<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>10</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Crabb, C.</style></author><author><style face="normal" font="default" size="100%">Bowers, A</style></author><author><style face="normal" font="default" size="100%">Owen, R.</style></author><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Appraisal of Personal Support Workers by Medicaid Managed Care Enrollees Aging with Disabilities</style></title><secondary-title><style face="normal" font="default" size="100%">American Public Health Association Annual Meeting and Expo</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2016</style></year></dates><language><style face="normal" font="default" size="100%">eng</style></language></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>10</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Molton, Ivan R</style></author><author><style face="normal" font="default" size="100%">Smith, Amanda E</style></author><author><style face="normal" font="default" size="100%">Lauer, Cara</style></author><author><style face="normal" font="default" size="100%">Denison, Paige</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Adapting an Evidence-Based Wellness Program for Older Adults with Long-Term Physical Disabilities</style></title></titles><dates><year><style  face="normal" font="default" size="100%">2015</style></year></dates><publisher><style face="normal" font="default" size="100%">Workshop at the American Society on Aging's (ASA) Aging in America (AiA) Conference, Chicago, Illinois</style></publisher><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Description&lt;/p&gt;
&lt;p&gt;Recent efforts have focused on enhancing wellness in community living seniors using evidence-based health promotion programs. However, very few of these programs have been tested in individuals aging with long-term physical disabilities (LTPD), such as muscular dystrophy, multiple sclerosis, post-polio syndrome or spinal cord injury. This presentation describes a new academic-community partnership to adapt and test a NCOA endorsed intervention (EnhanceWellness) in people aging with LTPD.&lt;/p&gt;
&lt;p&gt;Objectives&lt;/p&gt;
&lt;ol&gt;
	&lt;li&gt;
		By the end of this presentation attendees will be able to describe EnhanceWellness, an NCOA endorsed community-based health promotion program for older adults.&lt;/li&gt;
	&lt;li&gt;
		By the end of this presentation attendees will understand the prevalence and impact of long-term physical disabilities, including spinal cord injury and muscular dystrophy, in older adults.&lt;/li&gt;
	&lt;li&gt;
		By the end of this presentation attendees will be able to describe necessary adaptations to make interventions originally designed for older adults applicable for those aging with long-term physical disability.&lt;/li&gt;
	&lt;li&gt;
		By the end of this presentation attendees will have an appreciation for the challenges and opportunities present in integration of aging and physical disability service networks.&lt;/li&gt;
&lt;/ol&gt;
&lt;p&gt;Outcomes&lt;/p&gt;
&lt;p&gt;Pilot data from our first participants (n=8), which will include standardized scales measuring quality of life, emotional well-being, physical and social health and overall satisfaction with the program. Discussion of the adaptation process, including lessons learned, identification of challenges, and ways to remediate the inter-institutional and cultural barriers that exist between disability researchers and community agencies providing services to older adult&lt;/p&gt;
</style></abstract></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>13</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Molton, Ivan R</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Aging with and Aging into Disability</style></title></titles><dates><year><style  face="normal" font="default" size="100%">2015</style></year></dates><publisher><style face="normal" font="default" size="100%">Presentation for the Gerontological Professionals Network sponsored by the University of Washington's School of Nursing de Tournyay Center for Healthy Aging, Seattle, WA</style></publisher><language><style face="normal" font="default" size="100%">eng</style></language></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Terrill, Alexandra L</style></author><author><style face="normal" font="default" size="100%">Müller, Rachel</style></author><author><style face="normal" font="default" size="100%">Jensen, Mark P</style></author><author><style face="normal" font="default" size="100%">Molton, Ivan R</style></author><author><style face="normal" font="default" size="100%">Ipsen, Catherine</style></author><author><style face="normal" font="default" size="100%">Ravesloot, Craig</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Association Between Age, Distress, and Orientations to Happiness in Individuals With Disabilities.</style></title><secondary-title><style face="normal" font="default" size="100%">Rehabil Psychol</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2015</style></year><pub-dates><date><style  face="normal" font="default" size="100%">02/2015</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">60</style></volume><pages><style face="normal" font="default" size="100%">27-35</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Purpose/Objective: To determine how age and distress are associated in individuals with disabilities, and how happiness and its components (meaning, pleasure, and engagement) mediate or moderate this relationship. Research Method/Design: These were cross-sectional analyses of survey data from 508 community-dwelling adults with a variety of self-reported health conditions and functional disabilities. Measures included the Orientations to Happiness Questionnaire and items from the Behavior Risk Factor Surveillance System. Results: Greater distress was associated with lower global happiness in both mediation and moderation models. The mediation model showed that middle-aged participants (age: 45-64) scored lowest in global happiness, and the effect of age on distress was partially mediated by happiness. None of the happiness components mediated the relationship of age on distress. The moderation model showed a significant interaction effect for age and global happiness on distress, where younger participants low on happiness were significantly more distressed. Of the three happiness components, only meaning was significantly associated with distress. There was a significant interaction between age and meaning, where participants who were younger and scored low on the meaning scale reported significantly higher distress. Conclusions/Implications: Findings from this study lay groundwork for the development of clinical interventions to address distress in individuals with functional disabilities. Middle-aged and younger people with disabilities may be particularly affected by lower levels of happiness and might benefit from psychological interventions that focus on increasing overall well-being and providing meaning and purpose in life. (PsycINFO Database Record (c) 2014 APA, all rights reserved).&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">1</style></issue></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Rodakowski, Juleen</style></author><author><style face="normal" font="default" size="100%">Skidmore, Elizabeth R</style></author><author><style face="normal" font="default" size="100%">Anderson, Stewart J</style></author><author><style face="normal" font="default" size="100%">Begley, Amy</style></author><author><style face="normal" font="default" size="100%">Jensen, Mark P</style></author><author><style face="normal" font="default" size="100%">Buhule, Olive D</style></author><author><style face="normal" font="default" size="100%">Boninger, Michael L</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Additive effect of age on disability for individuals with spinal cord injuries.</style></title><secondary-title><style face="normal" font="default" size="100%">Arch Phys Med Rehabil</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Activities of Daily Living</style></keyword><keyword><style  face="normal" font="default" size="100%">Adult</style></keyword><keyword><style  face="normal" font="default" size="100%">Age Factors</style></keyword><keyword><style  face="normal" font="default" size="100%">Age of Onset</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged, 80 and over</style></keyword><keyword><style  face="normal" font="default" size="100%">Cohort Studies</style></keyword><keyword><style  face="normal" font="default" size="100%">Disability Evaluation</style></keyword><keyword><style  face="normal" font="default" size="100%">Disabled Persons</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Follow-Up Studies</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Injury Severity Score</style></keyword><keyword><style  face="normal" font="default" size="100%">Length of Stay</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Middle Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Paraplegia</style></keyword><keyword><style  face="normal" font="default" size="100%">Prospective Studies</style></keyword><keyword><style  face="normal" font="default" size="100%">Quadriplegia</style></keyword><keyword><style  face="normal" font="default" size="100%">Risk Assessment</style></keyword><keyword><style  face="normal" font="default" size="100%">Spinal Cord Injuries</style></keyword><keyword><style  face="normal" font="default" size="100%">Time Factors</style></keyword><keyword><style  face="normal" font="default" size="100%">Treatment Outcome</style></keyword><keyword><style  face="normal" font="default" size="100%">Young Adult</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2014</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2014 Jun</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">95</style></volume><pages><style face="normal" font="default" size="100%">1076-82</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;OBJECTIVE: To examine the additive effect of age on disability for adults with spinal cord injury (SCI). DESIGN: Prospective cohort study. SETTING: SCI Model Systems. PARTICIPANTS: Individuals with SCI (median age at injury, 32 y; range, 6-88 y) with a discharge motor FIM score and at least 1 follow-up motor FIM score who also provided measures of other covariates (N=1660). Of the total sample, 79% were men, 72% were white, 16% had incomplete paraplegia, 33% had complete paraplegia, 30% had incomplete tetraplegia, and 21% had complete tetraplegia. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The primary study outcome was the motor subscale of the FIM. A mixed-models approach was used to examine the additive effect of age on disability for individuals with SCI. RESULTS: When controlling for motor FIM at discharge from rehabilitation, level and severity of injury, age at injury, sex, race, and the age &amp;times; time interaction were not significant (P=.07). Age at the time of SCI was significantly associated with motor FIM (F1,238=22.49, P&amp;lt;.001). Two sensitivity analyses found significant interactions for both age &amp;times; time (P=.03, P=.02) and age &amp;times; time-square (P=.01, P=.006) models. Trajectory of motor FIM scores is moderated slightly by age at the time of injury. The older participants were at the time of injury, the greater the curvature and the more rapid decline were found in later years. CONCLUSIONS: These findings indicate that age moderately influences disability for some individuals with SCI: the older the age at the time of injury, the greater the influence age has on disability. The findings serve as an important empirical foundation for the evaluation and development of interventions designed to augment accelerated aging experienced by individuals with SCI.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">6</style></issue></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>47</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Verrall, Aimee M</style></author><author><style face="normal" font="default" size="100%">Alschuler, Kevin A</style></author><author><style face="normal" font="default" size="100%">Johnson, KL</style></author><author><style face="normal" font="default" size="100%">Molton, I R</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Aging with a Long-Term Physical Disability: Primary and Rehabilitation Care Use.</style></title></titles><dates><year><style  face="normal" font="default" size="100%">2014</style></year></dates><pub-location><style face="normal" font="default" size="100%">Poster presented at the American Public Health Association’s Annual Conference, New Orleans, Louisiana</style></pub-location><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;u&gt;Introduction.&lt;/u&gt;&amp;nbsp; People with disabilities and chronic conditions indicate high utilization of many types of health care in numerous settings. &amp;nbsp;People with long-term physical disabilities (LTPD), such as multiple sclerosis, muscular dystrophy, post-polio syndrome, and spinal cord injury, are living longer than ever.&amp;nbsp; Now, people with LTPDs&amp;rsquo; health may not only experience secondary conditions (pain, fatigue, depression) from their original disability, but aging as well.&amp;nbsp; In this study we examined the use of primary and rehabilitation care by people aging with LTPD.&amp;nbsp;&lt;/p&gt;
&lt;p&gt;&lt;u&gt;Methods.&lt;/u&gt; We identified needs, barriers / facilitators, and predisposing characteristics of primary and rehabilitation care use from a self-reported survey collected in 2012&amp;ndash;2013 of community dwelling people aging with LTPD. &amp;nbsp;We used Anderson&amp;rsquo;s model of health services utilization as a conceptual model.&lt;/p&gt;
&lt;p&gt;&lt;u&gt;Results&lt;/u&gt;.&amp;nbsp; The survey was completed by 1,369 people with LTPD with a mean age of 63 years.&amp;nbsp; In the last 12 months, 70% reported seeing a primary care provider (PCP) and 65% a rehabilitation provider.&amp;nbsp; The most common need predicting PCP use was severe mobility limitation and pain interference.&amp;nbsp; For seeing rehabilitation providers the main predictor, also a need, was all ranges of mobility issues (mild to severe).&amp;nbsp; Relative to men, women with LTPD were less likely to see a PCP.&amp;nbsp; Surprisingly, socioeconomic status and health insurance coverage were not predictors of health care usage.&lt;/p&gt;
&lt;p&gt;&lt;u&gt;Conclusion&lt;/u&gt;.&amp;nbsp; Needs, overwhelmingly mobility driven, affect use of health services among people with LTPD.&amp;nbsp; More research is needed to further describe the complex health care usage of people aging with LTPD.&amp;nbsp;&lt;/p&gt;
</style></abstract></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>47</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author><author><style face="normal" font="default" size="100%">Owen, Randall</style></author><author><style face="normal" font="default" size="100%">Gibbons, H</style></author><author><style face="normal" font="default" size="100%">Mitchell, D</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Aging with a Physical Disability in Medicaid Managed Care</style></title></titles><dates><year><style  face="normal" font="default" size="100%">2014</style></year></dates><pub-location><style face="normal" font="default" size="100%">Poster presented at the American Public Health Association’s Annual Conference, New Orleans, Louisiana</style></pub-location><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; This study examines the health care experiences and access of people with disabilities in Medicaid receiving managed care (MC) versus those in fee for services (FFS) health care over two years&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt;&amp;nbsp; The study uses survey data from 817 individuals (430 in MC and 387 in FFS) two years after the start of the MC initiative in addition to encounter data on health care utilization from the population of 39,653 in MC and 68,839 in FFS. The survey includes measures of health care appraisal, ease of receiving medication, and ease of using transportation. Health care utilization comprises emergency room (ER) use and days in the hospital. &amp;nbsp;Regression analyses with these outcomes included the Independent variables of age, gender, race, disability type, and enrollment in MC versus FFS.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt;&amp;nbsp; &amp;nbsp;Health care appraisal and ease of receiving medication did not differ between the MC and FFS groups. However, people with physical disabilities in MC reported a worse appraisal versus FFS, while people with a mental health disability in MC reported a better appraisal versus people in FFS (p&amp;lt;.05). Also, people with physical disabilities had better access to prescriptions in MC (p &amp;lt;.05).Transportation assistance was more positive (p &amp;lt;.01) for people in MC. &amp;nbsp;Both ER use and days in hospital decreased (-8% and -18%) for people in MC and increased for people in FFS (5%).&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;: As MC approaches increase for Medicaid participants with disabilities it is important to assess the differential experiences of various disability groups within MC and in comparison to FFS.&lt;/p&gt;
</style></abstract></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Kratz, Anna L</style></author><author><style face="normal" font="default" size="100%">Hirsh, Adam T</style></author><author><style face="normal" font="default" size="100%">Ehde, Dawn M</style></author><author><style face="normal" font="default" size="100%">Jensen, Mark P</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Acceptance of pain in neurological disorders: associations with functioning and psychosocial well-being.</style></title><secondary-title><style face="normal" font="default" size="100%">Rehabil Psychol</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Rehabil Psychol</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Activities of Daily Living</style></keyword><keyword><style  face="normal" font="default" size="100%">Adaptation, Psychological</style></keyword><keyword><style  face="normal" font="default" size="100%">Adult</style></keyword><keyword><style  face="normal" font="default" size="100%">Chronic Pain</style></keyword><keyword><style  face="normal" font="default" size="100%">Depressive Disorder</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Illness Behavior</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Multiple Sclerosis</style></keyword><keyword><style  face="normal" font="default" size="100%">Muscular Dystrophies</style></keyword><keyword><style  face="normal" font="default" size="100%">Pain Measurement</style></keyword><keyword><style  face="normal" font="default" size="100%">Postpoliomyelitis Syndrome</style></keyword><keyword><style  face="normal" font="default" size="100%">Quality of Life</style></keyword><keyword><style  face="normal" font="default" size="100%">Questionnaires</style></keyword><keyword><style  face="normal" font="default" size="100%">Social Adjustment</style></keyword><keyword><style  face="normal" font="default" size="100%">Socioeconomic Factors</style></keyword><keyword><style  face="normal" font="default" size="100%">Spinal Cord Injuries</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2013</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2013 Feb</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">58</style></volume><pages><style face="normal" font="default" size="100%">1-9</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">OBJECTIVE: Chronic pain acceptance has been shown to be related to positive adjustment to chronic pain in patients presenting with pain as a primary problem. However, the role of pain acceptance in adjustment to chronic pain secondary to a neurological disorder that is often associated with physical disability has not been determined. The purpose of this study was to examine whether two domains of chronic pain acceptance--activity engagement and pain willingness--predict adjustment to pain, controlling for pain intensity and key demographic and clinical variables in individuals with muscular dystrophy (MD), multiple sclerosis (MS), post-polio syndrome (PPS), or spinal cord injury (SCI).

METHOD: Participants were 508 community-dwelling adults with a diagnosis of MD, MS, PPS, or SCI who also endorsed a chronic pain problem. Participants completed self-report measures of pain acceptance, quality of life, pain interference, pain intensity, depression, and social role satisfaction.

RESULTS: Hierarchical linear regressions indicated that activity engagement predicted lower pain interference and depression, and greater quality of life and social role satisfaction. Pain willingness predicted less pain interference and depression. Together, the two pain acceptance subscales accounted for more variance in outcomes than did self-reported pain intensity.

CONCLUSIONS: Findings correspond with the broader pain acceptance literature, although activity engagement appears to be a more robust predictor of adjustment than does pain willingness. This research supports the need for future studies to determine the extent to which treatments that increase acceptance result in positive outcomes in persons with chronic pain secondary to neurological disorders.</style></abstract><issue><style face="normal" font="default" size="100%">1</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/23437995?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Molton, Ivan</style></author><author><style face="normal" font="default" size="100%">Hirsh, Adam T</style></author><author><style face="normal" font="default" size="100%">Smith, Amanda E</style></author><author><style face="normal" font="default" size="100%">Jensen, Mark P</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Age and the role of restricted activities in adjustment to disability related pain.</style></title><secondary-title><style face="normal" font="default" size="100%">J Health Psychol</style></secondary-title><alt-title><style face="normal" font="default" size="100%">J Health Psychol</style></alt-title></titles><dates><year><style  face="normal" font="default" size="100%">2013</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2013 May 29</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">19</style></volume><pages><style face="normal" font="default" size="100%">025-1034</style></pages><language><style face="normal" font="default" size="100%">ENG</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Chronic pain is common in individuals with multiple sclerosis and spinal cord injury and is associated with depressed mood. This may be because pain creates interference in performing and enjoying valued activities. The importance of pain interference may also vary with age, since older adults may have lowered expectations regarding function. This study analyzed relationships among pain variables, age, and mood in 521 individuals with multiple sclerosis or spinal cord injury. As predicted, pain interference mediated the relationship between pain severity and depressed mood. There was no evidence that older adults were less distressed by pain interference than were younger adults.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">8</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/23720543?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Brown, Pat</style></author><author><style face="normal" font="default" size="100%">Johnson, Kurt</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Aging with a disability and state vocational rehabilitation services.</style></title><secondary-title><style face="normal" font="default" size="100%">Work</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2013</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2013 Nov 27</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">48</style></volume><pages><style face="normal" font="default" size="100%">441-51</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;BACKGROUND: Disability prevalence in older adults is increasing. Given the low rates of employment among people with disabilities, especially those aging with multiple sclerosis (MS), spinal cord injury (SCI), late effects of polio (LEP), and muscular dystrophy (MD), services from federal-state vocational rehabilitation (VR) programs could positively impact employment status. OBJECTIVE: To describe VR services for individuals aging with MS, SCI, LEP and MD and the impact of aging on employment status.PARTICIPANTS: Thirteen Washington State VR counselors and 26 individuals, 45 to 65 years old, with MS, MD, LEP or SCI. METHODS: We examined national Rehabilitation Services Administration data (2006, 2007), including case closure, service outcomes and other demographics. We then purposively selected Washington State for our study. Interviews provided consumer and counselor perspectives on the components of successful case closure (employed) and the impact of aging and disability on employment. RESULTS: Washington State and national data were similar. Organizational and individual factors influence the effectiveness of VR services. CONCLUSION: People who could benefit from VR services are not being served; those who are served, are getting neither comprehensive services nor high quality outcomes. Additional research is needed to understand the variables associated with effective use of VR services.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">3</style></issue></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Alschuler, Kevin N</style></author><author><style face="normal" font="default" size="100%">Jensen, Mark P</style></author><author><style face="normal" font="default" size="100%">Sullivan-Singh, Sarah J</style></author><author><style face="normal" font="default" size="100%">Borson, Soo</style></author><author><style face="normal" font="default" size="100%">Smith, Amanda E</style></author><author><style face="normal" font="default" size="100%">Molton, Ivan R</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">The association of age, pain, and fatigue with physical functioning and depressive symptoms in persons with spinal cord injury.</style></title><secondary-title><style face="normal" font="default" size="100%">J Spinal Cord Med</style></secondary-title><alt-title><style face="normal" font="default" size="100%">J Spinal Cord Med</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Adult</style></keyword><keyword><style  face="normal" font="default" size="100%">Affect</style></keyword><keyword><style  face="normal" font="default" size="100%">Age Factors</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged, 80 and over</style></keyword><keyword><style  face="normal" font="default" size="100%">Chronic Pain</style></keyword><keyword><style  face="normal" font="default" size="100%">Cross-Sectional Studies</style></keyword><keyword><style  face="normal" font="default" size="100%">Depression</style></keyword><keyword><style  face="normal" font="default" size="100%">Fatigue</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Health Status</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Middle Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Motor Activity</style></keyword><keyword><style  face="normal" font="default" size="100%">Outcome Assessment (Health Care)</style></keyword><keyword><style  face="normal" font="default" size="100%">Predictive Value of Tests</style></keyword><keyword><style  face="normal" font="default" size="100%">Regression Analysis</style></keyword><keyword><style  face="normal" font="default" size="100%">Residence Characteristics</style></keyword><keyword><style  face="normal" font="default" size="100%">Spinal Cord Injuries</style></keyword><keyword><style  face="normal" font="default" size="100%">Young Adult</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2013</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2013 Sep</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">36</style></volume><pages><style face="normal" font="default" size="100%">483-91</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">CONTEXT/OBJECTIVE: To describe the relationship of pain and fatigue with physical and psychological functioning in adults with spinal cord injury (SCI).

DESIGN: Cross-sectional survey.

SETTING: Community-based survey.

PARTICIPANTS: Convenience sample of individuals with SCI.

INTERVENTION: Not applicable.

OUTCOME MEASURES: Physical functioning (Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Functioning item bank items), depression (Patient Health Questionnaire-9 (PHQ-9)), pain severity (0-10 Numerical Rating Scale (NRS)), and fatigue (0-10 NRS).

RESULTS: Pain and fatigue were independently associated with depression, but only pain was associated with physical functioning. Additionally, depression was more severe among middle-aged participants relative to younger or older participants. Physical functioning declined with increasing age, as well as with higher level of injury.

CONCLUSIONS: The findings support the need for continued development of effective treatments for both pain and fatigue in order to prevent and mitigate the negative effects these symptoms can have on functioning.</style></abstract><issue><style face="normal" font="default" size="100%">5</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/23941796?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Amtmann, Dagmar</style></author><author><style face="normal" font="default" size="100%">Borson, Soo</style></author><author><style face="normal" font="default" size="100%">Salem, Rana</style></author><author><style face="normal" font="default" size="100%">Johnson, Kurt L</style></author><author><style face="normal" font="default" size="100%">Verrall, Aimee</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Aging with disabilities: Comparing symptoms and quality of life indicators of individuals aging with disabilities to U.S. general population norms.</style></title><secondary-title><style face="normal" font="default" size="100%">Journal of the American Geriatrics Society</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Special Issue: 2012 Annual Scientific Meeting Abstract Book</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2012</style></year></dates><pub-location><style face="normal" font="default" size="100%">Seattle, WA</style></pub-location><volume><style face="normal" font="default" size="100%">60</style></volume><pages><style face="normal" font="default" size="100%">S185</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Background: Advances in medical care and rehabilitation have extended the lifespan of people with long-term physical disabilities. However, quantifying the excess burden of symptoms in persons aging with disabilities has been hindered by lack of common metrics across measures and clinical populations. The NIH-funded PROMIS initiative used modern psychometric methods to develop instruments that do use a common metric and provide US population norms for many important domains. The objective of the current study was to construct profiles of symptoms and QoL indicators in persons aging with a long-term disability and to compare them to US population norms. Methods: PROMIS short forms measuring 7 symptoms or QoL indicators (fatigue, pain interference with activities, physical and social function, depression, and sleep and wake disturbance) were completed by individuals with muscular dystrophy (264), multiple sclerosis (481), post-polio syndrome (445), and spinal cord injury (323) (total N=1513) participating in an ongoing longitudinal survey. Individuals aged 45-94 were included in this analysis. Scores for the overall sample, by diagnostic group and by age categories, were compared to the PROMIS US population norms. Results: Compared to the US general population, individuals aging with disabilities reported a higher symptom burden and poorer QoL on 6 of 7 measures (all p&amp;lt;0.0001). Only wake disturbance did not differ from the general population. Statistically significant differences ranged from a low of 2.4 points (sleep disturbance) to a high of 14.4 points (physical function) (T-score metric with a mean of 50 and sd of 10). Comparison to age group norms suggested that older (65+) individuals with disabilities experienced worse fatigue, more pain interference, higher depressive symptoms and lower social function than younger disabled groups.Differences between the disabled and general population groups in symptom burden and QoL widened with age; the oldest group, aged 75+, fared worst. Conclusions: Results clearly document that discrepancies in symptoms and QoL between the general population and people with disabilities increase with aging. Individuals with long-term disabilities constitute a subgroup of the aging population that may require specialized specialized models of health care to manage symptoms adequately, and optimize function and QoL.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">S4</style></issue></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Yorkston, Kathryn M</style></author><author><style face="normal" font="default" size="100%">Verrall, Aimee</style></author><author><style face="normal" font="default" size="100%">Johnson, Kurt L</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Aging with longstanding physical disability: A focus group study</style></title><secondary-title><style face="normal" font="default" size="100%">Journal of the American Geriatrics Society</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2012</style></year></dates><urls><web-urls><url><style face="normal" font="default" size="100%">http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2012.04000.x/pdf</style></url></web-urls></urls><volume><style face="normal" font="default" size="100%">60</style></volume><pages><style face="normal" font="default" size="100%">s240</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Background: People aging with longstanding physical disability must deal with competing trajectories. Physical function is declining while confidence in the ability to cope is improving. Social support is likely to decline with retirement &amp;amp; aging significant others while medical management is improving thus increasing life expectancy. Methods: Four focus groups were conducted soliciting advice for health care teams seeing patients aging with a longstanding disability. Participants included people with spinal cord injury (N = 7), postpolio syndrome (N = 7), multiple sclerosis (N = 5), and muscular dystrophy (N = 4). All were at least 45 years of age and living with their disability for at least 8 years. Focus groups transcripts were reviewed and coded using Atlas.ti and a framework of themes was developed. Results: Four major themes emerged which are described in Table 1. Conclusions: Health care providers should acknowledge the skills that people with longstanding disability bring to the task of prioritizing their goals and managing their condition. Healthcare providers can assist them in developing individualized self-management interventions that help to maintain function and independence as they age.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">S4</style></issue></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Goetz, Mark C</style></author><author><style face="normal" font="default" size="100%">Jensen, Mark P</style></author><author><style face="normal" font="default" size="100%">Verrall, Aimee</style></author><author><style face="normal" font="default" size="100%">Ehde, Dawn M</style></author><author><style face="normal" font="default" size="100%">Bamer, Alyssa M</style></author><author><style face="normal" font="default" size="100%">Molton, Ivan R</style></author><author><style face="normal" font="default" size="100%">Kraft, George H</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Age effects of sleep problems in individuals with multiple sclerosis.</style></title><secondary-title><style face="normal" font="default" size="100%">International Journal of MS Care</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Sleep and MS</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2011</style></year></dates><urls><web-urls><url><style face="normal" font="default" size="100%">http://www.ijmsc.org/doi/pdf/10.7224/1537-2073-13.S3.1</style></url></web-urls></urls><volume><style face="normal" font="default" size="100%">13</style></volume><pages><style face="normal" font="default" size="100%">17-18</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Background: Sleep disturbances in individuals with multiple sclerosis (MS) are relatively common (ie, with many studies showing prevalence of approximately 50%), and evidence indicates that sleep problems are more common in MS samples than in samples of individuals who do not have MS. There is also evidence among the general population suggesting that sleep problems increase with age. However, previous research suggests that among some disability groups (eg, spinal cord injury) there may be a decline in sleep problems with age. Objectives: Based on previous research, we hypothesized that 1) sleep dysfunction in an MS sample would be greater when compared with a normative sample and 2) an examination of aging variables (chronological age, disability duration, and age at disability onset) would show a negative relationship between chronological age and the severity of sleep disturbance. Methods: A survey was administered to 584 individuals with MS that included measures of demographic characteristics and the PROMIS Sleep Disturbance Item Bank. The analytic strategy was based on a Jensen et al. (2009) paper in which a series of multiple regression analyses examined the independent contribution of three age-related variables to sleep problems: chronological age, disability duration, and age at disability onset. Results: Hypothesis 1 was not supported in that comparisons of the MS and normative data on the PROMIS revealed no differences in sleep disruption. Hypothesis 2 was supported in that the findings suggested that younger and middle-aged participants reported more sleep disturbance than did older participants. When controlling for chronological age, disability duration and age at disability onset were not significantly associated with sleep difficulties. Conclusion: One possible explanation for the age effect found is a cohort effect where the older adult groups could potentially include participants who are healthier than the younger participants (ie, health factors associated with sleep disturbance might be related to mortality). It is also possible that age influences or is associated with some third variable that influences sleep quality (eg, employed vs. retired). Longitudinal research following the same group of patients over time is needed to help test these possible explanations.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">S3</style></issue></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Molton, Ivan R</style></author><author><style face="normal" font="default" size="100%">Jensen, Mark P</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Aging and disability: biopsychosocial perspectives.</style></title><secondary-title><style face="normal" font="default" size="100%">Physical medicine and rehabilitation clinics of North America</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Phys Med Rehabil Clin N Am</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Activities of Daily Living</style></keyword><keyword><style  face="normal" font="default" size="100%">Adaptation, Psychological</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged, 80 and over</style></keyword><keyword><style  face="normal" font="default" size="100%">Aging</style></keyword><keyword><style  face="normal" font="default" size="100%">Disability Evaluation</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Geriatric Assessment</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Incidence</style></keyword><keyword><style  face="normal" font="default" size="100%">Interpersonal Relations</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Mobility Limitation</style></keyword><keyword><style  face="normal" font="default" size="100%">Musculoskeletal Diseases</style></keyword><keyword><style  face="normal" font="default" size="100%">Psychology</style></keyword><keyword><style  face="normal" font="default" size="100%">Quality of Life</style></keyword><keyword><style  face="normal" font="default" size="100%">Risk Assessment</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2010</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2010 May</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">21</style></volume><pages><style face="normal" font="default" size="100%">253-65</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Understanding the complex trajectories of disability and aging requires a biopsychosocial approach that considers disability in the broader context of later adulthood. Although disability service researchers and gerontologists have many shared interests and a similar mission, the fields are relatively new to one another and have had little historical interaction. The purpose of this article is to increase and improve collaboration among investigators in these fields by providing some background in social gerontology to the disability researcher, and by applying key theories in aging to the issue of growing older with physical disability. The article discusses particular problem areas for older adults, including social support, and also discusses the parallel paradoxes of aging and disability.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">2</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/20494275?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Johnson, Kurt L</style></author><author><style face="normal" font="default" size="100%">Brown, Pat A</style></author><author><style face="normal" font="default" size="100%">Knaster, Elizabeth S</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Aging with disability in the workplace.</style></title><secondary-title><style face="normal" font="default" size="100%">Physical medicine and rehabilitation clinics of North America</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Phys Med Rehabil Clin N Am</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Aging</style></keyword><keyword><style  face="normal" font="default" size="100%">Disability Evaluation</style></keyword><keyword><style  face="normal" font="default" size="100%">Disabled Persons</style></keyword><keyword><style  face="normal" font="default" size="100%">Employment</style></keyword><keyword><style  face="normal" font="default" size="100%">Employment, Supported</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Middle Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Multiple Sclerosis</style></keyword><keyword><style  face="normal" font="default" size="100%">Muscular Dystrophies</style></keyword><keyword><style  face="normal" font="default" size="100%">Postpoliomyelitis Syndrome</style></keyword><keyword><style  face="normal" font="default" size="100%">Program Evaluation</style></keyword><keyword><style  face="normal" font="default" size="100%">Quality of Life</style></keyword><keyword><style  face="normal" font="default" size="100%">Rehabilitation, Vocational</style></keyword><keyword><style  face="normal" font="default" size="100%">Spinal Cord Injuries</style></keyword><keyword><style  face="normal" font="default" size="100%">United States</style></keyword><keyword><style  face="normal" font="default" size="100%">Workplace</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2010</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2010 May</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">21</style></volume><pages><style face="normal" font="default" size="100%">267-79</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Aging with disabilities, such as multiple sclerosis, spinal cord injury, muscular dystrophy, and postpolio syndrome, can lead to barriers to participation, including employment barriers. Many individuals develop strategies for overcoming these barriers that may become less successful as they experience more secondary conditions concomitant with the aging process. Rehabilitation professionals can help to overcome barriers to workplace participation and should work with clients to enhance employment outcomes.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">2</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/20494276?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Carter, Gregory T</style></author><author><style face="normal" font="default" size="100%">Weiss, Michael D</style></author><author><style face="normal" font="default" size="100%">Chamberlain, Joel R</style></author><author><style face="normal" font="default" size="100%">Han, Jay J</style></author><author><style face="normal" font="default" size="100%">Abresch, Richard T</style></author><author><style face="normal" font="default" size="100%">Miró, Jordi</style></author><author><style face="normal" font="default" size="100%">Jensen, Mark P</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Aging with muscular dystrophy: pathophysiology and clinical management.</style></title><secondary-title><style face="normal" font="default" size="100%">Physical medicine and rehabilitation clinics of North America</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Phys Med Rehabil Clin N Am</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Activities of Daily Living</style></keyword><keyword><style  face="normal" font="default" size="100%">Adaptation, Physiological</style></keyword><keyword><style  face="normal" font="default" size="100%">Adolescent</style></keyword><keyword><style  face="normal" font="default" size="100%">Adult</style></keyword><keyword><style  face="normal" font="default" size="100%">Aging</style></keyword><keyword><style  face="normal" font="default" size="100%">Child</style></keyword><keyword><style  face="normal" font="default" size="100%">Child, Preschool</style></keyword><keyword><style  face="normal" font="default" size="100%">Combined Modality Therapy</style></keyword><keyword><style  face="normal" font="default" size="100%">Disability Evaluation</style></keyword><keyword><style  face="normal" font="default" size="100%">Disabled Persons</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Middle Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Muscular Dystrophies</style></keyword><keyword><style  face="normal" font="default" size="100%">Prognosis</style></keyword><keyword><style  face="normal" font="default" size="100%">Quality of Life</style></keyword><keyword><style  face="normal" font="default" size="100%">Risk Assessment</style></keyword><keyword><style  face="normal" font="default" size="100%">Severity of Illness Index</style></keyword><keyword><style  face="normal" font="default" size="100%">Sickness Impact Profile</style></keyword><keyword><style  face="normal" font="default" size="100%">Survival Analysis</style></keyword><keyword><style  face="normal" font="default" size="100%">Treatment Outcome</style></keyword><keyword><style  face="normal" font="default" size="100%">Young Adult</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2010</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2010 May</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">21</style></volume><pages><style face="normal" font="default" size="100%">429-50</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Major advances in the fields of medical science and physiology, molecular genetics, biomedical engineering, and computer science have provided individuals with muscular dystrophy (MD) with more functional equipment, allowing better strategies for improvement of quality of life. These advances have also allowed a significant number of these patients to live much longer. As progress continues to change management, it also changes patients&amp;#39; expectations. A comprehensive medical and rehabilitative approach to management of aging MD patients can often fulfill expectations and help them enjoy an enhanced quality of life.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">2</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/20494287?dopt=Abstract</style></custom1></record></records></xml>