<?xml version="1.0" encoding="UTF-8"?><xml><records><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%">Müller, Rachel</style></author><author><style face="normal" font="default" size="100%">Terrill, Alexandra L</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%">Ravesloot, Craig</style></author><author><style face="normal" font="default" size="100%">Ipsen, Catherine</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Happiness, Pain Intensity, Pain Interference, and Distress in Individuals with Physical Disabilities.</style></title><secondary-title><style face="normal" font="default" size="100%">Am J Phys Med Rehabil</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%">2015 Mar 24</style></date></pub-dates></dates><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;OBJECTIVES: The aim of this study was to examine how the construct of happiness is related to pain intensity, pain interference, and distress in individuals with physical disabilities. DESIGN: This study involves cross-sectional analyses of 471 individuals with a variety of health conditions reporting at least mild pain. RESULTS: The first hypothesis that happiness mediates the relationship between pain intensity and two outcomes, pain interference and distress, was not supported. The second hypothesis was supported by a good fitting model (&amp;chi;10 = 12.83, P = 0.23, root-mean-square error of approximation = 0.025) and indicated that pain intensity significantly mediated the effect of happiness on pain interference (indirect effect: &amp;beta; = -0.13, P &amp;lt; 0.001) and on distress (indirect effect: &amp;beta; = 0.10, P = 0.01). Happiness showed a significant direct effect on pain intensity (&amp;beta; = -0.20, P &amp;lt; 0.001). A third model exploring the happiness components meaning, pleasure, and engagement fitted well (&amp;chi;4 = 9.65, P = 0.05, root-mean-square error of approximation = 0.055). Pain intensity acted as a significant mediator but only mediated the effect of meaning on pain interference (indirect effect: &amp;beta; = -0.07, P = 0.05) and on distress (indirect effect via pain interference: &amp;beta; = -0.04, P = 0.05). Only meaning (&amp;beta; = -0.10, P = 0.05), but neither pleasure nor engagement, had a significant direct effect on pain intensity. CONCLUSIONS: Participants who reported greater happiness reported lower pain interference and distress through happiness&amp;#39; effects on pain intensity. Experiencing meaning and purpose in life seems to be most closely (and negatively) associated with pain intensity, pain interference, and distress. Findings from this study can lay the groundwork for intervention studies to better understand how to more effectively decrease pain intensity, pain interference, and distress.&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%">Owen, Randall</style></author><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author><author><style face="normal" font="default" size="100%">Bowers, Anne</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Health services appraisal and the transition to Medicaid Managed Care from fee for service.</style></title><secondary-title><style face="normal" font="default" size="100%">Disabil Health J</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Disabil Health J</style></alt-title></titles><dates><year><style  face="normal" font="default" size="100%">2015</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2015 Oct 24</style></date></pub-dates></dates><language><style face="normal" font="default" size="100%">ENG</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;BACKGROUND: Many states are transitioning fee-for-service (FFS) Medicaid into Medicaid Managed Care (MMC) for people with disabilities. OBJECTIVE: This study examined managed care&amp;#39;s impact on health services appraisal (HSA) and unmet medical needs of individuals with disabilities receiving Medicaid. Key questions included 1) Do participant demographics and enrollment in MMC impact unmet medical needs and HSA? 2) Within MMC, do demographics and continuity of care relate to unmet medical needs? 3) Within MMC, do demographics, unmet medical needs and continuity of care relate to HSA? METHODS: We collected cross-sectional survey data (n&amp;nbsp;=&amp;nbsp;1615) from people with disabilities in MMC operated by for-profit insurance companies (n&amp;nbsp;=&amp;nbsp;849) and a similar group remaining in FFS (n&amp;nbsp;=&amp;nbsp;766) in one state. Regression analyses were conducted across these groups and within MMC only. RESULTS: Across Medicaid groups, MMC enrollment was not related to either HSA or unmet needs; health status, having a mental health disability and unmet transportation needs related to HSA and health status, unmet transportation needs and having a mental health or physical disability related to higher unmet medical needs. Within MMC, in addition to better health and fewer unmet medical needs, less continuity of care significantly decreased HSA. Higher unmet transportation needs, poorer health status, having a physical or mental health disability, and less continuity of care significantly decreased unmet medical needs. CONCLUSIONS: This research points to the importance of meeting unmet needs of individuals in MMC and the need for increased continuity of care as people transition from FFS.&lt;/p&gt;
</style></abstract><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/26632026?dopt=Abstract</style></custom1></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%">Ehde, Dawn M</style></author><author><style face="normal" font="default" size="100%">Goetz, Mark C</style></author><author><style face="normal" font="default" size="100%">Molton, Ivan R</style></author><author><style face="normal" font="default" size="100%">Bombardier, Charles H</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%">Happiness Matters in Aging with a Disability</style></title></titles><dates><year><style  face="normal" font="default" size="100%">2012</style></year></dates><publisher><style face="normal" font="default" size="100%">American Congress of Rehabilitation Medicine (ACRM) Annual Conference</style></publisher><pub-location><style face="normal" font="default" size="100%">Vancouver, BC</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;Objectives&lt;/u&gt;:&amp;nbsp; Psychosocial well-being, including happiness, is rarely studied in people with disabilities, despite the potential for such research to expand our understanding of the full range of functioning in the context of aging with a disability. This study aims to answer the following questions: (1) Where do people with disabilities fall on a happiness scale overall and across age groups (by disability group)? (2) &amp;nbsp;How do they compare to community samples without disability? (3) What are the correlates of happiness in people aging with physical disability?&lt;/p&gt;
&lt;p&gt;&lt;u&gt;Design&lt;/u&gt;:&amp;nbsp; Cross-sectional postal survey&amp;nbsp;&lt;/p&gt;
&lt;p&gt;&lt;u&gt;Setting&lt;/u&gt;:&amp;nbsp; Community&lt;/p&gt;
&lt;p&gt;&lt;u&gt;Participants:&lt;/u&gt; 1862 adults (63.3% female) with muscular dystrophy, multiple sclerosis, post-polio syndrome, or spinal cord injury.&lt;/p&gt;
&lt;p&gt;&lt;u&gt;Interventions&lt;/u&gt;: none&lt;/p&gt;
&lt;p&gt;&lt;u&gt;Main Outcome Measure&lt;/u&gt;:&amp;nbsp; The Subjective Happiness Scale (Lyubomirksy &amp;amp; Lepper, 1999) was used to assess happiness. The total score ranges from 1(lowest) to 7 (highest).&lt;/p&gt;
&lt;p&gt;&lt;u&gt;Results&lt;/u&gt;:&amp;nbsp; Analyses examined levels of happiness for the total sample and for each disability condition individually across four age cohorts: 18-44, 45-64, 65-74, and 75+ years. The sample&amp;rsquo;s mean happiness level varied between 5.04 (SD: 1.26) for those age 45-64 and 5.6 (SD: 1.16) for those age 65-74. Levels of happiness across different age cohorts and disability conditions were comparable to levels of happiness reported in other samples of adults without physical disabilities. Happiness differed significantly by disability condition and by age; older cohorts were happier than younger cohorts. Pain, vision loss, and falls were negatively correlated with happiness.&lt;/p&gt;
&lt;p&gt;&lt;u&gt;Conclusions&lt;/u&gt;: &amp;nbsp;Studying the full spectrum of psychosocial functioning, including happiness, may broaden our understanding of successful aging with physical disability.&lt;/p&gt;
&lt;p&gt;&lt;a href=&quot;/sites/agerrtc/files/files/happiness_poster%20DRAFT3.pdf&quot; target=&quot;_blank&quot;&gt;View Poster&lt;/a&gt;&lt;/p&gt;
</style></abstract></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%">Kraft, George H</style></author><author><style face="normal" font="default" size="100%">Amtmann, Dagmar</style></author><author><style face="normal" font="default" size="100%">Johnson, Kurt L</style></author><author><style face="normal" font="default" size="100%">Weir, Virginia G</style></author><author><style face="normal" font="default" size="100%">Verrall, Aimee</style></author><author><style face="normal" font="default" size="100%">Bamer, Alyssa M</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Hidden symptoms of multiple sclerosis increase with patient age</style></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://www.posters2view.com/ectrims2012/view.php?nu=187</style></url></web-urls></urls><publisher><style face="normal" font="default" size="100%">European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS)</style></publisher><pub-location><style face="normal" font="default" size="100%">Lyon, France</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;Background: Although many of the more obvious symptoms of multiple sclerosis (MS), such as weakness, ataxia, and bladder problems, are incorporated into the Kurtzke Expanded Disability Status Scale (EDSS), less information is available on the prevalence of &amp;quot;hidden&amp;quot; manifestations of this disease, such as fatigue, depression, pain, and anxiety. The recent completion of the NIH-funded PROMIS and Neuro-QoL initiatives allow comparison of less apparent symptoms with age-matched norms from a large, industrialized population.&amp;nbsp; The aim of the current study was to compare less apparent symptoms of MS as well as quality of life (QoL) indicators with population norms and to stratify changes in symptom burden with increasing age.&lt;/p&gt;
&lt;p&gt;Methods: PROMIS short forms, based on US population norms, on 11 hidden symptoms (fatigue, depression, pain interference, anxiety, sleep disturbance, and wake disturbance) and quality of life indicators (cognitive concerns, executive functioning, physical function, global mental function, and social role) were completed by 1,543 individuals with MS in three cross-sectional surveys.&amp;nbsp; Scores for the overall sample were compared on Neuro-QoL cognitive function.&amp;nbsp; Results in 9 domains from age groups 18-34 (n=104), 35-44 (n=195), 45-54 (n=440), 55-64 (n=544), 65-74 (n=223) and older than 75 (n=37) were compared with PROMIS population norms.&lt;/p&gt;
&lt;p&gt;Results: When comparing the whole sample to the US population, adults with MS reported significantly higher symptom burden on all 11 domains, (p&amp;lt;0.0001).&amp;nbsp; Depression showed the least difference and physical function the greatest difference. Comparisons to age group norms showed increasing symptom burden in older cohorts.&amp;nbsp; The 18-34 group reported significantly higher levels of fatigue, pain interference, sleep disturbance, and physical function than the corresponding age norm, (p&amp;lt;0.005).&amp;nbsp; Age groups 35-44 and 45-54 reported significantly higher burden on all domains except global mental function while age groups 55-64 and 65-74 reported higher burden on all 9 domains compared with PROMIS population norms (except age group 65-74 reported significantly less sleep disturbance), (p&amp;lt;0.005).&lt;/p&gt;
&lt;p&gt;Conclusion:&amp;nbsp; Our findings indicate that most of these less-apparent symptoms increase with age. In particular, physical and mental function and satisfaction with social role decrease while fatigue increases most with age.&amp;nbsp; Older adults living with MS may require targeted health care strategies to optimize quality of life.&lt;/p&gt;
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