Suzanne McDermott

Injury among male migrant farm workers in South Carolina

A record review and interview survey were carried out to determine the impact of injury on the health of male migrant workers in the Ridge area of South Carolina. Thirteen percent of the mens visits to the Rural Migrant Clinic were for injuries. A larger number, sixty percent, of mens visits to the local Emergency Room were due to injuries. Documentation of alcohol and drug use or the circumstances of the injury was more complete on the Emergency Room records than on the Clinic records.Interviews with 116 migrant workers were carried out in the camps during the summers of 1986 and 1987. Male migrant workers had similar rates of work related accidents as other hired farm workers in the United States. However, male migrant workers have more episodes of personal violence than black males living in other types of rural settings. Heavy drinking was associated with these violent episodes. Over 83 percent of the episodes of personal violence occurred in the camps after dark.It is suggested that camp conditions with poor sanitation, crowding, lack of recreational outlets, and high presence of available alcohol contributes to the high rates of injury in this group of men.A record review and interview survey were carried out to determine the impact of injury on the health of male migrant workers in the Ridge area of South Carolina. Thirteen percent of the mens visits to the Rural Migrant Clinic were for injuries. A larger number, sixty percent, of mens visits to the local Emergency Room were due to injuries. Documentation of alcohol and drug use or the circumstances of the injury was more complete on the Emergency Room records than on the Clinic records. Interviews with 116 migrant workers were carried out in the camps during the summers of 1986 and 1987. Male migrant workers had similar rates of work related accidents as other hired farm workers in the United States. However, male migrant workers have more episodes of personal violence than black males living in other types of rural settings. Heavy drinking was associated with these violent episodes. Over 83 percent of the episodes of personal violence occurred in the camps after dark. It is suggested that camp conditions with poor sanitation, crowding, lack of recreational outlets, and high presence of available alcohol contributes to the high rates of injury in this group of men.

Generating models of mental retardation from data with machine learning

The article focuses on generating simple and expressive domain models of Mental Retardation (MR) from data using knowledge discovery and data mining (KDD) methods. 2137 cases (mild or borderline MR) and 2165 controls (randomly selected) from the National Collaborative Perinatal Project (NCPP), a multicentric study involving pregnant mothers and the outcomes, constituted our sample. Twenty attributes (prenatal, perinatal and postnatal), thought to play a role in MR were utilized. The outcome variable (class) was, whether the child was retarded or not, based on the IQ score. Tree learners (C4.5, CART), rule inducers (C4.5 Rules, FOCL) and a reference classifier (Naive Bayes) were the machine learning algorithms used for model building. The predictive accuracy ranged from 68.4% (FOCL) to 70.3% (Naive Bayes). CART obtained a sensitivity of 79.0% and also generated highly stable and simple trees across fifty random two-third training), one-third (testing) partitions of the sample. The algorithms identified emotional/behavioral problems in children as a significant predictor of MR risk. Our study shows that the KDD methods hold promise in recovering useful structure from medical data.

Moving the research and science agenda forward.

This issue marks the beginning of the 7th volume of Disability and Health Journal (DHJO). This 7th volume also brings with it a special issue that captures the conceptualizations of aging with a disability versus aging into disability as presented in an invited meeting ‘‘Aging with Disability’’ held in Washington D.C. in May 2012. Our quarterly journal has transformed from a few good articles to many excellent and citable articles, and some journal issues contain article groupings of interesting and leading edge concepts (see articles in this issue related to disability and chronic disease). We expect these pioneering and innovative articles will continue to increase our Impact Factor, which is currently 1.446. At press time, the 136 manuscripts submitted to DHJO in 2013 represent our highest number of submissions to date, and we are hopeful the number will continue to grow in years to come. We have reviewed topics in nearly every field of disability and health, and manuscripts were submitted by authors from more than 30 countries. Thank you to all authors for submitting manuscripts to DHJO and for entrusting us with the opportunity to evaluate your work for publication. Our Editorial Board is also changing. We thank the members who have provided years of service in reviewing key manuscripts and offering guidance on publications in this relatively new field. We welcome our new members, from whom we anticipate continued review activity, editorial support, and new perspectives. Because the journal has been able to begin to fill the gap in the science of disability and health to a significant degree, we the Editors are interested in fostering new conceptualizations about health and disability through Commentaries and Viewpoints. Topics for these manuscripts are invited or approved before submission (see Guide for Authors, http://www.disabilityandhealthjnl.com/ authorinfo). We view Commentaries as opportunities to promote new or modified explanations, interpretations, or constructs of disability and health, including notes related to articles within our Journal. These usually require some level of citation to support a new conceptualization. The new section called Viewpoints, on the other hand, will be opinions and judgments, often less referenced, but grounded in theory or trends. We hope both Commentaries and Viewpoints will stimulate further research, including intervention studies, about disability and health.

Crime risk associated with disability

The link between injuries, intentional and unintentional, and health has been established as an important aspect of public health. The Centers for Disease Control and Prevention (CDC) funds surveillance, research, and preventive interventions related to injury, and Disability and Health Journal has published a few reports on the link between injury and disability. Despite the importance of this topic, there is a dearth of publications related to intentional injury and disability. This has been a topic of personal interest for me, and I hope to see more research and journal submissions in the coming years. In the early 1990s I became interested in intentional injuries in the form of crime against people with disabilities. As has been the case throughout my career, I was struck by an observation about my daughter, who was born in 1978 with an intellectual disability (ID). By the time she was 10 years of age, she was well known by our citydwelling neighbors in Columbia, South Carolina, and after school, she and her 3 brothers played with friends in the neighborhood or local park. As is the case with many people with ID, my daughter knew no strangers and she often wandered over to talk with people we did not know. At one point I went to our neighborhood police substation to post a picture of my daughter so the officers would know her and report unusual events. As a result of that conversation with the police officers, I learned that although the Uniform Crime Report (UCR) had a variable for disability status related to the suspected criminal, there was no uniform report of the disability status of the victim. I also learned that the UCR data were not required to be entered into a relational database. Therefore, local law enforcement departments never questioned information technology vendors about designing systems for reporting crime using data from the fields in various forms, including victim disability status. As a result, I decided to report this problem to the FBI, and I did this by calling an aide to my South Carolina senator, who was known for his citizen advocacy. Within days of my report, I was talking to office staff in the Office of the UCR. One other personal coincidence made me take action. The Columbia police chief had a son with cerebral palsy who rode on the special education school bus with my daughter. The chief was a pillar of the community, contacted by scores of people wanting his ear. When I called for an appointment to see him, the only aspect of my status that impressed his secretary was the relationship between his son and my daughter. With the help and support of

How can research lead to change in practice

In the field of disability and health we carry out research in order to build a knowledge base that we hope will inform policy and practice. Many articles published in Disability and Health Journal note in their discussions that more specific information, a larger number of subjects, well-defined cohorts or subjects, or additional interventional studies are needed in order to change practice or promote policy changes. Therefore, we have to ask ourselves if there are ways that our research community can fine-tune research designs and conduct analyses that will better facilitate adaption into the practices and policies of the field. A possible area of focus is in the analyses of disparities in the receipt of preventive services for individuals with intellectual and developmental disability. What should be the unit of analysis when receipt of preventive services is studied? The most immediate answer is ‘‘the individual’’ but is that the right answer in this case? The Americans with Disabilities Act and the International Classification of Functioning, Disability, and Health as well as scores of instruments, books, and articles suggest that the process of disablement is dynamic, and the environment needs to be the place where we look for solutions. A number of researchers have embraced this notion and report on features of homes, schools, health care environments, and neighborhoods. Many of these reports identify barriers and deficits, including inaccessible parking near buildings, entries without ramps or incorrectly constructed ramps, inadequate signage, narrow hallways and bathrooms, etc. On the positive side there are studies that focus on accessibility and universal design and how this contributes to the receipt of services, however these are fewer in number. So, are there features of the environment that should be incorporated into studies of receipt of preventive services among people with intellectual and developmental disability or other cognitive impairment? In general, the literature on health disparities sometimes uses neighborhood characteristics to predict or explain individual behavior. Thus, we have learned that two highly comparable people who have the same gender, age, marital status, race, income, and education, may have different access to health services if one person lives in a neighborhood were the poverty level is very low and the other lives in a neighborhood with a high poverty level. In order to improve access, findings like the neighborhood effect tell us that we need for public policy to make decisions regarding access to care. For instance, preferentially

DHJO: The past and the future

This past year has been one of economic caution, slowdowns, and downsizing. Health care costs in the US continue to rise, and federal, state, and local system responses appear to be band-aid fixes for the moment. There is much concern in some disability circles about the ability to continue needed supports for health-related issues of people with disabilities, and many states report closer scrutiny and requirement for medical justifications. The Affordable Care Act (ACA) has recognized some of those issues, and now requires coverage of those with pre-existing conditions and disabilities and has extended the age of adult children (including those with life-long health care needs such as cystic fibrosis, cerebral palsy, etc.) to be covered by their parents’ insurance. Although health and wellness has received a more elevated position in the ACA, the implementation and cost factors of health promotion and how those with disabilities will be affected for access to these and other services are not clear. Coordination of care for people with complex medical needs and impairments remain unfunded for the foreseeable future. Federal research dollars are also limited, although there is hope of some relaxation of those restrictions in the coming months. Disability and rehabilitation research are not the highest priority, as witnessed by budget comparisons within and among federal funding agencies. Center for Disease Control and Prevention’s budget was most notably diminished, and reductions in or inflexibility with disability-related research support is common because of budget line-items from Congress. National Institutes of Health is restructuring, and the National Center for Medical Rehabilitation Research has been reviewed by a blue ribbon panel appointed by the Director. National Institute for Disability Related Research was also appraised internally through the Department of Education, and welcomed new leadership. Coordinated research about disability among and within agencies, and establishing a national agenda