What is the gap in activity and participation between people with disability and the general population in Taiwan?

BACKGROUND: In 2010, the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was developed, based on the concept of the International Classification of Functioning, Disability and Health (ICF). The ICF provides a common language and framework for health and health-related status and attempts to integrate the biopsychosocial model as a multidimensional perspective in understanding functioning. Activities and participation (AP) is one salient component of the ICF refers to the execution of a task by an individual, and how such tasks are involved in their daily life. It is essential to examine the gap between the general adult population and adults with disabilities. This gap may be attributed to health status, personal factors, and natural and social environments, which include social and health services and policies. The purposes: (1) To develop a normative activity and participation (AP) value for the adult population and people with disabilities; and (2) to compare the gap in AP normative values between the two groups in Taiwan. METHODS: We use the WHODAS 2.0 to survey and develop a normative AP value for the general adult population, and used secondary data from National Disability Eligibility Determination System (NDEDS) of Taiwan to describe the AP functioning distribution of adult with disability. There were 1100 participants, selected by stratified proportional sampling from two cities. There were also 144,850 participants who were adults with disability, selected from the secondary database in Taiwan. RESULTS AND CONCLUSIONS: The AP curve for the disabled population increased rapidly at the beginning. The summary score was 13.21 in the performance at 90 percentile for the general population and 82.61 score for disabled adults that the similar gap in every domain, its means that there are significant functioning difference and health equality in general adults population and adults with disabilities. This presents a substantial challenge for both the government and the whole population of Taiwan, to begin considering how to reduce the gap in AP functioning and promote equality for people with disabilities, using social welfare policy. It is important to make sure disabled people have the same rights to be included in society as anybody else and better access to things in all areas of life that are according to Convention on the Rights of Persons with Disabilities (CRPD).

Development of traditional Chinese version of World Health Organization disability assessment schedule 2.0 36--item (WHODAS 2.0) in Taiwan: validity and reliability analyses.

BACKGROUND: World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) provided a standardized method for measuring the health and disability and the traditional Chinese version has not been developed. AIMS: To describe the process of developing the traditional Chinese version of the WHODAS 2.0 36-item version and to evaluate the concurrent validity and test-retest reliability of this instrument. METHODS: The study was conducted in two phases. Phase I was the process of translation of WHODAS 2.0 36-item version. Phase II was a cross-sectional study. The participants were 307 adults who were tested the validity and reliability of draft traditional Chinese version. RESULTS: The reliability of Cronbach's α and ICC in the WHODAS 2.0 traditional Chinese version were 0.73-0.99 and 0.8-089, respectively. The content validity was good (r=0.7-0.76), and the concurrent validity was excellent in comparison with the WHOQOL-BREF (p<0.5). The construct validity, the model was explained total variance was 67.26% by the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) illustrated the traditional Chinese version was good to assess disability. There was a valid and reliable measurement scales for evaluating functioning and disability status. CONCLUSION: For disability eligibility system of Taiwan government to measure the disability, the traditional Chinese version of the WHODAS 2.0 provided valuable evidence to design the assessment instrument.

Carbon monoxide: an old poison with a new way of poisoning.

We present two events of carbon monoxide (CO) poisoning, which spread out through ventilation pipes to kill or injure neighbors. This is a previously undocumented poisoning process. In the first event, three people died and eight others suffered CO poisoning from a gas-powered water heater in an apartment building. Similar to the first event, three people expired and three others were injured by CO poisoning in the second event. We subsequently determined the cause of these tragedies were due to obstructions at the openings of ventilation pipes. CO is one of the most common causes of poisoning worldwide and these cases often result in tragedy. Early recognition of CO poisoning resulting from obstructed ventilation pipes will facilitate proper management and prevent possible lethal disasters. Additionally, all clinicians and other paramedical personnel ought to raise the suspicion of chemical-related casualties when encountering clusters of patients from a single locale.

Hematological abnormalities of acute exposure to hexachloroethane smoke inhalation.

There has been no human epidemiological data regarding potential hematological effects of hexachloroethane-zinc oxide (HC/ZnO) inhalation. This is the first epidemiological study to investigate whether HC/ZnO inhalation exposure can induce hematological abnormalities in exposed soldiers. Twenty soldiers, who were exposed to a high concentration of HC/ZnO smoke for 3-10 min in a narrow tunnel (0.6 m in width) during military training, were recruited as the exposed group (n = 20). Another 64 soldiers, who were not visiting the explosion areas, were recruited as controls. Venous blood was collected from all participants for analyses of hematological parameters. After adjustment for potential confounders, there were significant differences in weekly mean hemoglobin (HB), red blood cell count (RBC), and hematocrit (HCT) between exposed soldiers and controls (p < .01) at the first follow-up through the first 4 weeks following exposure. In addition, mean white blood cell count (WBC) of exposed soldiers was significantly higher than that of controls at the 4-week follow-up. Further analysis showed HB, RBC, and HCT changes during the 1st week after exposure and reach lowest levels during the 2nd week. HB, RBC, HCT, and WBC returned to normal within 11 weeks after the HC/ZnO smoke exposure. All other hematological parameters remained unchanged at 72 weeks after the event. The authors concluded that inhalation of HC/ZnO smoke can induce acute, temporally related hematological abnormalities.

Bell's palsy associated with influenza vaccination: two case reports.

The etiology of Bell's palsy is often unknown. We present herein two cases of adults who developed a Bell's palsy following the administration of an influenza vaccine. While the incidence is low, with the widespread recommendation for annual influenza vaccines, patients should be apprised of the possibility of this complication and the benefit of early treatment.