Overweight among Children with Attention Deficit Hyperactivity Disorder

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<ul><li><p>agencies in the USA, the YAI/National Institute for People with</p><p>described incidence of Hispanic children with physical and mental</p><p>ealthDisabilities that provides a wide range of services, including health care,</p><p>to individuals with ID. The development of a more comprehensive</p><p>assessment of an individuals risk factors for obesity and an improved</p><p>method for tracking changes to and the recombination of psychotropic</p><p>and/or antipsychotic medication to limit weight gain by medical staff will</p><p>be outlined.</p><p>Re-assessing physical disability among US medical schools</p><p>Demetrius Moutsiakis, MD, MPH, School of Public Health and Health</p><p>Professions, University at Buffalo, Buffalo, NY</p><p>Thomas Polisoto, MD, Department of Rehabilitation Medicine, Erie</p><p>County Medical Center, Buffalo, NY</p><p>In 1996, one survey aimed to assess the prevalence of physical</p><p>disabilities among medical school graduates in the 1987 through 1990</p><p>graduating classes. The study reported 64 graduating medical students</p><p>with documented physical disability. This comprised 0.19% of the 33,138</p><p>students who graduated from the 67 medical schools.</p><p>This study seeks to determine what effects, if any, the passage of the</p><p>Americans with Disabilities Act (ADA) of 1991 has had on the admission</p><p>rate of individuals with disabilities. A questionnaire is sent to the deans of</p><p>student affairs at all accredited medical schools in the United States and</p><p>Puerto Rico (n5 125) in attempts to determine: (1) the prevalence of</p><p>medical students with physical disabilities (MSPD) who graduated during</p><p>the years 2000-2007, (2) the types of physical disabilities present, (3) the</p><p>onset of disabilities, either before or during medical school, and (4) the</p><p>academic standing of MSPD.</p><p>To date, 10medical schools have returned their completed surveys.On the</p><p>one hand, results appear to be favorable: 0.23% of the graduating medical</p><p>students reported having documented disability. On the other hand, only</p><p>two schools accounted for 85% of all graduating medical students with</p><p>documented physical disability. Half of the medical schools reported</p><p>having no graduating medical students with documented physical disability.</p><p>These results represent disturbing trends among US medical schools.</p><p>Texas disabled Hispanic children: A quest for healthcare access</p><p>Katandria L. Johnson, MA, MS, CCC-SLP, Social and Behavioral Sciences</p><p>Department, University of North Texas Health Science Center at Fort</p><p>Worth, Fort Worth, TX</p><p>Julius Larry, MPHc, Health Management and Policy, School of Public</p><p>Health, University of North Texas Health Science Center, Fort Worth, TX</p><p>Alberto Coustasse, MD,MBA, DrPH, Health Management and Policy,</p><p>School of Public Health, University of North Texas Health Science Center,</p><p>Fort Worth, TX</p><p>This study was designed to identify and describe barriers to andThere is increasing recognition that medication use, specifically</p><p>psychotropic medication, can cause significant weight gain. Given that</p><p>30-50% of adults with ID are dually diagnosed and receive psychotropic</p><p>medication and/or antipsychotic mediation, medication use amongst this</p><p>group has become an important factor in the treatment of individualswith ID.</p><p>Given the consequences of obesity and being overweight, and the</p><p>potential to significantly reverse these consequences by returning to</p><p>a normal body weight, the goal of this presentation is two-fold. The first</p><p>goal is discuss the results from a study examining the relations between</p><p>challenging behaviors, psychiatric care, medical conditions, and obesity</p><p>in adults with ID living in a group home setting.</p><p>The second goal of this presentation will be to describe the development and</p><p>implementation of an obesity center in one of the largest not-for-profit</p><p>Abstracts / Disability and Hfacilitators of healthcare access for the Hispanic pediatric population with</p><p>physical and mental disabilities.disabilities in the U.S. less than 18 years, which parents or guardians</p><p>reported the quality of health care services provided and their barriers to</p><p>access to healthcare was also performed.</p><p>Results revealed healthcare access disparities related to race/ethnicity, and</p><p>socioeconomic status still persist in the U.S. healthcare system. For patients,</p><p>the primary barrier to healthcare access was linked to lack of insurance and</p><p>secondary and tertiary barriers were lack of linguistic and cultural</p><p>competency of the front end and provider, respectively. Specific statistical</p><p>findings from the NHDR illustrated that families reported their childs</p><p>healthcare providers sometimes or never listened carefully; did not explain</p><p>facts clearly; respected what they had to say, nor spent enough timewith them.</p><p>Areas that can facilitate better healthcare access are to increase the cultural</p><p>and linguistic competencies of healthcare providers through policy</p><p>development. Cultural and linguistic assistance can be initiated at the</p><p>university level by recruiting multi-ethnic and linguistic students and by</p><p>increasing sociocultural and sociolinguistic content in the coursework,</p><p>practicum, or residencies. Such changes are central to effectively addressing</p><p>healthcare disparities and promoting positive, long-term healthcare</p><p>outcomes among culturally and linguistically diverse populations.</p><p>Unmet healthcare needs of persons with tetraplegia and their</p><p>primary caregivers: Policy implications</p><p>Colette Duggan, BSN, MSN, PhD, Research Department, Rehabilitation</p><p>Institute of Michigan, Detroit, MI</p><p>Virginia Miller, DrPH MS MPH, Department of Family Medicine and</p><p>Public Health Sciences, Wayne State University School of Medicine,</p><p>Detroit, MI</p><p>Persons with tetraplegic (cervical) spinal cord injuries (SCI) have</p><p>complex health care needs. They require access to a wide range of goods</p><p>and services to maintain their health and prevent/minimize further</p><p>functional losses. The severity of SCI impairment puts these individuals at</p><p>great risk for incurring serious, costly medical complications over their</p><p>lifetime. This 2-year, qualitative/quantitative study, funded by Blue Cross</p><p>Blue Shield of Michigan, focuses on the healthcare experiences of the</p><p>most needy and vulnerable segment of this population: public insurance</p><p>recipients with tetraplegia and their primary caregivers. Qualitative data</p><p>comes from in-depth, audiotaped interviews with 20 Medicaid/Medicare</p><p>recipients with tetraplegic injuries and their primary caregivers.</p><p>Participants also completed survey instruments measuring stress, health/</p><p>functioning, and quality of life. Content analysis of coded interviews</p><p>transcripts revealed many unmet needs. SCI consumers cited (a)</p><p>inadequate supplies, such as catheters and dressings; (b) difficulty</p><p>acquiring/repairing durable medical equipment, such as wheelchairs and</p><p>lifts; (c) denial of requests for ramps and other environmental</p><p>modifications, and (d) untrained, unreliable agency caregivers. SCI</p><p>caregivers cited (a) unsatisfactory service by home care agencies; (b) no or</p><p>insufficient financial compensation for SCI care provided by the family;</p><p>(c) lack of respite care for caregiver; and (d) lack of affordable health</p><p>insurance for family caregivers. Participants recommendations for</p><p>improving access to goods and services were based on an insider logic</p><p>that stressed long-term savings in hospital/nursing home costs through</p><p>prevention of SCI secondary complications and inclusion of health</p><p>insurance coverage and respite services for the family caregiver.</p><p>Overweight among Children with Attention Deficit Hyperactivity</p><p>DisorderPeer-reviewed journals, books, national reports including: Unequal</p><p>treatment and the National Healthcare Disparities Report (NHDR) 2005</p><p>were utilized to conduct this research study. An evaluation of the</p><p>e7Journal 2 (2009) e1ee15Juhee Kim, ScD, Kinesiology and Community Health, University of Illinois</p><p>at Urbana-Champaign, Champaign, IL</p></li><li><p>Medicare program National Health Insurance Experience</p><p>ealthJae Kennedy, Department of Health Policy and Administration,</p><p>Washington State University, Spokane, WA</p><p>Katie Mackay, MHPA (cand), Department of Health Policy and</p><p>Administration, Washington State University, Spokane, WA</p><p>Josh Engle, MHPA (cand), Department of Health Policy and</p><p>Administration, Washington State University, Spokane, WA</p><p>Research Objective: To identify critical differences in prescription drug</p><p>access among working age (18-64) and older (65+) Medicare beneficiaries.</p><p>Study Design: Secondary analysis of the 2005 Medicare Current</p><p>Beneficiary Survey (MCBS) on Access to Care.</p><p>Population Studied: Medicare beneficiaries in the period immediately</p><p>preceding implementation of the new Medicare prescription drug</p><p>benefit.</p><p>Principal Findings: Younger beneficiaries had significantly higher rates of</p><p>prescription nonadherance (28.9%) than older beneficiaries (11.6%).</p><p>Younger and older beneficiaries had similar rates of prescription drug</p><p>coverage (60.2% vs. 61.6%); but younger beneficiaries were more likely</p><p>to have coverage through Medicaid (28.3% vs. 6.8%) and less likely to</p><p>have private coverage (22.8% vs. 34.6%) or Medicare HMO coverage</p><p>(6.4% vs. 12.3%). Younger beneficiaries were more likely to be in poor</p><p>health (60.8% vs. 20.2%) and to have ADL limitations (29.8% vs. 15.3%)</p><p>than older beneficiaries.</p><p>Conclusions: Younger Medicare beneficiaries are at greater risk of</p><p>prescription nonadherance. This population is also more likely to</p><p>report poor health, low incomes, and multiple impairments or chronic</p><p>conditions.</p><p>Implications for Policy, Delivery or Practice: Adults under age 65 who</p><p>receive Social Security Disability Income (SSDI) become eligible for</p><p>Medicare 25 months after they begin to receive SSDI benefits. YoungerBo Fernhall, PhD, Kinesiology and Community Health, University of</p><p>Illinois at Urbana-Champaign, Champaign, IL</p><p>Objectives: To examine the prevalence of overweight among children with</p><p>Attention Deficit Hyperactivity Disorder (ADHD) and their difference by</p><p>medication.</p><p>Method:We conducted a secondary data analysis using the National Survey</p><p>of Childrens Health 2003(aged 6-17 years, n5 62,476). The definition of</p><p>ADHD is used from the question of Has a doctor or health professional</p><p>ever told that [study child] has ADD or ADHD? The odds of overweight</p><p>(BMI&gt; 95% percentile) were estimated among children with ADHD who</p><p>were or were not taking medication compared with children without</p><p>ADHD. Covariates were age, race, education, poverty, family structure,</p><p>number of family meals, computer and reading hours, TV viewing hours,</p><p>physical activity, sleep, participation of organized activities, and</p><p>supportive neighborhood. Further, we adjusted weights and multistage</p><p>sampling design effects in multivariate logistic regression models.</p><p>Results: Overall 9% of U.S. children had either ADD or ADHD in 2003.</p><p>Only girls with ADHD had a higher rate of overweight than that of girls</p><p>without ADHD (20% vs. 16%). However, both boys and girls with</p><p>ADHD and currently NOT taking medication were more likely to be</p><p>overweight than those without ADHD (OR (95% CI) for Boys, 1.44</p><p>(1.13-1.84) and Girls, 1.79 (1.20-2.67).</p><p>Conclusions: The prevalence of overweight among children with ADHD</p><p>is dependent on sex and medication. Children with ADHD who not take</p><p>ADHD medication have a higher risk of overweight than those taking</p><p>medication and compared to children without ADHD. These data</p><p>suggest that medication use should be carefully considered in children</p><p>with ADHD.</p><p>Age disparities in prescription drug access and utilization within the</p><p>e8 Abstracts / Disability and Hbeneficiaries are particularly vulnerable to rising drug costs, coverage</p><p>gaps, and discontinuities in prescription regimens. The new MedicareGuey-Ing Day, PhD, Bureau of Planning, Department of Health, The</p><p>Executive Yuan, Taiwan, Taipei, Taiwan</p><p>Shwu-Chong Wu, PhD, Institute of Health Policy and Management,</p><p>College of Public Health, National Taiwan Unerversity, Taipei, Taiwan</p><p>Shin-Chung Huang, Bureau of National Health Insurance, Taiwan., Taipei,</p><p>Taiwan</p><p>The study examines factors associated with the utilization of post-</p><p>hospital care of disabled stroke patients within 6 months after hospital</p><p>discharge and the varied costs to the national health insurance (NHI)</p><p>system. A sample of 1,534 disabled stroke individuals 50 and order who</p><p>were hospitalized in the past year was extracted from a nation-wide</p><p>random sample. The first hospitalization in that year was designated as</p><p>their index hospitalization. Six months of NHI claim data together with</p><p>matched survey results were analyzed. Multiple regression and ANOVA</p><p>identified factors associated with the use of post-hospital care.</p><p>Results: The hospital readmission rate within 6 months after index</p><p>hospitalization was 46.5%. Utilization of outpatient service was 98.1%,</p><p>emergency service 38.0%, home nursing service 12.2%, and rehabilitation</p><p>rate 32.3%. Results revealed that co-payment, long-term care arrangement,</p><p>living in cities, co-morbidities, functional dependency were significant</p><p>variables. Patients who are waived of NHI co-payments, cared in</p><p>institutions, living in municipalities, completely dependent, or have</p><p>suffered from three and more chronic diseases consume more health care</p><p>and higher cost to the NHI.</p><p>Implication &amp; Conclusion: In allocating NHI resources and policy design,</p><p>these factors should be taken into consideration for better resource</p><p>management and efficiency. While an diagnosis related groups system in</p><p>the NHI being started, issues concerning post-hospital care in terms of</p><p>insurance benefits and co-payment need to be re-examined. Theprescription drug benefit should help reduce, but not eliminate, access</p><p>barriers to prescribed medicines.</p><p>Meeting the occupational safety and health training needs of</p><p>workers with developmental disabilities</p><p>Robin Dewey, MPH, Labor Occupational Health Program, UC Berkeley,</p><p>Berkeley, CA</p><p>Approximately 4.5 million individuals in the US have developmental</p><p>disabilities. An estimated 30% of working-age adults with developmental</p><p>disabilities are employed either in segregated workshops or</p><p>mainstream settings. The results from recent needs assessments indicate</p><p>there are very few examples of health and safety training being provided</p><p>to workers with developmental disabilities. When safety training does</p><p>occur, it is usually limited to task-specific instructions provided on an as</p><p>needed basis. This lack of real health and safety training leaves these</p><p>workers unprepared to be able to identify hazards in a variety of settings,</p><p>know what to do when something unexpected happens, and advocate for</p><p>themselves when a problem arises. This presentation will describe</p><p>a unique effort to bridge this gap by creating an occupational safety and</p><p>health education training program that meets the cognitive needs of</p><p>workers with developmental disabilities. The training program has been</p><p>pilot-tested with several adults with developmental disabilities, including</p><p>employees participating in Walgreens Companys initiative to hire a third</p><p>of its warehouse employees from this population. Attendees will be</p><p>introduced to the learning activities that are p...</p></li></ul>

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