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Verdugo MÁ, Schalock RL, Gómez LE, Navas P. A Systematic Approach to Implementing, Evaluating, and Sustaining the Shared Citizenship Paradigm in the Disability Field. Behav Sci (Basel) 2023; 13:970. [PMID: 38131825 PMCID: PMC10740522 DOI: 10.3390/bs13120970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/01/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
The disability field continues to face challenges in transforming and implementing meaningful and effective changes in person-centered services and supports aligned with the principles of the Convention on the Rights of Persons with Disabilities. To guide this transformative process effectively, a paradigm must be operationalized through a systematic approach. This article outlines such a systematic approach, consisting of two components: (a) aligning the paradigm's foundational pillars to the elements of an explanatory/implementation model (the Quality of Life and Supports Model) to facilitate the paradigm's operationalization, acceptance, and application and (b) aligning implementation, evaluation, and sustainability strategies with ecological systems, implementation targets, and the paradigm's foundational pillars to drive change across systems. The synergy and alignment between these components underscore the importance of linking public policies with professional and organizational practices to promote social inclusion and enhance the quality of life for people with disabilities. We provide practical examples highlighting the collaborative potential of this synergy and emphasize the significance of evidence-based and person-centered practices in promoting equal rights and social inclusion for people with disabilities.
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Affiliation(s)
| | | | - Laura E. Gómez
- Department of Psychology, Universidad de Oviedo, 33003 Oviedo, Spain
| | - Patricia Navas
- INICO, Universidad de Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (P.N.)
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Morán L, Gómez LE, Verdugo MÁ, Schalock RL. The Quality of Life Supports Model as a Vehicle for Implementing Rights. Behav Sci (Basel) 2023; 13:bs13050365. [PMID: 37232602 DOI: 10.3390/bs13050365] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/19/2023] [Accepted: 04/26/2023] [Indexed: 05/27/2023] Open
Abstract
The Quality of Life Supports Model (QOLSM) is emerging as a new framework that is applicable to people with disabilities in general, but specially to people with intellectual and developmental disabilities (IDD). The aim of this conceptual paper is twofold. Firstly, it aims to show the overlap between the QOLSM and the Convention on the Rights of People with Disabilities (CRPD), highlighting how the former can be used to address many of the goals and rights embedded in the latter. Secondly, the article seeks to illustrate the connection between these two frameworks and highlight the importance of acknowledging and measuring the rights of people with IDD. Therefore, we posit that the new #Rights4MeToo scale is ideal for: (a) providing accessible means and opportunities for people with IDD to identify and communicate their needs regarding their rights; (b) enhancing the supports and services that families and professionals provide to them; and (c) guiding organizations and policies to identify strengths and needs in relation to rights and quality of life. We also discuss future research needs and summarize the main findings of this article, highlighting its implications for practice and research.
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Affiliation(s)
- Lucía Morán
- Department of Psychology, University of Oviedo, 33003 Oviedo, Spain
| | - Laura E Gómez
- Department of Psychology, University of Oviedo, 33003 Oviedo, Spain
| | - Miguel Ángel Verdugo
- Institute on Community Integration (INICO) and Department of Personality, Assessment and Psychological Treatments, University of Salamanca, 37005 Salamanca, Spain
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Pérez-Curiel P, Vicente E, Morán ML, Gómez LE. The Right to Sexuality, Reproductive Health, and Found a Family for People with Intellectual Disability: A Systematic Review. Int J Environ Res Public Health 2023; 20:ijerph20021587. [PMID: 36674341 PMCID: PMC9864803 DOI: 10.3390/ijerph20021587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/08/2023] [Accepted: 01/12/2023] [Indexed: 05/31/2023]
Abstract
Although sexuality, reproductive health, and starting a family are human rights that should be guaranteed for all citizens, they are still taboo issues for people with intellectual disability (ID), and even more so for women with ID. This paper systematically reviews the current qualitative and quantitative evidence on the rights of people with ID in regard to Articles 23 (right to home and family) and 25 (health, specifically sexual and reproductive health) of the Convention on the Rights of Persons with Disabilities (CRPD). A systematic review of the current literature, following PRISMA 2020, was carried out in ERIC, PsychInfo, Scopus, PubMed, ProQuest, and Web of Science. In all, 151 articles were included for review. The studies were categorized into six themes: attitudes, intimate relationships, sexual and reproductive health, sexuality and sex education, pregnancy, and parenthood. There are still many barriers that prevent people with ID from fully exercising their right to sexuality, reproductive health, and parenthood, most notably communicative and attitudinal barriers. These findings underline the need to continue advancing the rights of people with ID, relying on Schalock and Verdurgo's eight-dimensional quality of life model as the ideal conceptual framework for translating such abstract concepts into practice and policy.
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Affiliation(s)
- Patricia Pérez-Curiel
- Department of Psychology and Sociology, University of Zaragoza, C./Pedro Cerbuna, 12, 50009 Zaragoza, Spain
| | - Eva Vicente
- Department of Psychology and Sociology, University of Zaragoza, C./Pedro Cerbuna, 12, 50009 Zaragoza, Spain
| | - M. Lucía Morán
- Department of Education, University of Cantabria, Av./de los Castros, 52, 39005 Santander, Spain
| | - Laura E. Gómez
- Department of Psychology, University of Oviedo, 33003 Oviedo, Spain
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Swerts C, Lombardi M, Gómez LE, Verlet D, Debeer D, Maeyer JD, Vanderplasschen W. A Tool for Assessing the Quality of Life of Adolescents in Youth Care: Psychometric Properties of the QOLYSS. Interv Psicosoc 2023; 32:21-31. [PMID: 37361629 PMCID: PMC10268548 DOI: 10.5093/pi2022a17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/05/2022] [Indexed: 06/28/2023]
Abstract
Quality of life (QOL) has gained increased interest as a critical pathway to better understanding the lives and circumstances of children and adolescents in both the general population and among specific populations. Yet, QOL assessment among youngsters in youth care services remains a highly under-researched topic. This study examines the suitability and psychometric properties of a new QOL self-report scale for adolescents between 12 and 18 years old in youth care: the Quality of Life in Youth Services Scale (QOLYSS). The provisional version of the QOLYSS was pre-tested in a sample of 28 adolescents in youth care to examine its applicability and feasibility. Next, a comprehensive evaluation of the psychometric properties of the field-test version was conducted in a sample of 271 adolescents in youth care in Flanders, Belgium (M = 15.43, SD = 1.73). Classical item and factor analyses were carried out per subscale, (test-retest) reliability and item-discriminant validity of the subscales were examined, convergent validity was explored, and confirmatory factor analysis was used to examine the goodness-of-fit of different measurement models. Reliability measures of the scale are satisfactory, results are indicative of convergent validity, and confirmatory factor analysis provides evidence for the eight correlated factors model. Future lines of research concerning the ongoing development and application of the QOLYSS are discussed.
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Affiliation(s)
- Chris Swerts
- Ghent UniversityDepartment of Special Needs EducationBelgiumGhent University, Department of Special Needs Education, Belgium;
- HOGENT University of Applied Sciences and ArtsSocial-Educational Care WorkGhentBelgiumHOGENT University of Applied Sciences and Arts, Social-Educational Care Work, EQUALITY//Research Collective, Ghent, Belgium
| | - Marco Lombardi
- HOGENT University of Applied Sciences and ArtsSocial-Educational Care WorkGhentBelgiumHOGENT University of Applied Sciences and Arts, Social-Educational Care Work, EQUALITY//Research Collective, Ghent, Belgium
| | - Laura E. Gómez
- University of OviedoDepartment of PsychologySpainUniversity of Oviedo, Department of Psychology, Spain;
| | - Dries Verlet
- Ghent UniversityFaculty of Economics and Business AdministrationBelgiumGhent University, Faculty of Economics and Business Administration, Belgium;
- Statistics FlandersBrusselsBelgiumStatistics Flanders, Brussels, Belgium;
| | - Dries Debeer
- Ghent UniversityFaculty of Psychology and Educational SciencesResearch Support OfficeBelgiumGhent University, Faculty of Psychology and Educational Sciences, Research Support Office, Belgium
| | - Jessica De Maeyer
- HOGENT University of Applied Sciences and ArtsSocial-Educational Care WorkGhentBelgiumHOGENT University of Applied Sciences and Arts, Social-Educational Care Work, EQUALITY//Research Collective, Ghent, Belgium
| | - Wouter Vanderplasschen
- Ghent UniversityDepartment of Special Needs EducationBelgiumGhent University, Department of Special Needs Education, Belgium;
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Gómez LE. Quality of life in people with intellectual and developmental disabilities. Dev Med Child Neurol 2022; 64:1056-1057. [PMID: 35304746 PMCID: PMC9540622 DOI: 10.1111/dmcn.15209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/27/2022]
Abstract
This commentary is on the original article by Jacoby et al. on pages 1145–1155 of this issue.
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Gómez LE, Morán ML, Al-Halabí S, Swerts C, Verdugo MA, Schalock RL. Quality of Life and the International Convention on the Rights of Persons With Disabilities: Consensus Indicators for Assessment. Psicothema 2022; 34:182-191. [PMID: 35485530 DOI: 10.7334/psicothema2021.574] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The quality of life construct provides an ideal conceptual framework for translating such abstract concepts as self-determination, equity, accessibility, and inclusion. Through consultation with expert raters, we sought to develop and validate a bank of indicators and items, based on the quality of life conceptual framework, to be used as a means of evaluating and implementing the Articles of the Convention on the Rights of Persons with Disabilities (CRPD). METHOD Thirty-two experts in the field of intellectual and developmental disabilities participated, rating the suitability, importance, and clarity of a bank of 296 items, as well as the relevance of controlling for 70 sociodemographic variables. RESULTS After qualitative and quantitative analysis of the data, the final selection comprised 60 sociodemographic variables and 153 items that scored highly on all criteria and produced an excellent level of agreement between the experts. CONCLUSIONS This bank of items and set of sociodemographic variables constitute the pilot version of a CRPD assessment and monitoring instrument with sufficient evidence of content validity, which may be useful in developing evidence-based practices and in detecting rights violations.
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García-Domínguez L, Navas P, Verdugo MÁ, Arias VB, Gómez LE. Psychotropic drugs intake in people aging with intellectual disability: Prevalence and predictors. J Appl Res Intellect Disabil 2022; 35:1109-1118. [PMID: 35384179 PMCID: PMC9545215 DOI: 10.1111/jar.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 03/04/2022] [Accepted: 03/24/2022] [Indexed: 11/26/2022]
Abstract
Background Psychotropic medication is frequently administered to people with intellectual disability with mental health and/or behavioural problems, instead of other non‐pharmacological interventions. This study describes the mental health and behavioural problems of people aging with intellectual disability, their psychotropic medication intake, and the factors contributing to a greater medication intake. Method The sample consisted of 991 people with intellectual disability over 45 years. Descriptive statistics and multinominal logistic regression were carried out. Results Antipsychotics were the most used psychotropic drug. Older people with mild intellectual disability living in institutions and affected by mental health and behavioural problems were more likely to take larger amounts of psychotropic medication. Conclusions Antipsychotics continue to be widely used by people with intellectual disability and mental and behavioural health problems, especially those in institutionalised settings. Future research should consider if medication intake could be reduced providing better supports in the community and non‐pharmacological interventions.
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Affiliation(s)
| | - Patricia Navas
- Institute on Community Integration, University of Salamanca, Salamanca, Spain
| | | | - Víctor B Arias
- Institute on Community Integration, University of Salamanca, Salamanca, Spain
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Morán L, Gómez LE, Balboni G, Monsalve A, Verdugo MÁ, Rodríguez M. Predictors of individual quality of life in young people with Down syndrome. Rehabil Psychol 2022; 67:205-214. [PMID: 35298204 DOI: 10.1037/rep0000443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE/OBJECTIVE Although the concept of quality of life (QoL) has become a reference framework for the provision of support and services to people with intellectual disability (ID), its conceptualization and application for persons with Down syndrome (DS) have received little attention. This study analyzed QoL outcomes in children and young people with DS and examined the influence of several individual and environmental variables on QoL. RESEARCH METHOD/DESIGN A cross-sectional study was conducted. Participants were 404 children and young people with DS aged 4 to 21 who were users of 73 organizations providing services to people with ID. The KidsLife-Down Scale was used to assess QoL-related personal outcomes perceived by professionals and relatives. Descriptive statistics were calculated. Correlation coefficients were computed and multiple regression analyses were conducted for each QoL domain and for the composite score. RESULTS The highest scores were obtained in material well-being, physical well-being, and rights, whereas the lowest scores were observed in self-determination and social inclusion. Multiple regression analyses showed that age, level of ID, level of support needs, degree of dependency, type of schooling, and size of organization were predicting factors of scores in QoL domains. CONCLUSIONS This study underlines priority areas and relevant variables that must be considered when planning, implementing, and assessing supports and services to improve the QoL of children and young people with DS. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | - Giulia Balboni
- Department of Philosophy, Social and Human Sciences and Education
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Gómez LE, Schalock RL, Verdugo MÁ. A quality of life supports model: Six research-focused steps to evaluate the model and enhance research practices in the field of IDD. Res Dev Disabil 2021; 119:104112. [PMID: 34655955 DOI: 10.1016/j.ridd.2021.104112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/03/2021] [Accepted: 10/08/2021] [Indexed: 06/13/2023]
Abstract
In the field of intellectual and developmental disabilities (IDD) the constructs of quality of life and supports have been combined into a Quality of Life Supports Model (QOLSM) that is currently used internationally for supports provision, organization transformation, and systems change. With the model's increasing and widespan use in research and practice, there is a need to evaluate the model's impact at the individual, organization, and systems levels. The purpose of this article is to outline six specific research-focused evaluation steps that allow researchers to evaluate the model and thereby enhance research practices is the field of IDD. These steps involve: (1) operationalizing components of the QOLSM; (2) relating QOLSM components to the type of research planned and intended outcome indicators; (3) gathering evidence and establishing its credibility; (4) interpreting and communicating the results; (5) implementing research outcomes at the level of the microsystem, mesosystem and macrosystem; and (6) judging the impact of the model. These steps delineate a research framework that is based on a systematic approach to evidence-based practices and enhanced research practices in the field of IDD.
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Affiliation(s)
- Laura E Gómez
- Departamento de Psicología. Universidad de Oviedo, Spain.
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Gómez LE, Navas P, Verdugo MÁ, Tassé MJ. Empirically supported psychological treatments: The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability. World J Psychiatry 2021; 11:1039-1052. [PMID: 34888172 PMCID: PMC8613764 DOI: 10.5498/wjp.v11.i11.1039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/17/2021] [Accepted: 10/18/2021] [Indexed: 02/06/2023] Open
Abstract
This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability (ID) at all stages of their life. We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population, along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems. We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID. The review is structured around the three generations of therapies: Applied behavior analysis (e.g., positive behavior support), cognitive behavioral therapies (e.g., mindfulness-based cognitive therapy), and contextual therapies (e.g., dialectical behavior therapy). We conclude with some recommendations for professional practice in the fields of ID and psychiatry.
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Affiliation(s)
- Laura E Gómez
- Department of Psychology, University of Oviedo, Oviedo 33011, Asturias, Spain
| | - Patricia Navas
- Department of Personality, Evaluation and Psychological Treatments, Institute on Community Integration, University of Salamanca, Salamanca 37005, Salamanca, Spain
| | - Miguel Ángel Verdugo
- Department of Personality, Evaluation and Psychological Treatments, Institute on Community Integration, University of Salamanca, Salamanca 37005, Salamanca, Spain
| | - Marc J Tassé
- Department of Psychology and Psychiatry, The Ohio State University Nisonger Center-UCEDD, Columbus, OH 43210-1257, United States
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Gómez LE, Morán ML, Alcedo MÁ, Arias VB, Verdugo MÁ. Addressing Quality of Life of Children With Autism Spectrum Disorder and Intellectual Disability. Intellect Dev Disabil 2020; 58:393-408. [PMID: 33032321 DOI: 10.1352/1934-9556-58.5.393] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/29/2019] [Indexed: 06/11/2023]
Abstract
Despite the advances on the assessment of quality of life, this concept is barely studied and is riddled with important limitations for those with autism spectrum disorder (ASD). This article is aimed at validating a questionnaire to assess quality of life of children with ASD and intellectual disability (ID). Based on the KidsLife Scale, geared toward people with ID, the most reliable items for those with ASD were selected. Study participants were 420 persons, from 4 to 21 years old. Results indicated that the KidsLife-ASD Scale measured eight intercorrelated domains, had good reliability, and exhibited adequate evidences of validity. KidsLife-ASD emerges as a helpful tool to guide person-centered planning addressed at improving quality of life.
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Affiliation(s)
- Laura E Gómez
- Laura E. Gómez, M. Lucía Morán, and M. Ángeles Alcedo, Universidad de Oviedo, Oviedo, Asturias, 33003, Spain
| | - M Lucía Morán
- Laura E. Gómez, M. Lucía Morán, and M. Ángeles Alcedo, Universidad de Oviedo, Oviedo, Asturias, 33003, Spain
| | - M Ángeles Alcedo
- Laura E. Gómez, M. Lucía Morán, and M. Ángeles Alcedo, Universidad de Oviedo, Oviedo, Asturias, 33003, Spain
| | - Víctor B Arias
- Víctor B. Arias and Miguel-Ángel Verdugo, INICO, Universidad de Salamanca, Salamanca, 37005, Spain
| | - Miguel-Ángel Verdugo
- Víctor B. Arias and Miguel-Ángel Verdugo, INICO, Universidad de Salamanca, Salamanca, 37005, Spain
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Vicente E, Verdugo MA, Guillén VM, Martínez-Molina A, Gómez LE, Ibáñez A. Advances in the assessment of self-determination: internal structure of a scale for people with intellectual disabilities aged 11 to 40. J Intellect Disabil Res 2020; 64:700-712. [PMID: 32672375 DOI: 10.1111/jir.12762] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Advances in theoretical frameworks of self-determination require the development of new assessment instruments. This study examines the dimensional structure of a self-determination scale and analyses the factorial invariance of its measurement across age and gender. METHOD The AUTODDIS Scale was used to assess the self-determination of 541 people with intellectual disabilities aged from 11 to 40. RESULTS Different models (correlational and hierarchical structures) of the scale were tested. The correlational model obtained from the exploratory structural equation model approach provided the best fit for the data. The results also supported measurement invariance across youths (aged 11 to 21 years) and adults (aged 21 to 40 years) and across genders. CONCLUSIONS This study contributes to international research on self-determination and the development of assessment tools in this field, offering a better understanding of this multifaceted and complex construct. The results provide construct validity evidence regarding a new measurement tool tested across people aged 11 to 40, using information from third parties. However, further research is needed to explore the best ways to understand and assess the different factors related to self-determination.
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Affiliation(s)
- E Vicente
- Department of Psychology and Sociology, Faculty of Education, University of Zaragoza, Zaragoza, Spain
| | - M A Verdugo
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | - V M Guillén
- Department of Education, Faculty of Education, University of Cantabria, Santander, Spain
| | - A Martínez-Molina
- Department of Social Psychology and Methodology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - L E Gómez
- Department of Psychology, Faculty of Psychology, University of Oviedo, Oviedo, Spain
| | - A Ibáñez
- Department of Education, Faculty of Education, University of Cantabria, Santander, Spain
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Gómez LE, Monsalve A, Morán ML, Alcedo MÁ, Lombardi M, Schalock RL. Measurable Indicators of CRPD for People with Intellectual and Developmental Disabilities within the Quality of Life Framework. Int J Environ Res Public Health 2020; 17:E5123. [PMID: 32679924 PMCID: PMC7400318 DOI: 10.3390/ijerph17145123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/02/2020] [Accepted: 07/10/2020] [Indexed: 11/17/2022]
Abstract
This article proposes the quality of life (QOL) construct as a framework from which to develop useful indicators to operationalize, measure, and implement the Articles of the Convention on the Rights of Persons with Disabilities (CRPD). A systematic review of the scientific literature on people with intellectual and developmental disabilities (IDD) was carried out, with the aim of identifying personal outcomes that can be translated into specific and measurable items for each of the CRPD Articles aligned to the eight QOL domains. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the systematic review was conducted across the Web of Science Core Collection, Current Contents Connect (CCC), MEDLINE, KCI-Korean Journal Database, Russian Science Citation Index and SciELO Citation Index, for articles published between 2008 and 2020. A total of 65 articles focusing on people with IDD were selected. The results were grouped into four broad categories: conceptual frameworks used to monitor the CRPD; instruments used to assess the rights set out in the CRPD; recommendations on the use of inclusive research; and indicators or personal outcomes associated with specific rights contained in the CRPD.
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Affiliation(s)
- Laura E. Gómez
- Department of Psychology, Universidad de Oviedo, 33003 Oviedo, Spain; (A.M.); (M.L.M.); (M.Á.A.)
| | - Asunción Monsalve
- Department of Psychology, Universidad de Oviedo, 33003 Oviedo, Spain; (A.M.); (M.L.M.); (M.Á.A.)
| | - Mª Lucía Morán
- Department of Psychology, Universidad de Oviedo, 33003 Oviedo, Spain; (A.M.); (M.L.M.); (M.Á.A.)
| | - Mª Ángeles Alcedo
- Department of Psychology, Universidad de Oviedo, 33003 Oviedo, Spain; (A.M.); (M.L.M.); (M.Á.A.)
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Abstract
The aim of this study was to delve into the role of gender differences in social inclusion of children and youth with autism spectrum disorder (ASD) and intellectual disability (ID). A sample of 420 participants with ASD and ID aged between 4 and 21 years was evaluated using the ASD-KidsLife Scale. Females obtained lower scores in most of the items of social inclusion. These differences remained when the covariables of level of ID, support needs, and age were controlled. None of the items presented differential item functioning as a function of gender. Gender differences, as were found in social inclusion, are discussed and recommendations are given in order to provide equal opportunities to girls and boys with ASD.
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Verdugo MA, Fernández M, Gómez LE, Amor AM, Aza A. Predictive factors of quality of life in acquired brain injury. Int J Clin Health Psychol 2019; 19:189-197. [PMID: 31516497 PMCID: PMC6732774 DOI: 10.1016/j.ijchp.2019.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 06/13/2019] [Indexed: 11/10/2022] Open
Abstract
The sequelae and the disability and dependence that follow an acquired brain injury (ABI) may result in a significant reduction in the quality of life (QoL) of those affected. The objective was to assess the QoL of a sample of Spanish patients with an ABI and analyze the influence of certain sociodemographic and injury-related variables on their QoL. Method: The sample comprised 421 adults (60% male; Mage = 53.12; SD = 14.87). Professionals and relatives assessed the patients’ QoL through the CAVIDACE scale, an ABI-specific tool based on the eight-domain QoL model. Results: Univariate analyses showed statistically significant differences in the QoL scores in several sociodemographic (age, civil status, education level, prior employment status, type of home, level of supports, loss of legal capacity, recognized dependence, and degree of dependence) and injury-related (time since the injury, location of the injury, and presence of post-traumatic amnesia) variables. The multiple linear regression showed that loss of legal capacity, time since the injury, prior employment status, location of the injury, and degree of dependence were significant QoL predictors. Conclusions: These findings provide knowledge for the development of programs aimed at reducing the negative impact of ABI on QoL.
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Affiliation(s)
- Miguel A Verdugo
- Facultad de Psicología, Universidad de Salamanca, Spain.,Instituto de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
| | - María Fernández
- Facultad de Psicología, Universidad de Salamanca, Spain.,Instituto de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
| | - Laura E Gómez
- Facultad de Psicología, Universidad de Oviedo, Spain.,Instituto de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
| | - Antonio M Amor
- Facultad de Psicología, Universidad de Salamanca, Spain.,Instituto de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
| | - Alba Aza
- Facultad de Psicología, Universidad de Salamanca, Spain.,Instituto de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
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Díez C, Fontanil Y, Alonso Y, Ezama E, Gómez LE. Adolescents at Serious Psychosocial Risk: What Is the Role of Additional Exposure to Violence in the Home? J Interpers Violence 2018; 33:865-888. [PMID: 29294749 DOI: 10.1177/0886260517708762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Research into the effects of interpartner violence on the psychosocial development of the children of maltreated mothers is a relatively new field. This work examines the impact of exposure to interpartner violence (EIPV) on minors in middle and late adolescence, where this vicarious maltreatment is in addition to other situations of severe psychosocial risk. A group of adolescents who had suffered various types of direct maltreatment were compared with another group who, in addition to experiencing direct maltreatment, had mothers who had also been the victims of interpartner violence. There were 276 participants in total (138 adolescents and their mothers) reporting via questionnaires about their experiences related to maltreatment and about maladaptation and psychological dysfunction. The results demonstrate significant dysfunction in the adolescents, especially as indicated in the mothers' reports. In addition, the results make it clear that the adolescents are actively and directly involved in the episodes of interpartner violence and that the additional negative impact of vicarious maltreatment is evident in almost every aspect of their lives. Only the attitude toward teachers scored worse in the no-EIPV group. EIPV minors scored higher on personal and social maladjustment and worse on adaptive skills, and showed a more marked tendency to internalize problems. This study emphasizes the importance of considering EIPV as a form of child maltreatment and including it in programs of protection and intervention.
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Affiliation(s)
- Cristina Díez
- 1 Centro de Terapia y Mediación Familiar Genos, Oviedo, Spain
| | | | | | - Esteban Ezama
- 4 Centro de Investigaciones Comunicacionales, Oviedo, Spain
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Arias VB, Gómez LE, Morán ML, Alcedo MÁ, Monsalve A, Fontanil Y. Does Quality of Life Differ for Children With Autism Spectrum Disorder and Intellectual Disability Compared to Peers Without Autism? J Autism Dev Disord 2017; 48:123-136. [DOI: 10.1007/s10803-017-3289-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Gómez LE, Alcedo MÁ, Arias B, Fontanil Y, Arias VB, Monsalve A, Verdugo MÁ. A new scale for the measurement of quality of life in children with intellectual disability. Res Dev Disabil 2016; 53-54:399-410. [PMID: 27010958 DOI: 10.1016/j.ridd.2016.03.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/25/2016] [Accepted: 03/08/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Children and adolescents with intellectual disabilities make up a group which is in urgent need of an adequate operationalisation of the quality of life construct, not only to improve individual personal outcomes but also to develop and implement evidence based practices. For that reason, and with the aim of answering the growing demand for an adequate evaluation instrument for this group, the KidsLife scale was developed. METHOD This research provides evidence of the reliability and validity of the scale, which is composed of 96 items spread over eight subscales, and completed by a third-party respondent. The validation sample comprised 1060 people with intellectual disability, with ages ranging from 4 to 21 years old (M=13.51; SD=5.04). RESULTS The results suggest that the eight quality of life domains assessed on the scale are reliable (Cronbach's alpha ranging from 0.812 to 0.949). The evidence of the validity of the construct provided by Confirmatory Factor Analysis also demonstrated adequate indexes of fit for the eight-domain model. DISCUSSION Future lines of research which may use the KidsLife Scale are suggested and discussed.
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Affiliation(s)
- Laura E Gómez
- Departamento de Psicología, Universidad de Oviedo, Spain.
| | | | - Benito Arias
- Departamento de Psicología, Universidad de Valladolid, Spain
| | | | | | | | - Miguel Ángel Verdugo
- Instituto Universitario de Integración en la Comunidad (INICO), Universidad de Salamanca, Spain
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Gómez LE, Arias B, Verdugo MÁ, Tassé MJ, Brown I. Operationalisation of quality of life for adults with severe disabilities. J Intellect Disabil Res 2015; 59:925-941. [PMID: 26018763 DOI: 10.1111/jir.12204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 02/03/2015] [Accepted: 04/22/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND The operationalisation of quality of life for people with more severe disabilities has been acknowledged in the published research for more than two decades. This study aims to contribute to our knowledge and understanding of the quality of life of adults with severe disabilities by developing a set of quality of life indicators appropriate to this population using a Delphi method and the eight-domain conceptual model proposed by Schalock & Verdugo (2002). METHOD The participating panel in the Delphi method included 12 experts who evaluated each proposed item according to four criteria: suitability, importance, observability and sensitivity. Descriptive analyses were used to select the best items in each of the four rounds of this Delphi study, as well as examining the coefficients of concordance that were calculated for the final pool of items. RESULTS The four rounds of the Delphi study resulted in a final pool of 118 items (91 that were considered valid in the first round plus 27 items proposed, reformulated or discussed in the following rounds). Importance and sensitivity were the criteria that received the highest and lowest ratings, respectively, but also the ones that had the highest and lowest mean coefficients of concordance. Experts showed the strongest agreement for items related to material well-being, while the weakest was found for items related to personal development. CONCLUSIONS This study further contributes to our understanding of how to operationalise and measure quality of life in adults with severe disabilities. The item pool generated may prove helpful in the development of instruments for the measurement of quality of life-related outcomes in this population.
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Affiliation(s)
- L E Gómez
- Department of Psychology, University of Oviedo, Plaza Feijoo, s/n., Oviedo, 33003, Spain
| | - B Arias
- Department of Psychology, University of Valladolid, Paseo de Belén 1, Campus Miguel Delibes, Valladolid, 47011, Spain
| | - M Á Verdugo
- Institute on Community Integration (INICO), University of Salamanca, Avda. de la Merced, 109-131, Salamanca, 37005, Spain
| | - M J Tassé
- Nisonger Center, The Ohio State University, 1581 Dodd Dr, Columbus, OH, 43210, USA
| | - I Brown
- Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, Ontario, M5S 1V4, Canada
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Verdugo MA, Gómez LE, Arias B, Navas P, Schalock RL. Measuring quality of life in people with intellectual and multiple disabilities: validation of the San Martín scale. Res Dev Disabil 2014; 35:75-86. [PMID: 24246273 DOI: 10.1016/j.ridd.2013.10.025] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 10/19/2013] [Accepted: 10/21/2013] [Indexed: 06/02/2023]
Abstract
Although there are numerous quality of life instruments in the, field of intellectual disability, most of them are addressed to those, people with the highest levels of functioning, while only a few are, suitable for people with the lowest levels (i.e., people with profound, and severe intellectual disabilities, or people with intellectual and, developmental disabilities and other significant medical conditions or, disabilities). This study provides reliability and validity evidence of, the San Martín Scale, a 95-item Likert scale questionnaire that is, completed by a third-party respondent. The validation sample was composed, of 1770 people from Spain with intellectual and developmental, disabilities that showed extensive or pervasive support needs (8.7% had, mild intellectual disability, 28.25% moderate, 41.6% severe, and 21.4%, profound). The age of the participants ranged between 16 and 77 years old, (M=7.78; SD=12.32). The results suggested that the eight quality of, life domains assessed on the scale are reliable (Cronbach's alpha ranging, from .821 to .933). Confirmatory Factor Analyses provided construct, validity evidences related to the internal structure of the San Martín, Scale, and indicated that the eight first-order factor solution provided, the best fit to the data over unidimensional and hierarchical solutions. Implications of these findings and guidelines for further research are, discussed.
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Affiliation(s)
- Miguel A Verdugo
- Institute on Community Integration (INICO), University of Salamanca, Avda. de la Merced, 109-131, 37005 Salamanca, Spain.
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Gómez LE, Verdugo MÁ, Arias B, Navas P, Schalock RL. The development and use of Provider Profiles at the organizational and systems level. Eval Program Plann 2013; 40:17-26. [PMID: 23728204 DOI: 10.1016/j.evalprogplan.2013.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 05/03/2013] [Accepted: 05/05/2013] [Indexed: 06/02/2023]
Abstract
While the use of quality of life-related personal outcomes has been broadly reported during the last decade, little attention has been paid to the use of such data as a basis for developing and using Provider Profiles at the organizational and systems level. This article illustrates a way in which these evidence-based outcomes may be used not only to improve clinical decisions, but also managerial and policy strategies. To that end, the quality of life of 11,624 social service recipients was assessed by means of the application of the GENCAT Scale, a questionnaire to assess quality of life according to the eight-domain model (Schalock & Verdugo, 2002). Data were analyzed at organizational and the systems level in order to develop Provider Profiles. Once implemented, these profiles can be used to compare individuals in different diagnostic groups, develop province-level performance standards, encourage continuous program improvement, and guide the development of evidence-based policies.
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Affiliation(s)
- Laura E Gómez
- Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, 33003 Oviedo, Spain.
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Arias B, Ángel Verdugo M, Navas P, E. Gómez L. Factor structure of the construct of adaptive behavior in children with and without intellectual disability. Int J Clin Health Psychol 2013. [DOI: 10.1016/s1697-2600(13)70019-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Verdugo MA, Navas P, Gómez LE, Schalock RL. The concept of quality of life and its role in enhancing human rights in the field of intellectual disability. J Intellect Disabil Res 2012; 56:1036-1045. [PMID: 22672317 DOI: 10.1111/j.1365-2788.2012.01585.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The changed societal views of persons with disabilities are reflected in the 2006 United Nations Convention on the Rights of Persons with Disabilities. However, what is not specified in the Convention is how to operationalise and measure the Articles composing the Convention, and how to use that information to further enhance the human rights of persons with disabilities. METHOD The authors analyse the relationships between eight core quality of life domains and the 34 Articles contained in the Convention. RESULTS There is a close relationship between the core quality of life domains and the 34 Articles contained in the Convention. Furthermore, the current status of these Articles can be evaluated through the assessment of indicators associated with the eight core quality of life domains. CONCLUSIONS Based on the assessment of these quality of life-related outcomes, three strategies can be used to enhance the human rights of persons with intellectual disability. These three are to employ person-centred planning, publish provider profiles and implement a system of support.
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Affiliation(s)
- M A Verdugo
- Institute for Community Inclusion, University of Salamanca, Spain.
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Navas P, Verdugo MA, Arias B, Gómez LE. Development of an instrument for diagnosing significant limitations in adaptive behavior in early childhood. Res Dev Disabil 2012; 33:1551-1559. [PMID: 22522214 DOI: 10.1016/j.ridd.2012.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 03/01/2012] [Indexed: 05/31/2023]
Abstract
Although adaptive behavior became a diagnostic criterion in the 5th edition of the American Association on Intellectual and Developmental Disabilities, AAIDD (Heber, 1959, 1961), there are no measures with adequate psychometric properties for diagnosing significant limitations in adaptive behavior according to the current conception of the construct. This fact has led to an excessive reliance on intellectual functioning measures. The goal of the present paper consists of presenting the development of the AAIDD's forthcoming Diagnostic Adaptive Behavior Scale (DABS) in Spain, and, specifically, it will be focused on one of its three forms: DABS Form 4-8 years old. The sample consisted of 388 people, aged 4-8 years old, with and without intellectual disabilities. The functioning of an initial pool of 168 items was analyzed under the assumptions of Item Response Theory models (IRT) with the aim to select those items around the cut-off point for determining significant limitations in adaptive behavior. A set of 72 items was selected (96 items were removed due to misfit, unsatisfying response category functioning, or low precision of measurement). The final version seems to be essentially unidimensional, shows good fit to the model, and represents an accurate precision of measurement around the cutoff point for diagnosing significant limitations in conceptual, social or practical skills.
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Affiliation(s)
- Patricia Navas
- Institute on Community Integration, University of Salamanca, Avda. de la Merced, 109-131, 37005 Salamanca, Spain.
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26
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Gómez LE, Arias B, Verdugo MÁ, Navas P. Application of the Rasch rating scale model to the assessment of quality of life of persons with intellectual disability. J Intellect Dev Disabil 2012; 37:141-150. [PMID: 22546020 DOI: 10.3109/13668250.2012.682647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Most instruments that assess quality of life have been validated by means of the classical test theory (CTT). However, CTT limitations have resulted in the development of alternative models, such as the Rasch rating scale model (RSM). The main goal of this paper is testing and improving the psychometric properties of the INTEGRAL Quality of Life Scale (i.e., fit statistics, person and item reliability coefficients) with RSM. METHOD The sample comprised 271 Spanish adults with intellectual disability. RESULTS The results showed that the data fitted the model, point-biserial correlations were adequate, items showed precision, reliability of items (.98) and persons (.89) were adequate, and the response categories were suitable (thresholds were ordered). However, one item ("I feel excluded from society") did not fit the model and a few items were too easy for participants to achieve. CONCLUSIONS Although it seems necessary to include more difficult items and to delete one, the INTEGRAL Scale is a useful instrument with evidence of validity.
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Vargas VM, Torres D, Corona F, Vergara M, Gómez LE, Delgado-Lezama R, Cueva-Rolón R. Cholinergic facilitation of erection and ejaculation in spinal cord-transected rats. Int J Impot Res 2004; 16:86-90. [PMID: 14963478 DOI: 10.1038/sj.ijir.3901169] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Penile reflexes (PRs) were monitored in chronic spinal cord-transected rats by identifying them visually, and at the same time they were recorded as the electromyographic activity of bulbospongiosus muscles. Intraperitoneal injection of the agonist muscarine (10 microg) produced a facilitation of PRs. A decrease in the latency, an increase in the number of clusters and often an increase in the duration of cups were found after muscarine. In addition, 66% (six out of nine) of the animals ejaculated after muscarine. These results suggest that cholinergic receptor stimulation may be involved in erectile and ejaculatory mechanisms mediated by the spinal cord.
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Affiliation(s)
- V M Vargas
- Departamento de Agrobiología, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico
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Abstract
The effects of muscarinic receptor stimulation were tested on the urethro genital reflex (UGR) in anesthetized and spinal cord-transected rats. Drugs were applied directly to the spinal cord. The electromyographic activity (EMG) of the bulbospongiosus (BS) muscle was used for recording UGR. In six animals BS as well as soleus, posterior biceps or peroneus tertius muscle EMG was recorded simultaneously. Muscarine (5, 10, 20, 50 and 100 microg) was applied in 22 animals after cutting L6-S1 dorsal roots. Some observations were made on another six animals, to which an extensive bilateral dorsal rhizotomy (L3-S2) was performed. Rhythmic bursts of similar frequency and size to those seen during UGR were found in BS muscle a few minutes after muscarine application. No rhythmic bursting was found on the hindlimb muscles, but exclusively on BS muscles. The effects of homatropine (25, 50, 100 and 200 microg), an acetylcholine muscarinic receptor antagonist, were tested in 21 rats after UGR was elicited three times at low stimulation intensity (7 mm Hg). Homatropine produced two effects: (i) A significant increase in the latency of UGR. (ii) A facilitation of UGR inhibition. In view of these results it can be speculated that muscarinic receptor stimulation is involved in the elicitation of UGR.
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Affiliation(s)
- L Gil
- Centro de Investigaciones en Reproducción Animal, Universidad Autónoma de Tlaxcala, Apartado Postal # 40, Tlaxcala 90140, Panotla, Mexico
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Sansone GR, Bianca R, Cueva-Rolón R, Gómez LE, Komisaruk BR. Cardiovascular responses to vaginocervical stimulation in the spinal cord-transected rat. Am J Physiol 1997; 273:R1361-6. [PMID: 9362300 DOI: 10.1152/ajpregu.1997.273.4.r1361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The present study ascertained whether increases in heart rate (HR) and systolic blood pressure (SBP) produced by vaginocervical stimulation (VS; 500 g force) persist in the unanesthetized rat after chronic spinal cord transection at selected levels. Three groups were used: spinal cord transection at T7 (n = 10) or L5 (n = 10) or a sham-operated control group (Sh, n = 10). In the Sh group, VS increased significantly both HR, by 95 +/- 14.3 beats/min (bpm) (22 +/- 3.7% above baseline), and BP, by 37 +/- 5.7 mmHg (37 +/- 7.7% above baseline), confirming earlier findings. In the T7 group, VS significantly decreased HR by 107 +/- 21.4 bpm (27 +/- 4.1% below baseline) and increased BP by 41.3 +/- 12.9 mmHg (32 +/- 8.3% above baseline). In response to VS, HR increased in every rat in the Sh group and decreased in every rat in the T7 group. In the L5 group, VS failed to significantly affect HR or BP. In the present study, specific levels of spinal cord transection produced differential HR and BP responses to VS in the rat. A model is presented addressing the component responses of autonomic dysreflexia that can occur, contingent on the level of spinal cord injury, in women during parturition or sexual intercourse.
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Affiliation(s)
- G R Sansone
- Institute of Animal Behavior, Rutgers, The State University of New Jersey, Newark 07102, USA
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Nasser JR, Gómez LE, Sánchez D, Guerin M, Basombrío MA. Immunogenicity of the recombinant SAPA protein of Trypanosoma cruzi for mice. J Parasitol 1997; 83:76-81. [PMID: 9057700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The humoral and cellular immune responses induced by the recombinant SAPA (shed acute phase antigen) of Trypanosoma cruzi were studied in mice and correlated with the immunologic control of parasitemia. The immunizing schedule used consisted of 2 weekly injections of 50 micrograms glutathione-S-transferase (GST)-SAPA in Freund's adjuvant. Specific alpha GST-SAPA antibodies were detected by enzyme-linked immunosorbent assay 1 wk after each antigen dose, the concentration of antibodies after the second injection being 30-fold higher than after the first. Immediate- (ITH) and delayed-type hypersensitivity (DTH) reactions were observed as footpad swelling after injecting 50 micrograms GST-SAPA in preimmunized mice as compared to naive controls. Adoptive transfer experiments indicated that these cutaneous reactions were mediated by lymphoid cells and not by serum. Both humoral and cellular responses were specific for the GST-SAPA antigen and did not cross-react with either the GST or the recombinant GST-1 T. cruzi antigen. Immunized mice that had developed high levels of antibody and DTH reaction to GST-SAPA were able to control the level of parasitemia after challenge with 10(3) blood trypomastigotes. The levels of parasitemia obtained were lowered to about 1/3 (P < 0.05) and mortality at day 60 was reduced from 67 to 25% (P = 0.085). Comparison of this immunizing method with other schedules involving more injections or higher antigen doses indicates that control of parasitemia can be obtained with low amounts of antigen and seems to be associated with the development of DTH.
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Affiliation(s)
- J R Nasser
- Laboratorio de Patologia Experimental Facultad de Ciencias de la Salud, Universidad Nacional de Salta, Argentina
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Gómez LE, Ortega C, Durán I, Cueva-Rolón R. Neural mechanisms accounting for the increase in blood pressure and heart rate during vagino-cervical stimulation. J Auton Nerv Syst 1996; 60:154-62. [PMID: 8912265 DOI: 10.1016/0165-1838(96)00048-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The rise in blood pressure and heart rate produced by the mechanical stimulation of the uterine cervix (VS) was examined after adrenalectomy, after pelvic or hypogastric neurectomies or after spinal cord transection in anesthetized rats. Neither adrenalectomy, nor hypogastric neurectomy prevented the rise in heart rate and blood pressure produced by VS. After the spinal cord transection at T6 level, VS was still able to produce the rise in blood pressure. However, the rise in blood pressure was significantly lower than that produced in the same animals before the transection. No changes in heart rate were produced by VS after spinal cord transection. This result can be explained because this level of transection prevents the reach of the afferent inflow to the superior cervical ganglia. Pelvic neurectomy abolished completely the effects of VS on blood pressure and heart rate. Low intensity (1-2 times the threshold) electrical stimulation of the pelvic nerve produced a rise in blood pressure. Even though heart rate increased during electrical stimulation, the change in heart rate was not statistically different from the pre-stimulation value. These results suggest that the changes in blood pressure and heart rate produced by VS represent a neuronal reflex response mediated by the pelvic nerve. The fact that the effects of VS on blood pressure persist in spinal cord-transected animals suggests that the reflex is integrated at the spinal level. However, the cardiovascular responses to VS were significantly lower than before transection, suggesting that supraspinal centers are also involved in the reflex.
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Affiliation(s)
- L E Gómez
- Centro de Investigación en Reproducción Animal, CINVESTAV, Tlaxcala, Mexico
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Cueva-Rolón R, Sansone G, Bianca R, Gómez LE, Beyer C, Whipple B, Komisaruk BR. Vagotomy blocks responses to vaginocervical stimulation after genitospinal neurectomy in rats. Physiol Behav 1996; 60:19-24. [PMID: 8804637 DOI: 10.1016/0031-9384(95)02245-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
To ascertain whether any effects of vaginocervical stimulation (VS) are mediated by the vagus nerve, all known afferent nerves from the reproductive tract to the spinal cord were transected and the rats were tested for residual responses to VS. After combined bilateral transection of the pelvic, hypogastric, and pudendal nerves (NX), the following responses to VS were greatly reduced or abolished: lordosis to flank-perineum palpation, leg extension, immobilization, and blockage of both tail withdrawal to radiant heat and leg withdrawal to foot pinch. However, after these nerve cuts, the following persisted as significant residual responses to VS: 1) analgesia [measured as increase in vocalization threshold (VOCT) to tailshock], 2) pupil dilatation (PD), and 3) increase in heart rate (HR). Subsequent bilateral subdiaphragmatic vagotomy (VX) significantly reduced the magnitude of PD and abolished the analgesia. By contrast, VX produced no significant effect on the HR increase to VS. The above findings provide evidence that brain-mediated responses to vaginocervical stimulation can be elicited via the vagus nerves.
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Affiliation(s)
- R Cueva-Rolón
- Center for Research in Animal Reproduction (CIRA), Centro de Investigación y Estudios Avanzados, Unidad Tlaxcala, México
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Komisaruk BR, Bianca R, Sansone G, Gómez LE, Cueva-Rolón R, Beyer C, Whipple B. Brain-mediated responses to vaginocervical stimulation in spinal cord-transected rats: role of the vagus nerves. Brain Res 1996; 708:128-34. [PMID: 8720868 DOI: 10.1016/0006-8993(95)01312-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The present study was designed to ascertain whether the vagus nerves convey functional sensory activity from the reproductive tract in rats. Previously, vaginocervical mechanostimulation (VS) was shown to increase pupil diameter (PD) and the threshold of vocalization to tail shock (Voc-T). These responses were attenuated but not abolished by combined bilateral transection of the 'genito-spinal' nerves (i.e. pelvic, hypogastric and pudendal). Subsequent bilateral vagotomy further reduced or abolished the residual responses. In the present study, spinal cord transection above the known level of entry of the genito-spinal nerves was combined with bilateral vagotomy. In ovariectomized rats, after spinal cord transection at thoracic 7 (T7X), lumbar 5 (L5X) levels, or sham surgery (Sh), responses to VS were measured, the vagus nerves were then transected bilaterally, and responses to VS were again measured. VS significantly increased Voc-T and PD after sham procedure or spinal cord transection at either level. Subsequent bilateral vagotomy abolished the VS-induced increase in PD in the T7X group. Due to low survival rate, the effect of vagotomy on Voc-T could not be determined. Consequently, we performed a second experiment. In non-ovariectomized rats, VS significantly increased PD but reduced Voc-T in the T7X group compared to the Sh group, and subsequent bilateral vagotomy abolished both responses. These findings provide evidence that, in the rat, the vagus nerves provide a functional sensory pathway from the reproductive tract directly to the medulla oblongata of the brain, bypassing the spinal cord.
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Affiliation(s)
- B R Komisaruk
- Institute of Animal Behavior, Rutgers, State University of New Jersey, Newark, 07102, USA
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Gómez LE, Nasser JR, Basombrío MA. Complete immunization against Trypanosoma cruzi verified in individual mice by complement-mediated lysis. Mem Inst Oswaldo Cruz 1996; 91:55-61. [PMID: 8734949 DOI: 10.1590/s0074-02761996000100009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Experimental systems to assay immunity against Trypanosoma cruzi usually demonstrate partial resistance without excluding the establishment of sub-patent infections in protected animals. To test whether Swiss mice immunized with attenuated parasites might develop complete resistance against virulent T. cruzi, experiments were performed involving challenge with low numbers of parasites, enhancement of local inflammation and the combination of natural and acquired resistance. Absence of infection was established after repeated negative parasitological tests (including xenodiagnosis and hemoculture), and lack of lytic antibody was tested by complement mediated lysis. Immunization with 10(7) attenuated epimastigotes conferred protection against the development of high levels of parasitemia after challenge with Tulahuen strain, but was unable to reduce the number of infected animals. However, when a strong, delayed-type hypersensitivity reaction was triggered at the site of infection by injecting a mixture of virulent and attenuated T. cruzi, a significant proportion of immunized animals remained totally free of virulent infection. The same result was obtained when the immunization experiment was performed in four month old Swiss mice, displaying a relatively high natural resistance and challenged with wild, vector-borne parasites. These experiments demonstrate that complete resistance against T. cruzi can be obtained in a significant proportion of animals, under conditions which replicate natural, vector delivered infection by the parasite.
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Affiliation(s)
- L E Gómez
- Facultad de Ciencias de la Salud, Universidad Nacional de Salta, Argentina
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Abstract
In urethane-anesthetized rats, the compound action potential of the pelvic nerve was found to consist of three different waves, two in the A delta fiber and one in the C-fiber range of conduction velocity. Electrical stimulation of the pelvic nerve produced a complete inhibition of the withdrawal response to noxious foot pinch or foot compression. The electromyographic (EMG) activity of the contralateral posterior biceps muscle was used to record the withdrawal response. The withdrawal response inhibition was related to the duration and the frequency of electrical stimulation. Low (5-10 Hz) and high (100-300 Hz) frequencies were ineffective in inhibiting the withdrawal response, whereas intermediate frequencies (20-80 Hz) produced a complete inhibition of the withdrawal response. Short (300 ms) trains of stimulation inhibited the withdrawal response only during the stimulation period. Longer trains of stimulation (500 ms-10 s) produced long-lasting inhibition of the response to noxious stimulation. The inhibition persisted for up to 20 s after the end of electrical stimulation of the pelvic nerve. A delta fiber stimulation was adequate to inhibit the withdrawal response in most (15 out of 17) of the animals. However, A delta plus C-fiber stimulation was needed to inhibit the response to noxious stimulation in two animals. In addition to inhibiting the response to noxious stimulation, pelvic nerve electrical stimulation reflexively activated abdominal muscles. On the basis of present findings using electrical stimulation, it can be suggested that, in the rat, A delta and C-visceral afferents of the pelvic nerve mediate the analgesic effect of vaginocervical probing pelvic and A delta afferents the contraction of abdominal muscles in the fetus-expulsion reflex.
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Affiliation(s)
- R Cueva-Rolón
- Institute of Animal Behavior, Rutgers University, New Brunswick, NJ, USA
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Gómez LE, Lehmann PA. Pharmacokinetics of the novel anticonvulsant HEPP after single intravenous administration of three different doses in dogs. Biopharm Drug Dispos 1995; 16:105-12. [PMID: 7780044 DOI: 10.1002/bdd.2510160205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
HEPP (D, L-3-hydroxy-3-ethyl-3-phenylpropanamide) is a novel compound with a wide spectrum of anticonvulsant activity and relatively low toxicity. The aim of this investigation was to study the pharmacokinetics of HEPP in mongrel dogs and to assess its linearity after intravenous administration of 8, 15, and 30 mg kg-1. A biphasic disappearance pattern with a rapid distribution phase was observed in the plasma concentration versus time curve. The mean terminal half-life (t1/2 beta) was the same after the three doses (3.4 +/- 0.15 h) and the mean half-lives of the distribution phase (t1/2 alpha) were not significantly different after the three doses (0.09 +/- 0.02, 0.08 +/- 0.07, and 0.11 +/- 0.03 h for 8, 15, and 30 mg kg-1 respectively). The mean AUC0-infinity values were 44.1 +/- 10.8, 72.1 +/- 8.8, and 127.4 +/- 23.2 micrograms h mL-1, respectively, showing a linear increase. The individual values of AUC0-infinity corrected for the administered dose (AUC0-infinity/D) were 0.29 +/- 0.04, 0.23 +/- 0.05, and 0.22 +/- 0.06 h mL-1. These values were not statistically different. Neither the mean residence time (MRT = 4.55 +/- 1.50, 4.90 +/- 1.32, and 5.07 +/- 1.95 h), the steady state volume of distribution (Vss = 0.86 +/- 0.11, 1.01 +/- 0.17, and 1.20 +/- 0.40 L kg-1) nor the systemic clearance (Cl = 3.36 +/- 0.82, 3.53 +/- 0.44, and 4.02 +/- 0.68 mL min-1 kg-1) showed significant differences between doses. The values of Vss suggest that HEPP is distributed in the whole body fluid.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- L E Gómez
- Departamento de Farmacología y Toxicología, Instituto Politécnico Nacional, México City, México
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Gómez LE, Cueva-Rolón R, Lehmann PA. Disposition kinetics of HEPP in rats after intravenous, oral, and intraperitoneal administration. Correlation of plasma and brain levels with the anticonvulsant effect. Biopharm Drug Dispos 1995; 16:77-89. [PMID: 7780049 DOI: 10.1002/bdd.2510160203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
D, L-3-hydroxy-3-ethyl-3-phenylpropanamide (HEPP) is a synthetic drug with anticonvulsant effects in a variety of seizure models. HEPP pharmacokinetics was studied after single 50 mg kg-1 intravenous (i.v.), intraperitoneal (i.p.), and oral (PO) administration in male albino Wistar rats. The plasma concentration against time curves showed a biphasic decay pattern with a similar distribution phase and the same terminal rate constant (beta = 0.22 h-1) by all three routes. The apparent volume of distribution at steady state (Vss = 0.80 L kg-1) indicates that HEPP is extensively distributed in extracellular tissues. This finding agrees very well with its low binding to plasma protein (mean bound fraction = 19.3 +/- 1.1%). The systemic clearance (Cl) was very low (3.30 mL min-1 kg-1). The bioavailability after IP and PO administration was 0.80 and 0.60 respectively. In the pharmacokinetic-pharmacodynamic studies a direct relationship was found between the protective effect of HEPP against pentylenetetrazole (PTZ) induced seizures and its concentration in plasma and/or brain. The concentrations at half-maximal effect (EC50) with 95% confidence interval (Cl) were 70.6 (66-75.5) micrograms mL-1 in serum and 60.1 (55.4-65.1) micrograms g-1 in brain. There was a rapid uptake of HEPP into the brain, and after the distributive phase, the disappearances in plasma and brain were almost parallel [C(serum) = 109 e-0.25t, r2 = 0.95; C(brain) = 38 e-2.53t + 91 e-0.21t, r2 = 0.93], with a C(brain)/C(plasma) ratio of 1.1.
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Affiliation(s)
- L E Gómez
- Departamento de Farmacología y Toxicología, Instituto Politécnico Nacional, México City, México
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