Charts and LMS Tables of Transfontanellar and Transvertical Ear-to-Ear Distances for Gestational Age.

Introduction: To date cranial development has only been described by analyzing occipitofrontal circumference (OFC). More precise methods of determining head measurements have not been widely adopted. The use of additional measurements has the potential to better account for the three-dimensional structure of the head. Our aim was to put forward centile curves of such measurements for gestational age along with a compound head volume index. Methods: We created generalized additive models for location, scale, and shape of two ear-to-ear distances (EED), transfontanellar (fEED) and transvertical (vEED), from birth anthropometric data. Same was done for OFC, crown-heel length, and birth weight to allow for comparison of our models with growth charts by Voigt et al. and Fenton and Kim. Results: Growth charts and tables of LMS parameters for fEED and vEED were derived from 6,610 patients admitted to our NICU and 625 healthy term newborns. With increasing gestational age EEDs increase about half as fast compared to OFC in absolute terms, their relative growths are fairly similar. Discussion: Differences to the charts by Fenton and Kim are minute. Tape measurements, such as fEED or vEED can be added to routine anthropometry at little extra costs. These charts may be helpful for following and evaluating head sizes and growth of preterm and term infants in three dimensions.

Evaluation of an online health promotion program for vocational rehabilitation consumers.

PURPOSE/OBJECTIVE: The purpose of this study was to test the comparative effectiveness of three variations of an online-based health promotion program for improving health and employment outcomes in a sample of Vocational Rehabilitation consumers. RESEARCH METHOD/DESIGN: A total of 222 VR consumers participated in a randomized trial of three health promotion variations and provided baseline, 2-, 4-, and 6-month data. Data were analyzed using repeated measures ANOVA. The three health promotion variations included (a) FACTSHEETS-a series of four electronic factsheets; (b) HPE-an online interactive health promotion website that included health behavior content and tailored action planning, and (c) HPE + MI-the online health promotion website plus two 30-minute calls with a trained motivational interviewer. RESULTS: Contrary to expectations, evidence did not support between-group differences based on intervention intensity. In fact, the Factsheet, HPE, and HPE + MI participants all experienced significant reductions in secondary conditions, F(2.85, 489) = 7.808, p < .001, HRQoL symptom days, F(2.7, 495) = 4.795, p = .004; and significant improvements in healthy lifestyle behaviors, F(2.6, 495) = 3.66, p = .017 over the 6-month study period. Although this study did not include a control group, a control group from another study with a similar population did not experience similar outcomes. CONCLUSION/IMPLICATIONS: People with disabilities experience significantly higher rates of secondary health conditions and lower employment rates than people without disabilities. The combination of these factors signifies the need for health promotion programming outside the work setting.

Working well with a disability: health promotion as a means to employment.

PURPOSE/OBJECTIVE: The purpose of this study was to test the utility of the Working Well with a Disability health-promotion program with vocational rehabilitation (VR) clients. Health-promotion interventions have been shown to reduce limitation from secondary conditions, which can be a significant barrier to labor force participation among people with disabilities. The state and federal VR system represents a potential access point for delivery of health-promotion activities. RESEARCH METHOD/DESIGN: A total of 297 VR clients participated in a randomized trial of the Working Well health promotion program. Control and intervention participants provided baseline and four waves of quarterly follow-up data. Data were analyzed with repeated-measures ANOVA. RESULTS: Intervention-group participants who attended over half of the Working Well sessions reported significantly lower rates of limitation from secondary conditions over the 1-year study span, F(1, 124) = 4.11, p = .004. Control-group participants also experienced significantly lower rates of limitation, but pre- to postdifferences were less dramatic, F(1, 308) = 4.19, p = .006. CONCLUSIONS/IMPLICATIONS: Overall, health data indicated that the Working Well program may be particularly helpful to VR clients with higher rates of secondary health conditions and may represent one strategy for overcoming barriers to employment.

A prospective study to examine the influence of secondary health conditions on vocational rehabilitation client employment outcomes.

BACKGROUND: Adults with disabilities experience a variety of secondary health conditions that have a negative association with employment. Vocational rehabilitation (VR) provides one possible access point for providing health promotion activities to help clients manage these conditions. OBJECTIVE: To build the case for providing health promotion services in the VR setting, this research assesses how secondary health conditions impact employment closures over time for VR clients. Specifically, we hypothesize that higher rates of secondary conditions will be negatively associated with employment outcomes at 18 months. METHODS: VR clients with physical disability (n = 162) provided longitudinal data at baseline and at 6, 12, and 18 months. Two binary logistic regression models used self-report data to predict employment outcomes. The first model used explanatory variables measured at baseline or prior to receiving VR services, and the second model measured variables after 18 months in the VR program. Both models included variables to control for demographic characteristics, disability severity, baseline employment, and receipt of social insurance payments. The second model also included variables to account for VR services received. RESULTS: Both models showed that higher reported rates of secondary conditions were associated with lower probabilities of employment (p = .012; p = .022). The expanded model also showed that receipt of counseling services through VR increased the probability of employment (p = .04) and that receipt of medical services through VR reduced the probability of employment (p = .02). CONCLUSIONS: VR can improve client employment outcomes through expanded counseling and guidance services or possibly through improved access to health promotion programming that helps clients manage secondary health conditions.

Cognitive factors in odor detection, odor discrimination, and odor identification tasks.

The purpose of this study was to determine cognitive correlates of olfactory performance across three different tasks. A total of 170 men and women (30-87 years of age) were assessed in olfactory sensitivity, discrimination, and identification. Also, participants were tested in a range of cognitive tests covering executive functioning, semantic memory, and episodic memory. Hierarchical regression analyses showed that proficiency in executive functioning and semantic memory contributed significantly to odor discrimination and identification performance, whereas all of the cognitive factors proved unrelated to performance in the odor threshold test. This pattern of outcome suggests that an individual's cognitive profile exerts a reliable influence on performance in higher order olfactory tasks.

Self-employment and economic leadership as two promising perspectives on rural disability and work.

A defining difference between rural and urban circumstances for people with disabilities involves opportunities for work. One of the most significant elements of the rural context is that economic conditions in rural communities consistently trail the national economy. This paper presents an overview of disability in rural America and outlines an ecological model for guiding the development of rural solutions to rehabilitation problems. Two promising examples of such solutions, self-employment as a rural vocational rehabilitation employment option and rural economic leadership by people with disabilities, are outlined.