sans-serif; font-size: 12pt; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">Persons with disabilities are subject to unique forms of deprivation of liberty, often justified by reference to the need to protect their right to life, right to health, and to protect the human rights of others. This paper examines disability-specific forms of deprivation of liberty, particularly those authorised in mental health and capacity law, in light of their compliance with European and international human rights frameworks. It explores the apparent tension between Article 5 of the European Convention on Human Rights, which permits deprivation of liberty of ‘persons of unsound mind’ in certain circumstances, and Article 14 of the UN Convention on the Rights of Persons with Disabilities, which states that ‘the existence of a disability shall in no case justify a deprivation of liberty.’ The challenges in attempting to comply with both provisions are illustrated through reference to developments in England and Wales. This paper also seeks to offer a way forward for States Parties to both Conventions, in order to protect the rights of persons with disabilities.

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Branton, Tim, und Guy Brookes. „Definitions and criteria: the 2007 amendments to the Mental Health Act 1983“. Advances in Psychiatric Treatment 16, Nr. 3 (Mai 2010): 161–67. http://dx.doi.org/10.1192/apt.bp.108.006577.

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SummaryThis article deals with the provisions for the lawful detention and compulsory treatment of patients in England and Wales. The 2007 amendments to the Mental Health Act 1983 redefine ‘mental disorder’ and ‘medical treatment’ and remove the classifications required for longer-term detention, abolishing the so-called ‘treatability test’ and introducing a new appropriate-treatment test. ‘Learning disability’ is brought within the definition of mental disorder but only if ‘associated with abnormally aggressive or seriously irresponsible conduct’. The exclusion for promiscuity, other immoral conduct or sexual deviancy is repealed; the exclusion for dependence on alcohol and drugs is retained. The revised definition of ‘medical treatment’ includes psychological treatment and removes the requirement that treatment is under medical supervision. The basic structure of the 1983 Act is retained. Use of the powers is discretionary. The principles of the Mental Capacity Act 2005 are imported into the decision-making framework through the wording of the Mental Health ActCode of Practice.

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Carroll, John, und Jill Davies. „Stopping Over-Medication of People With a Learning Disability, Autism or Both (STOMP) – a Community Audit“. BJPsych Open 9, S1 (Juli 2023): S151—S152. http://dx.doi.org/10.1192/bjo.2023.408.

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AimsThe stopping over-medication of people with a learning disability, autism or both (STOMP) campaign was launched by NHS England in 2016 as part of the Transforming Care programme. It aims to reduce the inappropriate prescribing of psychotropic medication to manage challenging behaviour in the absence of a licenced indication. The current audit aimed to demonstrate adherence to national standards for STOMP within the community learning disability teams (CLDTs) of Oxleas NHS Foundation Trust. Additionally, a secondary aim was to compare current adherence to the previous audit undertaken in 2019.MethodsAudit standards were derived from national guidance by the Royal College of Psychiatrists and the National Institute for Health and Care Excellence. The population was defined as all patients open to a CLDT prescriber (medical or non-medical) between April 2020 - March 2021. A multidisciplinary working group agreed inclusion and exclusion criteria before designing an electronic audit questionnaire. A random sample of 20% of patients from each of the three CLDTs (Bexley, Bromley & Greenwich) was generated. Data were collected between October and November 2021.ResultsThe clinical records of 111 patients were reviewed, 86 of whom met inclusion criteria. Of these, 65 patients were taking psychotropic medication and progressed to full auditing. Key findings were: 85% of patients on established psychotropics had a medication review within the previous 6 months, of which 100% were assessed for their response to treatment and 86% were assessed for side effects; 78% of patients had their capacity to consent to treatment documented and, of those lacking capacity, 81% had a best interests decision documented. All but one of these key findings demonstrated an improvement compared to the 2019 audit.ConclusionOverall, this 2021 audit demonstrates a substantial improvement since the previous audit in 2019. However, adherence to national standards continues to be below 100%. Dissemination of findings and an updated action plan are indicated before re-audit in 2023.

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Gupta, Jaya, Angela Hassiotis, Ingrid Bohnen und Yogesh Thakker. „Application of community treatment orders (CTOs) in adults with intellectual disability and mental disorders“. Advances in Mental Health and Intellectual Disabilities 9, Nr. 4 (06.07.2015): 196–205. http://dx.doi.org/10.1108/amhid-02-2015-0007.

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Purpose – The purpose of this paper is to explore use of community treatment orders (CTOs) in adults with intellectual disability (ID) and mental health problems across England and Wales. Design/methodology/approach – A web-based exploratory survey was sent to 359 consultants on the database of the Faculty of the Psychiatry of ID, Royal College of Psychiatrists who had declared ID as their main speciality. Socio-demographic details of responding consultants, clinical characteristics of adults with ID on CTO, subjective views of consultants on using CTOs in people with ID were collected and analysed. Findings – In total, 94 consultant questionnaires were returned providing information on 115 patients detained under CTO. More than 75 per cent of the respondents had used CTO in their clinical practice. Patients subject to CTO were generally young, white males with mild ID and living in supported accommodation. CTOs were primarily used in situations of non-engagement (52.2 per cent), non-compliance with medication (47 per cent) or non-compliance with social care supports (49.6 per cent). Practical implications – Responding consultants expressed concerns about encroachment of civil liberties and ethics of using CTOs in people with ID who may lack capacity and stressed that decision to use CTOs needs to be therefore done on individual basis. Originality/value – This is the first national study to examine the practice of applying CTOs in adults with ID and mental disorders. Current practice is based on evidence from research done in adults with normal intelligence. Further research is needed to investigate the utility of CTOs in routine clinical practice in adults with ID and mental disorders.

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Bartlett, Annie, Nadia Somers, Matthew Fiander und Mari Anne Harty. „Pathways of care of women in secure hospitals: which women go where and why“. British Journal of Psychiatry 205, Nr. 4 (Oktober 2014): 298–306. http://dx.doi.org/10.1192/bjp.bp.113.137547.

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BackgroundCare pathways for women needing expensive, secure hospital care are poorly understood.AimsTo characterise women in low and medium security hospitals in England and Wales and to compare populations by security and service provider type.MethodCensus data from all specialist commissioning areas. Sociodemographic, clinical, medico-legal, criminological and placement needs data were requested on all women in low and medium secure hospital beds. Parametric tests were used for continuous data and chi-square or Fisher's exact tests for categorical data. Thematic analysis was used for free text data.ResultsThe independent sector is the main service provider. A third of all women (n = 1149) were placed outside their home region despite spare local National Health Service (NHS) capacity. The independent sector provides for women with relatively rare disorders, including intellectual disability. The NHS admits most serious offenders. One in 20 are detained because of self-harm alone.ConclusionsPatient-specific factors (notably the diagnosis of personality disorder) and organisational inadequacy (commissioner and service provider) contribute to placements that compromise rehabilitation. Responses should include local solutions for women whose main risk is self-harm and a national approach to women with highly specialist needs.

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GARTHWAITE, KAYLEIGH, CLARE BAMBRA, JONATHAN WARREN, ADETAYO KASIM und GRAEME GREIG. „Shifting the Goalposts: A Longitudinal Mixed-Methods Study of the Health of Long-Term Incapacity Benefit Recipients during a Period of Substantial Change to the UK Social Security System“. Journal of Social Policy 43, Nr. 2 (04.02.2014): 311–30. http://dx.doi.org/10.1017/s0047279413000974.

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AbstractThe UK social security safety net for those who are out of work due to ill health or disability has experienced significant change, most notably the abolition of Incapacity Benefit (IB) and the introduction of Employment and Support Allowance (ESA). These changes have been underpinned by the assumption that many recipients are not sufficiently sick or disabled to ‘deserve’ welfare benefits – claims that have been made in the absence of empirical data on the health of recipients. Employing a unique longitudinal and mixed-methods approach, this paper explores the health of a cohort of 229 long-term IB recipients in the North East of England over an eighteen-month period, during a time of significant changes to the UK welfare state. In-depth interviews with twenty-five of the survey cohort are also presented to illustrate the lived experiences of recipients. Contributing to debates surrounding the conceptualisation of work-readiness for sick and disabled people, findings indicate IB recipients had significantly worse health than the general population, with little change in their health state over the eighteen-month study period. Qualitative data reinforced the constancy of ill health for IB recipients. Finally, the paper discusses the implications for social policy, noting how the changing nature of administrative definitions and redefinitions of illness and capacity to work can impact upon the lives of sick and disabled people.

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Joanne, Crook, Patel Deepa, Ward Emily und Marvin Vanessa. „P29 An evaluation of the views of adolescent patients with a learning disability and their carers on a medicines information leaflet“. Archives of Disease in Childhood 103, Nr. 2 (19.01.2018): e1.35-e1. http://dx.doi.org/10.1136/archdischild-2017-314584.40.

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AimThis study aims to assess the views of adolescent patients with Learning Disability (APLD) and their carers, on a Medicines Information (MI) leaflet MethodsA questionnaire was devised with 10 questions. Its purpose was to find out if APLD/carers thought the MI leaflet was useful and if they would recommend it. The MI leaflet includes information about preparation before a hospital appointment; problems patients may face with their medicines, medicine interactions and information resources. ‘Full of life’ is a charity that supports families who care for APLD. Patients and carers from the charity were invited to attend a focus group. MI leaflets and questionnaires were distributed for comment, to those who attended. Ethics approval was not required for this study. Data was assessed using Microsoft Excel.Results20 questionnaires were distributed, 17 completed questionnaires were returned at the end of the session (85% response rate). 70% (n=12) of questionnaires were completed by carers, 24% (n=4) by family members and 1% (n=1) by a patient. 100% (n=17) of carers/patients who read the MI leaflet found it useful. Over 70% (n=12) stated that the leaflet had improved their understanding about medications. All patients/carers would recommend the leaflet to others. Comments about features that patient/carer’s liked included: ‘Very informative’ and ‘I like the colour of the leaflet, the writing is simple to understand’. The patients/carers were asked about ways the leaflet could be improved. Comments included; ‘Laminate the leaflet’, ‘Make the background colour lighter to make the text stand out.’ Limitations included a small sample size, over a short period of time. Patients were sampled from a patient charity focus group, so not representative.ConclusionAPLD may regularly access healthcare services and are faced with challenges. Patients can find it difficult to explain their health conditions and have problems with speech and language structure. This can lead to important medical information being missed.1 UK health organisations have been actively engaged in improving the care for patients with LD.2 The Care Quality Commission (CQC) has resolved to ‘pay particular attention to the needs of people in more vulnerable circumstances’.3 Our multi-disciplinary team have developed a MI leaflet for APLD. Overall, the MI leaflet was received very positively. The extent of an LD can vary significantly; the MI leaflet has been designed for the ‘higher level learners’.For other patients, with less capacity, the leaflet would be more suited to be used by carers. Opportunities for future work include a ‘more visual, simplistic’ leaflet for ‘lower level learners’.ReferencesJubraj B, Deakin A, Mills S, et al. Pharmacy consultations with patients with learning disabilities. The Pharmaceutical Journal19 Jan 2016. http://www.pharmaceutical-journal.com/learning/learning-article/pharmacy-consultations-with-patients-with-learning-disabilities/20200330.articleNHS England. Building the right supportOctober 2015. https://www.england.nhs.uk/wp-content/uploads/2015/10/ld-nat-imp-planoct15.pdfCare Quality Commission. Position statement and action plan for learning disability 2010–2015. http://www.cqc.org.uk/sites/default/files/documents/cqc_learning_disability_position_statement_and_action_plan_0.pdf

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Zigmond, A., und A. J. Holland. „Unethical Mental Health Law; History Repeats Itself“. International Journal of Mental Health and Capacity Law, Nr. 3 (08.09.2014): 50. http://dx.doi.org/10.19164/ijmhcl.v0i3.315.

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The powers enshrined in mental health legislation go directly to fundamental principles central to any caring and democratic society. The tension and dilemma that exists is, on the one hand, the importance of respect for an individual’s right to make decision’s affecting his/her own life to, on the other, the recognition that there are people with mental disabilities that may be vulnerable to abuse and/or neglect and who throughout their lives or at particular times need care and/or treatment, which they may not seek or be able to consent to themselves. In any society it is through case law and statute that an attempt is made to resolve this tension and to ensure that individual rights are not infringed and that those who need care and treatment receive what is in their best interest. Thus a change in such legislation requires the most rigorous of examination and must be judged on the grounds that it a) does not infringe accepted principles such as those of the United Nations Declaration of Human Rights and the European Convention, b) is based on sound ethical principles and does not conflict with the established law of the country, and c) it is practicable and achieves the right balance with respect to the potential tension described above. As practising clinicians (one working in an acute psychiatric service the other in a district learning disability service) we are not in a position expertly to judge the first of these but we believe we can contribute to the second and the third. In this paper we consider specifically the reasons for, and the consequences that follow, the failure on the Government’s part to accept the central importance of decision-making capacity assessment in any new mental health legislation.The Green Paper proposals for a new Mental Health Act for England and Wales have now been published. A broad definition of ‘mental disorder’ has been retained, a new system of tribunals is to be established and compulsory treatment in the community would become lawful. However, it rejects the recommendation of the expert committee chaired by Professor Richardson that the assessment of an individual’s decision-making capacity should be a determining factor in the use of compulsory detention. Given this, it does not address the relationship between this legislation and the proposed Mental Incapacity Act. The failure to recognise the central place of decision-making capacity in a modern Mental Health Act is, we believe, a serious omission as it is a reflection of a failure to acknowledge that the basic principle of autonomy is central to such legislation.

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Bartlett, Peter. „English Mental Health Reform: Lessons from Ontario?“ International Journal of Mental Health and Capacity Law 1, Nr. 5 (08.09.2014): 27. http://dx.doi.org/10.19164/ijmhcl.v1i5.359.

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Reforms in areas related to mental disability are under debate in England to an extent unprecedented for almost half a century. The Law Commission’s proposals on incapacity, following further consultation from the Lord Chancellor’s Department, have now largely been accepted in principle by the government for legislative enactment at some time in the undetermined future. A joint green paper from the Home Office and the Department of Health has established a policy agenda concerning the governance of people with serious personality disorders. Proposals by an expert committee chaired by Professor Genevra Richardson on mental health reform have likewise been followed up by a government green paper, and the two green papers have in turn resulted in a joint white paper on reform of the Mental Health Act 1983. All this takes place as the Human Rights Act 1998 takes effect, with its guarantees relating to liberty and security of the person, standards for hearings, respect for private and family life, and protection from inhuman or degrading treatment. Throughout the development of the reforms, a number of similar themes have recurred, involving civil rights, the provision of appropriate legal processes, anti-discrimination, the respect for people with capacity, the extension of controls into the community, and the safety both of people with mental disabilities and of the public as a whole.At least in the public arena, most of the debate has focussed on the English situation. The premise of this paper is that the situation in the rest of the world may have something to teach us. The paper examines the law of Ontario. While it focuses primarily on those issues related to the Richardson Report and its subsequent government response, Ontario legislation divides issues somewhat differently to English law, and thus overlap with the other reform proposals is inevitable.

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Pytel, Aleksandra, Jan Aleksander Beszlej, Monika Biercewicz, Anna Roszmann, Dorota Krówczyńska und Aleksandra Kołtuniuk. „The Effect of Frailty Syndrome on the Quality of Life of Individuals with Parkinson’s Disease: A Pilot Observational and Multicenter Study on the Polish Population“. International Journal of Environmental Research and Public Health 19, Nr. 22 (18.11.2022): 15226. http://dx.doi.org/10.3390/ijerph192215226.

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Parkinson’s disease (PD) is a neurodegenerative disorder involving decreased dopamine release and atrophy of dopaminergic neurons of the substantia nigra. Frailty syndrome (FS) is common in older adults, which, in combination with PD symptoms, can substantially affect the quality of life (QOL). This study aimed to assess the prevalence of FS among PD patients and to identify variables affecting their QOL with particular attention to FS. The study included 296 patients (n = 173 women) with a mean age of 70.3 ± 5.7 years suffering from PD for an average of 8.2 ± 5.6 years. Patients were classified as at least stage II according to the Hoehn and Yahr scale. The following standardized questionnaires were used in the study: Schwab and England Activities of Daily Living (SE-ADL), Parkinson’s Disease Questionnaire (PDQ-39), Beck Depression Inventory (BDI), Unified Parkinson’s Disease Rating Scale (UPDRS), and Tilburg Frailty Indicator (TFI). FS was found in 96% (n = 283) of the PD patients studied. No depression occurred in 30% (n = 89) of subjects, moderate depression in 48% (n = 141) of subjects, and severe depression in 22% (n = 66) of subjects. The mean score of the PDQ-39 questionnaire in PD subjects with FS was 41.6 pts (min–max: 5.2–81.5 pts; SD = 17.4 pts), which was statistically significantly higher than in subjects without FS (p < 0.05). FS has been shown to be present in most of the subjects with PD. FS occurs more frequently with a longer PD period, which is associated with reduced physical capacity and QOL. Physical activity improves QOL and reduces disease progression. FS, similar to PD, is a common cause of disability in older adults and their dependency. Predictors such as depression, advanced stage of the disease, higher education, and low professional and economic status significantly affect the QOL level of PD patients. However, the results obtained among the Polish population of PD patients do not confirm the impact of FS on the QOL, so there is a need to conduct further research on this subject.

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Fulop, Naomi J., Angus IG Ramsay, Rachael M. Hunter, Christopher McKevitt, Catherine Perry, Simon J. Turner, Ruth Boaden et al. „Evaluation of reconfigurations of acute stroke services in different regions of England and lessons for implementation: a mixed-methods study“. Health Services and Delivery Research 7, Nr. 7 (Februar 2019): 1–250. http://dx.doi.org/10.3310/hsdr07070.

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Background Centralising acute stroke services is an example of major system change (MSC). ‘Hub and spoke’ systems, consisting of a reduced number of services providing acute stroke care over the first 72 hours following a stroke (hubs), with a larger number of services providing care beyond this phase (spokes), have been proposed to improve care and outcomes. Objective To use formative evaluation methods to analyse reconfigurations of acute stroke services in different regions of England and to identify lessons that will help to guide future reconfigurations, by studying the following contrasting cases: (1) London (implemented 2010) – all patients eligible for Hyperacute Stroke Units (HASUs); patients admitted 24 hours a day, 7 days a week; (2) Greater Manchester A (GMA) (2010) – only patients presenting within 4 hours are eligible for HASU treatment; one HASU operated 24/7, two operated from 07.00 to 19.00, Monday to Friday; (3) Greater Manchester B (GMB) (2015) – all patients eligible for HASU treatment (as in London); one HASU operated 24/7, two operated with admission extended to the hours of 07.00–23.00, Monday to Sunday; and (4) Midlands and East of England – planned 2012/13, but not implemented. Design Impact was studied through a controlled before-and-after design, analysing clinical outcomes, clinical interventions and cost-effectiveness. The development, implementation and sustainability of changes were studied through qualitative case studies, documentation analysis (n = 1091), stakeholder interviews (n = 325) and non-participant observations (n = 92; ≈210 hours). Theory-based framework was used to link qualitative findings on process of change with quantitative outcomes. Results Impact – the London centralisation performed significantly better than the rest of England (RoE) in terms of mortality [–1.1%, 95% confidence interval (CI) –2.1% to –0.1%], resulting in an estimated additional 96 lives saved per year beyond reductions observed in the RoE, length of stay (LOS) (–1.4 days, 95% –2.3 to –0.5 days) and delivering effective clinical interventions [e.g. arrival at a Stroke Unit (SU) within 4 hours of ‘clock start’ (when clock start refers to arrival at hospital for strokes occurring outside hospital or the appearance of symptoms for patients who are already in-patients at the time of stroke): London = 66.3% (95% CI 65.6% to 67.1%); comparator = 54.4% (95% CI 53.6% to 55.1%)]. Performance was sustained over 6 years. GMA performed significantly better than the RoE on LOS (–2.0 days, 95% CI –2.8 to –1.2 days) only. GMB (where 86% of patients were treated in HASU) performed significantly better than the RoE on LOS (–1.5 days, 95% CI –2.5 to –0.4 days) and clinical interventions [e.g. SU within 4 hours: GMB = 79.1% (95% CI 77.9% to 80.4%); comparator = 53.4% (95% CI 53.0% to 53.7%)] but not on mortality (–1.3%, 95% CI –2.7% to 0.01%; p = 0.05, accounting for reductions observed in RoE); however, there was a significant effect when examining GMB HASUs only (–1.8%, 95% CI –3.4% to –0.2%), resulting in an estimated additional 68 lives saved per year. All centralisations except GMB were cost-effective at 10 years, with a higher net monetary benefit than the RoE at a willingness to pay for a quality-adjusted life-year (QALY) of £20,000–30,000. Per 1000 patients at 10 years, London resulted in an additional 58 QALYs, GMA resulted in an additional 18 QALYs and GMB resulted in an additional 6 QALYs at costs of £1,014,363, –£470,848 and £719,948, respectively. GMB was cost-effective at 90 days. Despite concerns about the potential impact of increased travel times, patients and carers reported good experiences of centralised services; this relied on clear information at every stage. Planning change – combining top-down authority and bottom-up clinical leadership was important in co-ordinating multiple stakeholders to agree service models and overcome resistance. Implementation – minimising phases of change, use of data, service standards linked to financial incentives and active facilitation of changes by stroke networks was important. The 2013 reforms of the English NHS removed sources of top-down authority and facilitative capacity, preventing centralisation (Midlands and East of England) and delaying implementation (GMB). Greater Manchester’s Operational Delivery Network, developed to provide alternative network facilitation, and London’s continued use of standards suggested important facilitators of centralisation in a post-reform context. Limitations The main limitation of our quantitative analysis was that we were unable to control for stroke severity. In addition, findings may not apply to non-urban settings. Data on patients’ quality of life were unavailable nationally, clinical interventions measured changed over time and national participation in audits varied. Some qualitative analyses were retrospective, potentially influencing participant views. Conclusions Centralising acute stroke services can improve clinical outcomes and care provision. Factors related to the service model implemented, how change is implemented and the context in which it is implemented are influential in improvement. We recommend further analysis of how different types of leadership contribute to MSC, patient and carer experience during the implementation of change, the impact of change on further clinical outcomes (disability and QoL) and influence of severity of stroke on clinical outcomes. Finally, our findings should be assessed in relation to MSC implemented in other health-care specialties. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Morrall, Stephen, und Charles Urquhart. „Disability Discrimination“. Legal Information Management 3, Nr. 2 (2003): 76–79. http://dx.doi.org/10.1017/s147266960000181x.

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Disability discrimination law is a fast evolving area of the law in England and Wales. This article sets out the basic concepts of what constitutes a “disability”, what constitutes “discrimination” and some of the factors that tribunals, employees and employers should consider in a disability discrimination dispute.

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Turner, David M. „Disability and Crime in Eighteenth-Century England“. Cultural and Social History 9, Nr. 1 (März 2012): 47–64. http://dx.doi.org/10.2752/147800412x13191165982953.

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Matthews, David R. „Learning disability consent and capacity“. Learning Disability Practice 6, Nr. 2 (März 2003): 26–27. http://dx.doi.org/10.7748/ldp.6.2.26.s19.

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Tavares Milhem Ygnatios, Nair, Cesar de Oliveira, Juliana Vaz de Melo Mambrini, Fabíola Bof de Andrade, Maria Fernanda Lima-Costa und Juliana Lustosa Torres. „Differences in disability and nutritional status among older Brazilian and English adults: the Brazilian Longitudinal Study of Aging (ELSI-Brazil) and English Longitudinal Study of Aging (ELSA) cohorts“. American Journal of Clinical Nutrition 114, Nr. 2 (08.04.2021): 422–28. http://dx.doi.org/10.1093/ajcn/nqab060.

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ABSTRACT Background Brazil and England are 2 countries at different stages in their demographic, epidemiological, and nutritional transitions and with distinct socioeconomic and politic contexts, but with similar universal health systems. We aimed to examine disability and its association with objective anthropometric indicators of nutritional status, including BMI, waist circumference, and waist-to-height ratio, comparing older Brazilian and English adults. Methods We used cross-sectional data from 2 nationally representative aging studies. For Brazil, we included 9412 participants who participated in the baseline (2015–2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The English data were from 8024 participants of the wave 6 (2012–2013) of the English Longitudinal Study of Aging (ELSA). Disability was defined as difficulty to perform at least 1 activity of daily living. We used logistic regression models to examine the association between anthropometric indicators and disability, adjusted for sociodemographic and health-related characteristics, considering the interaction term between each anthropometric indicator and country. Results All health-related characteristics were worse in Brazil than England, although the prevalence of disability was similar among Brazilian (17.85%) and English (16.27%) older adults. Fully adjusted models showed statistically significant interaction terms between country and anthropometric indicators. The strength of the associations in Brazil was weaker compared with England. All anthropometric indicators were positively associated with disability: elevated BMI, in Brazil (OR: 1.27; 95% CI: 1.06, 1.51) and in England (OR: 1.80; 95% CI: 1.51, 2.14); elevated waist circumference, in Brazil (OR: 1.21; 95% CI: 1.02, 1.44) and in England (OR: 1.90; 95% CI: 1.51, 2.37); and elevated waist-to-height ratio, in Brazil (OR: 1.20; 95% CI: 0.96, 1.52) and in England (OR: 1.83; 95% CI: 1.37, 2.44). Conclusions Elevated BMI and waist circumference increased the odds of disability in both populations. However, these associations were stronger in England than in Brazil.

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Chauhan, Prathiviraj Singh. „Attitude, Accessibility and Disability: Decoding the Trajectory of Exclusion in Malini Chib's One Little Finger“. Dialogue: A Journal Devoted to Literary Appreciation 18, Nr. 1 (25.06.2022): 96–105. http://dx.doi.org/10.30949/dajdtla.v18i1.19.

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Disability is an integral part of human existence, which restricts participation of a person with disability in normal activities of the developmental process. India has a substantial share of the population of persons with disability but their conditions are quite miserable. They are bound to live substandard life due to the lack of accessible infrastructure and inclusion in society. Malini Chib, a disability rights activist, presents an insider perspective of reality through her autobiographical narrative. She has lived with cerebral palsy since her childhood in India and England. Her experiences point out the deep rooted trajectory of exclusion that operates within India's cultural practices. Negative attitude, inaccessibility and lack of community participation constitute the trajectory of exclusion of persons with disability in India. She has been rejected as a 'vegetable' by Indian doctors, forcing her parents to seek a better life for her in England. Her stay and education in England empowered her to work for her community.

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Jarman, Andrea Loux. „Disability and Demonstrating Christian Commitment“. Ecclesiastical Law Journal 16, Nr. 1 (13.12.2013): 57–65. http://dx.doi.org/10.1017/s0956618x13000823.

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Community lies at the heart of both church and school life in the Church of England. In some areas, church communities are sustained by families who choose to attend a particular church based on the quality of the church school in its parish. Many Voluntary Aided Church of England schools (church schools) give priority admission to parents on the basis of faith in the oversubscription criteria of their admission arrangements. While the Church stresses inclusiveness in its recommendations regarding admissions policies to church schools, where a church school is very popular and oversubscribed arguably priority must be given to parents of the faith in the school's catchment area. Otherwise parishioner children whose families regularly attend church could fail to be admitted to their local church school because of competition for places.

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Piachaud, D. „Disability, Retirement and Unemployment of Older Men“. Journal of Social Policy 15, Nr. 2 (April 1986): 145–62. http://dx.doi.org/10.1017/s0047279400001641.

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ABSTRACTAmong older men in England from 1971 to 1981 the increase in the extent of those defined as disabled was of the same order as the increase in unemployment. Using Census data for the forty-six counties of England, changes in disability, retirement and economic activity are related to changes in unemployment. A substantial proportion of the overall increase in disability and the decline in economic activity is attributable to the general rise in unemployment.

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Stones, Richard, Osman Hassan Ahmed und Richard Weiler. „How disability can win England the World Cup“. British Journal of General Practice 64, Nr. 623 (27.05.2014): 298. http://dx.doi.org/10.3399/bjgp14x680209.

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Shakespeare, Tom. „Disability in eighteenth-century England: imagining physical impairment“. Disability & Society 28, Nr. 7 (Oktober 2013): 1038–40. http://dx.doi.org/10.1080/09687599.2013.801694.

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Chatzitheochari, Stella, und Lucinda Platt. „Report: Disability Differentials in Educational Attainment in England“. Children and Young People Now 2018, Nr. 8 (02.08.2018): 46. http://dx.doi.org/10.12968/cypn.2018.8.46.

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Researchers from the University of Warwick and the London School of Economics set out to discover how academic and social influences contribute to the educational outcomes and choices of young people with disabilities. The researchers analysed data from the Longitudinal Study of Young People in England, a study that followed approximately 16,000 adolescents from 658 secondary schools aged 13 to 20.

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Marculescu, Andreea. „:Recovering Disability in Early Modern England“. Sixteenth Century Journal 45, Nr. 3 (01.09.2014): 790–91. http://dx.doi.org/10.1086/scj24246020.

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Choi, HwaJung, Robert Schoeni, Tsai-Chin Cho und Kenneth Langa. „Trends in Disability Among Adults 55-64 in the United States and England From 2002 to 2016“. Innovation in Aging 4, Supplement_1 (01.12.2020): 303. http://dx.doi.org/10.1093/geroni/igaa057.970.

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Abstract The paper’s goal is to assess whether and, if so, the extent to which prevalence in disability of adults near retirement ages in the US increased over time compared to their peers in England and examine income group differences in the relative trends. This study uses 2002-2016 Health and Retirement Study (HRS) and English Longitudinal Study of Ageing (ELSA) focusing on adults aged 55-64. Annual percent changes over the period of 2002-2016 for limitations in instrumental activities of daily living (IADL) and activities of daily living (ADL) are estimated for each survey (HRS and ELSA) using multivariable logistic regressions to adjust for individual-level characteristics While disability prevalence of adults ages 55-64 in England improved over the years of 2002-2016 (annual % change= -2.01 for IADL; - 2.53 for ADL), disability prevalence of US adults has not improved and in fact even worsened in terms of IADL (annual % change= +1.35). There are substantial variations in the IADL/ADL trends by income groups. In the US, the adverse trends in disability were more pronounced among the lowest income groups (annual % change in IADL=1.76 for bottom 20% vs. -2.08 for top 20%; annual % change in ADL=1.08 for bottom 20% vs. -2.08 for top 20%). In England, the disability status improved over time for all but the lowest income group. We will examine further to identify specific factors contributing to divergent/convergent trends in disability between the US and England.

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Randolph, David Charles. „Functional capacity evaluation and disability management“. Journal of Back and Musculoskeletal Rehabilitation 7, Nr. 3 (01.11.1996): 181–86. http://dx.doi.org/10.3233/bmr-1996-7309.

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Zaninotto, Paola, George David Batty, Sari Stenholm, Ichiro Kawachi, Martin Hyde, Marcel Goldberg, Hugo Westerlund, Jussi Vahtera und Jenny Head. „Socioeconomic Inequalities in Disability-free Life Expectancy in Older People from England and the United States: A Cross-national Population-Based Study“. Journals of Gerontology: Series A 75, Nr. 5 (15.01.2020): 906–13. http://dx.doi.org/10.1093/gerona/glz266.

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Abstract Background We examined socioeconomic inequalities in disability-free life expectancy in older men and women from England and the United States and explored whether people in England can expect to live longer and healthier lives than those in the United States. Methods We used harmonized data from the Gateway to Global Aging Data on 14,803 individuals aged 50+ from the U.S. Health and Retirement Study (HRS) and 10,754 from the English Longitudinal Study of Ageing (ELSA). Disability was measured in terms of impaired activities and instrumental activities of daily living. We used discrete-time multistate life table models to estimate total life expectancy and life expectancy free of disability. Results Socioeconomic inequalities in disability-free life expectancy were of a similar magnitude (in absolute terms) in England and the United States. The socioeconomic disadvantage in disability-free life expectancy was largest for wealth, in both countries: people in the poorest group could expect to live seven to nine fewer years without disability than those in the richest group at the age of 50. Conclusions Inequalities in healthy life expectancy exist in both countries and are of similar magnitude. In both countries, efforts in reducing health inequalities should target people from disadvantaged socioeconomic groups.

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Glover, Gyles, und Ian Brown. „People with intellectual disabilities hospitalised by courts in England“. Tizard Learning Disability Review 20, Nr. 1 (05.01.2015): 41–47. http://dx.doi.org/10.1108/tldr-10-2014-0034.

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Purpose – The purpose of this paper is to describe the characteristics of individuals with intellectual disability in psychiatric hospitals in England who have been referred from the courts following charge or conviction for imprisonable offences. Design/methodology/approach – Further analysis of data from the national census of psychiatric inpatients with intellectual disability or autism. Findings – In total, 31 per cent of psychiatric inpatients with intellectual disability or autism were detained on a court order. In comparison to others they were older but fewer appeared to have severe disabilities. Fewer were hospitalised for mental illness or challenging behaviour, more for personality disorder. Rates in relation to numbers with intellectual disability in the population varied widely between regions of the country. Research limitations/implications – The census was weak on exploring the nature of the risk posed by patients. As with all censuses it is always possible that the day chosen was unusual. Groups of patients characterised by longer stays inevitably appear more prominent. Practical implications – Staff with expertise in the forensic mental health skills of risk assessment and management in the context of intellectual disability will be needed to resettle these patients satisfactorily. Originality/value – The study draws attention to wide variations around the country in rates of use of hospital beds. This applies as much to detention under court orders, including restriction orders, as to informal admission, raising questions about the consistency of court judgements around the country.

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Macurdy, Allan H. „Rights Respiration: Disability, Isolation, and a Constitutional Right of Interaction“. Texas Wesleyan Law Review 13, Nr. 2 (März 2007): 737–48. http://dx.doi.org/10.37419/twlr.v13.i2.20.

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In 1772, Lord Mansfield, Chief Justice of the King's Bench, presided over a case involving a slave, James Somerset, who had been brought by his master from Virginia to England and who claimed that his simple presence on English soil made him free. Among Somerset's lawyers was one Francis Hargrave, who was arguing the first case of his career that day. Hargrave maintained that "the Air of England was too pure for slavery," quoting the advocate in a prior case and drawing upon the commonly held understanding that slavery was incompatible with a society of rights, and that it deprived the individual of the very indicia of humanity. Asking rhetorically whether the law of a lowly colony or a barbarous state should prevail over the law of England, Hargrave declared that "[i]n England ... freedom is the grand object of the laws, and dispensed to the meanest individual."

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Hurst, Keith. „Where is the greatest illness and disability in England?“ Nursing Standard 22, Nr. 41 (18.06.2008): 14. http://dx.doi.org/10.7748/ns.22.41.14.s20.

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Jackson, Robin. „Politics and intellectual disability in England: an historical perspective“. International Journal of Developmental Disabilities 63, Nr. 1 (03.02.2016): 52–58. http://dx.doi.org/10.1080/20473869.2015.1107364.

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Armstrong, Felicity. „Disability, Education and Social Change in England since 1960“. History of Education 36, Nr. 4-5 (Juli 2007): 551–68. http://dx.doi.org/10.1080/00467600701496849.

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Marshall, Kim. „Disability Discrimination and Higher Education in England and Wales and Australia Compared“. International Journal of Discrimination and the Law 6, Nr. 4 (Juni 2005): 289–324. http://dx.doi.org/10.1177/135822910500600403.

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In its original form the provisions of the UK Disability Discrimination Act 1995 (DDA) contained little of practical help to students with disabilities. This situation was rectified when the Special Educational Needs and Disabilities Act (SENDA) was passed in 2001 becoming the new Part 4 of the DDA. From 2002 legal duties not to discriminate against students with disabilities came into effect. In the Commonwealth of Australia a very different attitude towards disability discrimination has been demonstrated by having legislation to combat disability discrimination in place since 1992, which included specific provisions on education from the outset. The purpose of this article is to examine the approach taken in both jurisdictions towards the use of the anti-discrimination statutes and consider the effectiveness of the legislation in preventing discrimination on the ground of disability in higher education. The paper will examine points of similarity and divergence in the respective systems regarding the application of anti-disability discrimination laws to higher education as well as look to the longer established jurisprudence of the Australian courts for potential guidance that may be helpful to the nascent Part 4 of the DDA and the types of issues that may arise.

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Sheehan, Rory, Hassan Mansour, Matthew Broadbent, Angela Hassiotis, Christoph Mueller, Robert Stewart, Andre Strydom und Andrew Sommerlad. „Recording of intellectual disability in general hospitals in England 2006–2019: Cohort study using linked datasets“. PLOS Medicine 20, Nr. 3 (20.03.2023): e1004117. http://dx.doi.org/10.1371/journal.pmed.1004117.

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Background Accurate recognition and recording of intellectual disability in those who are admitted to general hospitals is necessary for making reasonable adjustments, ensuring equitable access, and monitoring quality of care. In this study, we determined the rate of recording of intellectual disability in those with the condition who were admitted to hospital and factors associated with the condition being unrecorded. Methods and findings Retrospective cohort study using 2 linked datasets of routinely collected clinical data in England. We identified adults with diagnosed intellectual disability in a large secondary mental healthcare database and used general hospital records to investigate recording of intellectual disability when people were admitted to general hospitals between 2006 and 2019. Trends over time and factors associated with intellectual disability being unrecorded were investigated. We obtained data on 2,477 adults with intellectual disability who were admitted to a general hospital in England at least once during the study period (total number of admissions = 27,314; median number of admissions = 5). People with intellectual disability were accurately recorded as having the condition during 2.9% (95% CI 2.7% to 3.1%) of their admissions. Broadening the criteria to include a nonspecific code of learning difficulty increased recording to 27.7% (95% CI 27.2% to 28.3%) of all admissions. In analyses adjusted for age, sex, ethnicity, and socioeconomic deprivation, having a mild intellectual disability and being married were associated with increased odds of the intellectual disability being unrecorded in hospital records. We had no measure of quality of hospital care received and could not relate this to the presence or absence of a record of intellectual disability in the patient record. Conclusions Recognition and recording of intellectual disability in adults admitted to English general hospitals needs to be improved. Staff awareness training, screening at the point of admission, and data sharing between health and social care services could improve care for people with intellectual disability.

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Corrigan, Lisa M. „The Right to Maim: Debility, Capacity, Disability“. QED: A Journal in GLBTQ Worldmaking 6, Nr. 3 (01.10.2019): 255–57. http://dx.doi.org/10.14321/qed.6.3.0255.

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Sheehi, Stephen. „The Right to Maim: Debility, Capacity, Disability“. Journal of Middle East Women's Studies 16, Nr. 1 (01.03.2020): 72–76. http://dx.doi.org/10.1215/15525864-8016547.

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Kinkaid, Eden. „The right to maim: debility, capacity, disability“. Gender, Place & Culture 25, Nr. 6 (12.03.2018): 936–37. http://dx.doi.org/10.1080/0966369x.2018.1449139.

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Pransky, Glenn. „Clinical Update: Functional Capacity Evaluations and Disability“. Guides Newsletter 3, Nr. 2 (01.03.1998): 4–5. http://dx.doi.org/10.1001/amaguidesnewsletters.1998.marapr02.

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Abstract According to the AMA Guides to the Evaluation of Permanent Impairment, a functional capacity evaluation (FCE) measures an individual's physical abilities via a set of activities in a structured setting and provides objective data about the relationship between an impairment and maximal ability to perform work activities. A key distinction between FCEs and self-reported activities of daily living is that the former involve direct observation by professional evaluators. Numerous devices can quantify the physical function of a specific part of the musculoskeletal system but do not address the performance of whole body tasks in the workplace, and these devices have not been shown to predict accurately the ability to perform all but the simplest job tasks. Information about reliability has been proposed as a way to identify magnification and malingering, but variability due to pain and poor comprehension of instructions may cause variations in assessments. Structured work capacity evaluations involve a set of activities but likely underestimate the individual's ability to do jobs that involve complex or varying activities. Job simulations involve direct observation of an individual performing actual job tasks, require a skilled and experienced evaluator, and raise questions about expense, time, objectivity and validity of results, and interpretation of results in terms of the ability to perform specific jobs. To understand the barriers to return to work, examiners must supplement FCEs with information regarding workplace environment, accommodations, and demotivators.

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Lawrence, C. „Mental Disability in Victorian England: The Earlswood Asylum, 1847-1901“. English Historical Review 117, Nr. 473 (01.09.2002): 1006–8. http://dx.doi.org/10.1093/ehr/117.473.1006.

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Taylor, Paul, Karen Corteen, Cassandra Ogden und Sharon Morley. „‘Standing’ by: disability hate crime and the police in England“. Criminal Justice Matters 87, Nr. 1 (März 2012): 46–47. http://dx.doi.org/10.1080/09627251.2012.671023.

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Potente, Cecilia, und Christiaan Monden. „Disability pathways preceding death in England by socio-economic status“. Population Studies 72, Nr. 2 (04.05.2018): 175–90. http://dx.doi.org/10.1080/00324728.2018.1458993.

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Moscone, Francesco. „Geographical variations in expenditure of learning disability services in England“. Applied Economics 43, Nr. 23 (September 2011): 2997–3005. http://dx.doi.org/10.1080/00036840903425194.

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Gilliard, Jane, Robin Means, Angela Beattie und Gavin Daker-White. „Dementia care in England and the social model of disability“. Dementia 4, Nr. 4 (November 2005): 571–86. http://dx.doi.org/10.1177/1471301205058312.

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Bebbington, A. C. „The expectation of life without disability in England and Wales“. Social Science & Medicine 27, Nr. 4 (Januar 1988): 321–26. http://dx.doi.org/10.1016/0277-9536(88)90265-1.

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McCulloch, Janet, Sam Bracebridge, Mary Thompson, Emily van de Venter und Isabel Oliver. „Developing capacity in field epidemiology in England“. Perspectives in Public Health 134, Nr. 5 (28.08.2014): 297–99. http://dx.doi.org/10.1177/1757913914547331.

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Lipton, RB, JN Liberman, KB Kolodner, ME Bigal, A. Dowson und WF Stewart. „Migraine Headache Disability and Health-Related Quality-of-life: A Population-Based Case-Control Study from England“. Cephalalgia 23, Nr. 6 (Juli 2003): 441–50. http://dx.doi.org/10.1046/j.1468-2982.2003.00546.x.

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The aims of this study were: (i) to compare health-related quality of life (HRQoL) as measured by the Medical Outcomes Study Short Form 36-Item Health Survey (SF-36) in a population sample of migraine headache sufferers and controls without migraine; (ii) to assess the relationship of HRQoL and work-related disability attributed to headache in a population sample. The study was conducted in two phases. First, a population-based, telephone interview survey of 5769 residents of greater London, England was conducted to identify individuals with migraine headache (cases) and controls without migraine. In the second stage, in-person interviews were conducted in a matched sample of 200 migraine cases and 200 controls selected from survey respondents. At the beginning of the in-person interview, participants were asked to complete the SF-36. In addition, a work-related disability score based on the telephone interview was defined as the number of lost work days or days when usual activity was reduced by 50% or more over the previous year. The disability score was trichotomized as mild ( n = 98), moderate ( n = 49), and severe disability ( n = 49). Compared with controls, individuals with migraine headache scored significantly lower in eight of the nine domains of the SF-36 as well as in the overall Physical Component Summary (PCS) score and Mental Component Summary (MCS) score. Further, among migraine sufferers, each of the disability groups scored significantly lower in seven of the nine domains and in the summary scales. Scores showed greater reductions in HRQoL for the moderate and severe disability groups vs. the mild disability group in five of nine scales and in the Total Physical Summary score. We conclude that, in a population-based sample of migraine headache sufferers, individuals with migraine headache have lower HRQoL scores compared with controls. Moreover, among individuals with migraine headache, work-related disability is associated with lower HRQoL scores. Specifically, individuals classified with moderate to severe work-related disability had lower HRQoL scores than those classified with low disability.

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Marshall, Pablo. „State of the Reform of Legal Capacity in Chile“. International Journal of Mental Health and Capacity Law, Nr. 27 (23.12.2021): 60–69. http://dx.doi.org/10.19164/ijmhcl.27.1198.

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The Chilean legal regulation of disability has advanced towards an adequate legal framework for the progressive development of state practices respectful of the rights of people with disabilities. The ratification of the CRPD (2008) has been followed by an increasing amount of legislation directed to the inclusion of people with disabilities. The most important of this new disability regulation is the Law 20422 [on equal opportunities and social inclusion of people with disability]. Chile, in this way, can be regarded as a slow but persistent student of the teachings of the CRPD. Despite these positive developments, certain obligations under the CRPD are still pending, especially clear in the legal regulation affecting mental disability. The controversies surrounding legal capacity and mental health law are probably the most important issues surrounding the hesitation to carry out a reform.

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