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Rennane S, Sobol D, Stein BD, Dick A. Insurance coverage during transitions: Evidence from Medicaid automatic enrollment for children receiving supplemental security income. Health Serv Res 2024; 59:e14261. [PMID: 37985435 PMCID: PMC11063087 DOI: 10.1111/1475-6773.14261] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To analyze relationships between Medicaid automatic enrollment for child Supplemental Security Income (SSI) recipients and health insurance coverage during transitions. DATA SOURCES AND STUDY SETTING Medical Expenditure Panel Study, 2000-2020 and National Survey for Children with Special Health Care Needs, 2001-2010. STUDY DESIGN Leveraging variation in SSI-Medicaid automatic enrollment status across regions and over time, we estimate a regression model to quantify associations between automatic enrollment and insurance coverage. We validate our findings in the NS-CSHCN. DATA COLLECTION Our sample includes children receiving SSI for a disability. We also analyze a subsample of children newly enrolled in SSI. PRINCIPAL FINDINGS Automatic enrollment is associated with a statistically significant increase in insurance coverage. Expanding automatic enrollment to all states is associated with increases in Medicaid enrollment of 3% (CI 0.9%-6.7%) among all SSI children and 7% (CI 1.1%-13.9%) among children newly enrolled in SSI. We find similar decreases in uninsurance. Analysis in the NS-CSHCN replicates these findings. CONCLUSIONS Medicaid automatic enrollment policies are associated with increased insurance coverage for SSI children, particularly those transitioning into the program. Medicaid policy defaults could play an important role in reducing administrative burdens to improve children's coverage and access to care.
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DiDanieli M. Autonomy is not a sufficient basis for analysing the choice for medical assistance in dying in unjust conditions: in favour of a dignity-based approach. J Med Ethics 2024; 50:421-422. [PMID: 37414540 DOI: 10.1136/jme-2023-109284] [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] [Received: 05/19/2023] [Accepted: 06/09/2023] [Indexed: 07/08/2023]
Abstract
In their paper titled Choosing death in unjust conditions: hope, autonomy and harm reduction, Wiebe and Mullin argue against the stance of diminished autonomy in chronically ill, disabled patients living in unjust sociopolitical environments who pursue medical assistance in dying (MAiD). They suggest that it would be paternalistic to deny these people this choice and conclude that MAiD should actually be seen as a form of harm reduction for them.This response to their article argues that basing discussions surrounding this important topic on a single bioethical concept does not address the needs of this cohort and is restrictively siloed. The discussion should include considerations of human rights and the need for legislative reforms to address social conditions, in addition to traditional bioethical principles. Work in this area needs to become interdisciplinary and collaborative as well as integrate input from the patients themselves. The concept of the dignity of these patients, in its broadest sense, needs to be infused into the discussion in order to optimise the exploration for solutions for this cohort.The stance of MAiD as harm reduction, in this context, does not meet the definition of harm reduction, nor does it represent a commitment to the best interests of these patients.
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Affiliation(s)
- Maria DiDanieli
- Burlington Family Health Team, Burlington Ontario Health Team, Burlington, Ontario, Canada
- Edinburgh School of Law, The University of Edinburgh, Edinburgh, UK
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Aldawood A, Hind D, Rushton S, Field B. Theories, models and frameworks to understand barriers to the provision of mobility-assistive technologies: a scoping review. BMJ Open 2024; 14:e080633. [PMID: 38749698 PMCID: PMC11097887 DOI: 10.1136/bmjopen-2023-080633] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVES There is strong evidence that mobility-assistive technologies improve occupational performance, social participation, educational and employment access and overall quality of life in people with disabilities. However, people with disabilities still face barriers in accessing mobility products and related services. This review aims to summarise and synthesise: (1) theories, models and frameworks that have been used to understand mobility-assistive technology access, (2) determinants of access and (3) gaps in knowledge. DESIGN A scoping review using the five-step framework by Arksey and O'Malley. DATA SOURCES We searched the MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and SCOPUS databases for publications published between 2000 and 2024. We searched for articles published up to 20 March 2024. ELIGIBILITY CRITERIA We included English-published literature in peer-reviewed journals that reported (a) barriers to the provision of mobility-assistive technologies, (b) including at least one theory, model or framework and (c) between 2000 and 2024. DATA EXTRACTION AND SYNTHESIS We extracted the study characteristics, theories, models, framework usage, research recommendations, key findings on mobility-assistive technology barriers and theoretical propositions. We conduct a theoretical synthesis guided by Turner's approach. RESULTS We included 18 articles that used 8 theories, models and frameworks, synthesised into 9 propositions. The synthesised theory emphasises that mobility is essential for human flourishing, and that certain health conditions may impose restrictions on mobility. This impact can be alleviated by two direct determinants: (1) the provision of suitable services and (2) their comprehensive provision. Policies and costs influence these services indirectly. Environmental and personal factors also affect the use of these services. Ineffectively addressing these determinants can limit access to mobility-assistive technologies and subsequent disabilities. CONCLUSION Our synthetic model describes the logic of providing evidence-based mobility-assistive technologies, and we identify the determinants of access that can act as targets for future work to improve the provision of mobility-assistive technologies.
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Affiliation(s)
- Asma Aldawood
- School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Daniel Hind
- School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
| | - Simon Rushton
- Department of Politics and International Relations, University of Sheffield, Sheffield, UK
| | - Becky Field
- School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
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Banks LM, Soukkhaphone B, Scherer N, Siengsounthone L, Carew MT, Shakespeare T, Chen S, Davey C, Goyal D, Zinke-Allmang A, Kuper H, Chanthakoumane K. Impact evaluation of a cash-plus programme for children with disabilities in the Xiengkhouang Province in Lao PDR: study protocol for a non-randomised controlled trial. BMJ Open 2024; 14:e081536. [PMID: 38740503 PMCID: PMC11097848 DOI: 10.1136/bmjopen-2023-081536] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/26/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION More than 170 countries have implemented disability-targeted social protection programmes, although few have been rigorously evaluated. Consequently, a non-randomised controlled trial is being conducted of a pilot 'cash-plus' programme implemented by UNICEF Laos and the Laos government for children with disabilities in the Xiengkhouang Province in Laos. The intervention combines a regular cash transfer with provision of assistive devices and access for caregivers to a family support programme. METHODS AND ANALYSIS The non-randomised controlled trial will involve 350 children with disabilities across 3 districts identified by programme implementers as eligible for the programme (intervention arm). Implementers have also identified approximately 180 children with disabilities in neighbouring districts, who would otherwise meet eligibility criteria but do not live in the project areas (control arm). The trial will assess the impact of the programme on child well-being (primary outcome), as well as household poverty, caregiver quality of life and time use (secondary outcomes). Baseline data are being collected May-October 2023, with endline 24 months later. Analysis will be intention to treat. A complementary process evaluation will explore the implementation, acceptability of the programme, challenges and enablers to its delivery and mechanisms of impact. ETHICS AND DISSEMINATION The study has received ethical approval from the London School of Hygiene and Tropical Medicine and the National Ethics Committee for Health Research in Laos. Informed consent and assent will be taken by trained data collectors. Data will be collected and stored on a secure, encrypted server and its use will follow a detailed data management plan. Findings will be disseminated in academic journals and in short briefs for policy and programmatic actors, and in online and in-person events. TRIAL REGISTRATION NUMBER ISRCTN80603476.
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Affiliation(s)
| | | | | | | | - Mark T Carew
- London School of Hygiene and Tropical Medicine, London, UK
| | - Tom Shakespeare
- London School of Hygiene and Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK
| | - Shanquan Chen
- London School of Hygiene and Tropical Medicine, London, UK
| | - Calum Davey
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Anja Zinke-Allmang
- Department of Global Health & Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Hannah Kuper
- Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
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Aram J, Slopen N, Cosgrove C, Arria A, Liu H, Dallal CM. Self-Reported Disability Type and Risk of Alcohol-Induced Death - A Longitudinal Study Using Nationally Representative Data. Subst Use Misuse 2024:1-8. [PMID: 38635979 DOI: 10.1080/10826084.2024.2340993] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
BACKGROUND Disability is associated with alcohol misuse and drug overdose death, however, its association with alcohol-induced death remains understudied. OBJECTIVE To quantify the risk of alcohol-induced death among adults with different types of disabilities in a nationally representative longitudinal sample of US adults. METHODS Persons with disabilities were identified among participants ages 18 or older in the Mortality Disparities in American Communities (MDAC) study (n = 3,324,000). Baseline data were collected in 2008 and mortality outcomes were ascertained through 2019 using the National Death Index. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated for the association between disability type and alcohol-induced death, controlling for demographic and socioeconomic covariates. RESULTS During a maximum of 12 years of follow-up, 4000 alcohol-induced deaths occurred in the study population. In descending order, the following disability types displayed the greatest risk of alcohol-induced death (compared to adults without disability): complex activity limitation (aHR = 1.7; 95% CI = 1.3-2.3), vision limitation (aHR = 1.6; 95% CI = 1.2-2.0), mobility limitation (aHR = 1.4; 95% CI = 1.3-1.7), ≥2 limitations (aHR = 1.4; 95% CI = 1.3-1.6), cognitive limitation (aHR = 1.2; 95% CI = 1.0-1.4), and hearing limitation (aHR = 1.0; 95% CI = 0.9-1.3). CONCLUSIONS The risk of alcohol-induced death varies considerably by disability type. Efforts to prevent alcohol-induced deaths should be tailored to meet the needs of the highest-risk groups, including adults with complex activity (i.e., activities of daily living - "ALDs"), vision, mobility, and ≥2 limitations. Early diagnosis and treatment of alcohol use disorder within these populations, and improved access to educational and occupational opportunities, should be considered as prevention strategies for alcohol-induced deaths.
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Affiliation(s)
- Jonathan Aram
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA
| | - Candace Cosgrove
- Mortality Research Group, Center for Economic Studies, U.S. Census Bureau, USA
| | - Amelia Arria
- Department of Behavioral and Community Health, University of Maryland School of Public Health, USA
| | - Hongjie Liu
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, USA
| | - Cher M Dallal
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, USA
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D'souza S, Ghatole B, Raghuram H, Parakh S, Tugnawat D, Shaikh A, Singh S, Bandewar SS, Bhan A. COVID-19 Vaccine decision-making: trust among the transgender and disability communities in India. J Commun Healthc 2024:1-10. [PMID: 38597810 DOI: 10.1080/17538068.2024.2335784] [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] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND Historical marginalisation and ongoing trust deficits in health and government systems shape present-day vaccine perceptions among marginalised communities. This paper sought to understand the role of trust in decision-making about COVID-19 vaccine uptake in the transgender and disability communities in India. METHODS Using a participatory approach we interviewed 24 community representatives, identifying themselves as transgender individuals or as persons with disability, and 21 key informants such as vaccine programme managers, vaccine providers, and community advocates. We undertook an inductive thematic analysis of the data using a socio-ecological model. RESULTS Fear of side effects in relation to specific needs of the two communities and mistrust of systems involved in vaccination shaped four different pathways for vaccine decision-making. Mistrust of systems was influenced by past negative experiences with the health system, creating contexts in which information and misinformation are shared and interpreted. Participants negotiated their doubts about safety and mistrust of systems by interacting with different sources of influence showing patterns of decision-making that are dynamic, context-dependent, and intersectional. CONCLUSION These findings will help in determining the content, strategies and approaches to equitable vaccine communication for these two communities. The two communities ought to be included in vaccine trials. Vaccine information must respond to the specific needs of these two communities which could be enabled by collaboration and engagement with community members and influencers. Finally, long-term investment towards the needs of marginalised communities is vital to dismantle cycles of marginalisation and distrust and in turn improve vaccine acceptance and uptake.
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Affiliation(s)
- Sharin D'souza
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
| | - Bhakti Ghatole
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
| | - Harikeerthan Raghuram
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
| | - Sana Parakh
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
| | - Deepak Tugnawat
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
| | - Aqsa Shaikh
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Satendra Singh
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
- Department of Physiology, University College of Medical Sciences, Delhi, India
| | - Sunita Sheel Bandewar
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
- Forum for Medical Ethics Society, Mumbai, India
- Vidhayak Trust, Pune, India
| | - Anant Bhan
- Initiative for Health Equity Advocacy and Research, Bhopal Hub, Sangath, Bhopal, India
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Engel L, Arowolo I, Ewesesan R, Khan MN, Ripat J, Bottari C, Hunt A, Poncet F, Karpa J. Contextual factors of financial capability and financial well-being for adults living with brain injury: a qualitative photovoice study. Brain Inj 2024; 38:273-281. [PMID: 38334038 DOI: 10.1080/02699052.2024.2310210] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To identify the contextual factors related to financial capability and financial well-being for adults living with acquired brain injury (ABI). DESIGN & METHOD We conducted a qualitative descriptive study using photovoice and included 17 adults who live with ABI in Manitoba, Canada. Over 3-to-5 weeks, participants took photos of their financial capability (i.e. knowledge, skills, and behaviors related to managing finances) or their financial well-being (i.e. subjective and objective financial outcomes). Participants were interviewed about their photos. Five researchers iteratively and thematically analyzed interview transcripts. MAIN OUTCOMES/RESULTS Analysis identified the importance of the economic, social, technology, and physical or sensory context. Subthemes related to: (i) hard times finding financial resources; (ii) processes not making sense; (iii) getting help from the right person; and (iv) invisible disability bias and stigma. CONCLUSIONS There is decreased literature about financial capability or financial well-being after ABI. The results of this study highlight the salience of finance to living with ABI and the importance of the context to addressing financial-related life participation for people living with ABI. Information about contextual factors related to finance can improve rehabilitation assessment and intervention practice as well as emphasize needed accessibility changes to financial environments.
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Affiliation(s)
- Lisa Engel
- Department of Occupational Therapy, The University of Manitoba, Winnipeg, MB, Canada
- The Institute for Work & Health, Toronto, ON, Canada
| | - Ibiyemi Arowolo
- The Centre for Advancement of Teaching and Learning, The University of Manitoba, Winnipeg, MB, Canada
| | - Roheema Ewesesan
- Department of Occupational Therapy, The University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, The University of Manitoba, Winnipeg, MB, Canada
| | | | - Jacquie Ripat
- Department of Occupational Therapy, The University of Manitoba, Winnipeg, MB, Canada
| | - Carolina Bottari
- École de Réadaptation, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal/Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montréal, QC, Canada
| | - Anne Hunt
- Department of Occupational Science and Occupational Therapy, The University of Toronto, Toronto, ON, Canada
| | - Frédérique Poncet
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal/Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montréal, QC, Canada
- Centre de réadaptation Lethbridge-Layton-Mackay/Lethbridge-Layton-Mackay Rehabilitation Centre, Montréal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada
| | - Jane Karpa
- Department of Psychiatric Nursing, Brandon University, Brandon, MB, Canada
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Fortin-Bédard N, Bouchard D, Ladry NJ, Lettre J, Normand B, Beaulieu-Bonneau S, Lecours A, Perreault K, Annie L, Routhier F, Lamontagne ME. Impacts of the COVID-19 pandemic on health and social professionals working with people with disabilities: A qualitative study. Work 2024:WOR230404. [PMID: 38457170 DOI: 10.3233/wor-230404] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Since the beginning of the COVID-19 pandemic, protection and isolation measures established by the Canadian and Quebec governments have directly affected the work of health and social professionals (HSPs). These measures have added pressure on HSPs, complexified their work and added tasks to their already busy workload. However, few studies have explored in depth the impacts of the pandemic on HSPs working with people with disabilities. OBJECTIVE The objective of this study was to qualitatively explore the experiences of HSPs working among people with disabilities in the province of Quebec, Canada, during the COVID-19 pandemic (January and February 2021), including the impact on their work, the relationships with their colleagues, and on their immediate social and familial environment. METHODS HSPs participated in a semi-structured interview. A mixed thematic analysis approach, combining inductive and deductive coding, was carried out using N'Vivo 12. RESULTS Fifty-five HSPs participated in the interviews (mean [SD] age, 42 [9]). They mostly identified as women (91% ). Three main themes representing the impacts of the pandemic were identified, including 1) Health and Well-being; 2) Family and social networks including the subthemes; 2.1) Fear of being a vector of contamination for their loved ones; 2.2) Work-family balance; 2.3) Social Network, and finally 3) Work, highlighting, including 3.1) Workload and adaptative strategies developed; 3.2) Relationship with colleagues; 3.3) Perceived support received at work, and 3.4) Services offered to patients. CONCLUSIONS These findings highlight the importance of closely tracking and supporting the well-being of HSPs.
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Affiliation(s)
- Noémie Fortin-Bédard
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
- School of Social Work and Criminology, Université Laval, Quebec, Canada
| | - David Bouchard
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
| | - Naomie-Jade Ladry
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
| | - Josiane Lettre
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
| | - Boucher Normand
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
- School of Social Work and Criminology, Université Laval, Quebec, Canada
| | - Simon Beaulieu-Bonneau
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
- School of Psychology, Université Laval, Quebec City, Quebec, Canada
| | - Alexandra Lecours
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
- Departement of Occupational Therapy, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Kadija Perreault
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
- Department of Rehabilitation, Université Laval, Quebec, Canada
| | - LeBlanc Annie
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
| | - FranÇcois Routhier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
- Department of Rehabilitation, Université Laval, Quebec, Canada
| | - Marie-Eve Lamontagne
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
- Department of Rehabilitation, Université Laval, Quebec, Canada
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Park J, Kang D, Eun SD. Creating a Rehabilitation Sports Public Service Information Systems Using Service Design Thinking: Physical Activity Management of the Disabled after Discharge in the Republic of Korea. Healthcare (Basel) 2024; 12:594. [PMID: 38470705 PMCID: PMC10930681 DOI: 10.3390/healthcare12050594] [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: 12/05/2023] [Revised: 01/19/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
The Republic of Korea has established an institutional framework to expedite the provision of rehabilitation sports public services to individuals with disabilities post-hospital discharge (Act on Guarantee of Right to Health and Access to Health Services for People with Disabilities in December 2017). Regrettably, this service remains non-operational to date. This study employs a service design approach to identify and develop essential elements for the effective implementation of public rehabilitation sports services in Korea. Adopting the service design method, including the empathize-define-ideate-prototype phases, co-creation activities were conducted with three teams comprising people with disabilities, caregivers, rehabilitation physicians, specialized sports instructors, facility managers, and government officials, emphasizing equitable distribution. By leveraging the experiences of people with disabilities, these teams collaboratively engaged in creative activities to formulate strategies for delivering prompt and user-friendly rehabilitation sports public services post-hospital discharge. Contributions from each team were meticulously collected and organized, incorporating diverse perspectives into the development of the Korean Rehabilitation Sports Public Service Information System (KRSPSIS). Additionally, we presented a scenario illustrating the practical application of the KRSPSIS. Through this system, we anticipate providing more efficient and convenient rehabilitation sports public services to individuals with disabilities during the critical early stages following hospital discharge.
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Affiliation(s)
- Jiyoung Park
- Department of Safety and Health, Wonkwang University, Iksan 54538, Jeonbuk, Republic of Korea;
| | - Dongheon Kang
- Department of Healthcare and Public Health Research, National Rehabilitation Center, Ministry of Health and Welfare, Seoul 01022, Republic of Korea
| | - Seon-Deok Eun
- Department of Healthcare and Public Health Research, National Rehabilitation Center, Ministry of Health and Welfare, Seoul 01022, Republic of Korea
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Silva FL, Tavares SJDO, Silveira FM, Antunes LS, Antunes LAA, Assaf AV. Educational strategies for oral assistance for the disabled and their effects on dentistry students' formation: A systematic review. Spec Care Dentist 2024; 44:339-359. [PMID: 37186236 DOI: 10.1111/scd.12868] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/14/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023]
Abstract
AIMS This systematic review aimed to analyze the influence of educational strategies for oral health care for Persons with disabilities (PwDs) on the technical, ethical, and social training of undergraduate dental students. METHODS AND RESULTS An extensive search was performed in the following databases: Cochrane, Embase, PubMed, Scopus, Web of Science, LILACS/BBO and OpenGrey database. Observational, nonrandomized, and quantitative comparisons before and after some type of educational strategy in undergraduate dentistry was included. The risk of bias was assessed using the risk of bias in nonrandomized intervention studies (ROBINS-I) tool. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Nine were included and suggested that a significant improvement was observed in the technical training of undergraduate dental students although there was no consensus on the acquisition of ethical/social competences after the application of educational strategies. The included studies presented a moderate to serious risk of bias, and the certainty of evidence for both, technical and ethical/social evaluative constructs, as very low. CONCLUSION Although studies show that awareness regarding PwD significantly increases technical skills in dental students, the evidence is poor due to the high risk of bias and inconsistency observed in both the technical and ethical/social constructs; further studies on this topic are therefore essential. Prospero: (CRD42021288463).
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Affiliation(s)
- Fernanda Luiza Silva
- Post-graduation Program in Dentistry, Federal Fluminense University (UFF), Rio de Janeiro, Brazil
| | | | - Flávia Maia Silveira
- Post-graduation Program in Dentistry, Federal Fluminense University (UFF), Rio de Janeiro, Brazil
| | - Leonardo Santos Antunes
- Post-graduation Program in Dentistry, Federal Fluminense University (UFF), Rio de Janeiro, Brazil
| | | | - Andréa Videira Assaf
- Post-graduation Program in Dentistry, Federal Fluminense University (UFF), Rio de Janeiro, Brazil
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Bogner MS, Faulks D. Understanding oral health from the point of view of adults with disabilities and/or complex medical conditions: A scoping review. Spec Care Dentist 2024; 44:280-299. [PMID: 37248195 DOI: 10.1111/scd.12882] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023]
Abstract
AIM This study aimed to review the qualitative scientific literature investigating experience of the mouth and oral health amongst adults with disabilities and/or complex health conditions. METHODS A scoping review methodology was applied in accordance with the methodological framework of Arksey & O'Malley and the PRISMA-SCR checklist. Electronic searching was performed using the databases Pubmed, Embase, and PsychInfo. RESULTS Thirty articles were included in the final selection. The populations included in the selected studies were very varied in terms of health conditions and disabilities. Three major themes relating to the experience and understanding of the mouth, oral health, and function were highlighted in the review: the representation of oral health, the influence of oral health on the participant's life, and the influence of the socio-environmental context on oral health. No study explicitly described the functional, social, and psychological roles of the mouth in a comprehensive manner. CONCLUSIONS Perception of the mouth and oral health differs depending on the individual and their health condition. Oral health is described as dependent on the socio-environmental context, however, outside of the experience of dental care services, this context is not investigated in the literature. This scoping review demonstrated that exhaustive understanding of the dimensions of the mouth and oral health has not been explored in published research for this population.
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Affiliation(s)
- Marie-Sophie Bogner
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Denise Faulks
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, Clermont-Ferrand, France
- CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
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12
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de Groot S, Kouwijzer I, Valent L, van der Woude L. Handbike configurations and the prevalence of experienced sitting and riding-related problems in recreational handcyclists training for the HandbikeBattle. Disabil Rehabil Assist Technol 2024:1-11. [PMID: 38372244 DOI: 10.1080/17483107.2024.2315466] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/02/2024] [Indexed: 02/20/2024]
Abstract
Implications for rehabilitationA large variety in handbike configurations is seen in recreationally-active handcyclists.Although the majority of the recreationally-active handcyclists seemed to be satisfied with their handbike configurations, 31-50% of them thought that their handbike configuration could be improved.Evidence-based guidelines for handbike fitting should be developed in the future.
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Affiliation(s)
- Sonja de Groot
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands
| | - Ingrid Kouwijzer
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands
| | - Linda Valent
- Research & Development, Rehabilitation Center Heliomare, Wijk aan Zee, the Netherlands
| | - Lucas van der Woude
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, The Netherlands
- Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Runciman P, Eken M, van der Hoven H, Badenhorst M, Blauwet C, Gouttebarge V, Swartz L, Derman W. Evaluating workforce needs: an investigation of healthcare professionals' attitudes, beliefs and preparedness towards the management of Para athlete mental health at the Tokyo 2020 and Beijing 2022 Paralympic Games. Br J Sports Med 2024:bjsports-2023-107406. [PMID: 38272650 DOI: 10.1136/bjsports-2023-107406] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVES To examine healthcare professionals (HCPs) attitudes, beliefs and preparedness towards the management of Para athlete mental health during the Tokyo 2020 and Beijing 2022 Paralympic Games. METHODS A cross-sectional observational study was conducted. National Paralympic Committee's HCPs (n=857) working at the Tokyo 2020 and Beijing 2022 Paralympic Games were invited to respond to an anonymous online survey regarding the management of Para athlete mental health in their team. Data were analysed using descriptive frequency statistics. RESULTS The survey was completed by 256 HCPs (30% of respondents). Most HCPs agreed that mental health was a concern in Para athletes (n=210; 82%). However, half (n=122; 48%) agreed that they did not screen Para athletes for mental health symptoms, and half (n=130; 51%) agreed that there was increased stigma around disclosure of mental health symptoms among Para athletes, compared with athletes without disability. Most HCPs (n=221; 86%) agreed they wanted to improve their knowledge and skills surrounding athlete mental healthcare. Culturally sensitivite, non-discriminatory and contextual factors were highlighted as desired areas of education for HCPs and active information dissemination for Para athletes. CONCLUSION HCPs working at the Paralympic Games considered Para athlete mental healthcare important and reported perceived stigma, yet indicated low rates of mental health screening. Most respondents expressed the need for mental health education. Culturally sensitive training and active education strategies should be implemented to optimally manage Para athlete mental health.
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Affiliation(s)
- Phoebe Runciman
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University, Stellenbosch, South Africa
| | - Maaike Eken
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University, Stellenbosch, South Africa
| | - Helene van der Hoven
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University, Stellenbosch, South Africa
| | - Marelise Badenhorst
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Cheri Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Vincent Gouttebarge
- Amsterdam UMC location, University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef, Amsterdam, Netherlands
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center of Excellence, Amsterdam, The Netherlands
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Stellenbosch University, Stellenbosch, South Africa
- International Olympic Committee Research Centre, Pretoria, South Africa
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Ramadhani A, Izzati FR, Maharani DA, Malik NA, Setiawati F. Perception of Special-Care Dentistry among Dental Students at Universitas Indonesia: A Cross-Sectional Study. Dent J (Basel) 2024; 12:19. [PMID: 38275680 PMCID: PMC10814598 DOI: 10.3390/dj12010019] [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: 11/22/2023] [Revised: 12/30/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVE To assess the perceptions of special-care dentistry (SCD) among dental students in the Faculty of Dentistry, Universitas Indonesia, Indonesia. METHODS This cross-sectional study used a self-administered online questionnaire, and all preclinical and clinical students were invited to participate. The survey items comprised four domains related to participants' characteristics, perceptions of SCD, perceptions of managing patients with special needs, and perceptions of SCD education. The chi-square test and Mann-Whitney test were used in the analysis. RESULTS A total of 572 students participated in this study. The findings showed that the clinical students were more familiar with SCD than the preclinical students were (p = 0.008). A statistically significant relationship was found between the study program and the ability to work independently with special-needs patients after graduation (p < 0.001), the ability to refer special-needs patients to specialists (p = 0.042), the perception of postgraduate training-program needs (p < 0.001), and the opportunity to consider postgraduate training (p = 0.004). CONCLUSION Most of the respondents had a favorable perception of SCD. Thus, an improved SCD curriculum and SCD training for undergraduate and postgraduate students should be provided to develop the knowledge and skills needed to provide care to special-needs patients.
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Affiliation(s)
- Atik Ramadhani
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Universitas Indonesia, Depok 16424, Indonesia; (A.R.); (F.R.I.); (D.A.M.)
| | - Fiki Rizqa Izzati
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Universitas Indonesia, Depok 16424, Indonesia; (A.R.); (F.R.I.); (D.A.M.)
| | - Diah Ayu Maharani
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Universitas Indonesia, Depok 16424, Indonesia; (A.R.); (F.R.I.); (D.A.M.)
| | - Normaliza Ab Malik
- Department of Conservative Dentistry and Prosthodontic, Faculty of Dentistry, Universiti Sains Islam Malaysia, Bandar Baru Nilai, Nilai 71800, Malaysia;
| | - Febriana Setiawati
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Universitas Indonesia, Depok 16424, Indonesia; (A.R.); (F.R.I.); (D.A.M.)
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Ryu M, Seo K, Song Y. Physical Leisure Activities in Adolescents with Disabilities: Data from National Survey of Disabled Persons. Healthcare (Basel) 2024; 12:190. [PMID: 38255078 PMCID: PMC10815825 DOI: 10.3390/healthcare12020190] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
The impact of activities of daily living (ADLs) on the life satisfaction of adolescents with disabilities and the potential role of physical leisure activities as a moderator in this context have received attention. However, little is known about the influence of physical leisure activities on the relationship between ADLs and life satisfaction in adolescents with disabilities. This cross-sectional study aimed to investigate the moderating effect of physical leisure activities on the relationship between ADLs and life satisfaction among adolescents with disabilities. Secondary data analysis was conducted by extracting data from 5364 adolescents aged 12-18 years with disabilities from the 2020 National Survey of Disabled Persons of Korea. The potential moderating effect of physical leisure activities on the relationship between ADLs and life satisfaction was investigated using Pearson's correlation analysis and hierarchical multiple regression. Significant positive correlations were found for living, life satisfaction, and physical leisure activities. Physical leisure activities were found to play a moderating role in the relationship between ADLs and life satisfaction. This study concluded that increasing physical leisure activities, even with dependent ADLs, promotes life satisfaction, especially if ADLs are low, highlighting the necessity of increasing leisure activities in adolescents with disabilities.
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Affiliation(s)
- Mikyung Ryu
- College of Nursing, Chungnam National University, Daejeon 35015, Republic of Korea;
| | - Kawoun Seo
- Department of Nursing, Joongbu University, Chungnam 32713, Republic of Korea;
| | - Youngshin Song
- College of Nursing, Chungnam National University, Daejeon 35015, Republic of Korea;
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Ma Y, Zhang J, Li D, Tang L, Li Y, Cui F, Wang J, Wen C, Yang J, Tian Y. Genetic Susceptibility Modifies Relationships Between Air Pollutants and Stroke Risk: A Large Cohort Study. Stroke 2024; 55:113-121. [PMID: 38134266 DOI: 10.1161/strokeaha.123.044284] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The extent to which genetic susceptibility modifies the associations between air pollutants and the risk of incident stroke is still unclear. This study was designed to investigate the separate and joint associations of long-term exposure to air pollutants and genetic susceptibility on stroke risk. METHODS The participants of this study were recruited by the UK Biobank between 2006 and 2010. These participants were followed up from the enrollment until the occurrence of stroke events or censoring of data. Hazard ratios (HRs) and 95% CIs for stroke events associated with long-term exposure to air pollutants were estimated by fitting both crude and adjusted Cox proportional hazards models. Additionally, the polygenic risk score was calculated to estimate whether the polygenic risk score modifies the associations between exposure to air pollutants and incident stroke. RESULTS A total of 502 480 subjects were included in this study. After exclusion, 452 196 participants were taken into the final analysis. During a median follow-up time of 11.7 years, 11 334 stroke events were observed, with a mean age of 61.60 years, and men accounted for 56.2% of the total cases. Long-term exposures to particulate matter with an aerodynamic diameter smaller than 2.5 µm (adjusted HR, 1.70 [95% CI, 1.43-2.03]) or particulate matter with an aerodynamic diameter smaller than 10 µm (adjusted HR, 1.50 [95% CI, 1.36-1.66]), nitrogen dioxide (adjusted HR, 1.10 [95% CI, 1.07-1.12]), and nitrogen oxide (adjusted HR, 1.04 [95% CI, 1.02-1.05]) were pronouncedly associated with increased risk of stroke. Meanwhile, participants with high genetic risk and exposure to high air pollutants had ≈45% (31%, 61%; particulate matter with an aerodynamic diameter smaller than 2.5 µm), 48% (33%, 65%; particulate matter with an aerodynamic diameter smaller than 10 µm), 51% (35%, 69%; nitrogen dioxide), and 39% (25%, 55%; nitrogen oxide) higher risk of stroke compared with those with low genetic risk and exposure to low air pollutants, respectively. Of note, we observed additive and multiplicative interactions between genetic susceptibility and air pollutants on stroke events. CONCLUSIONS Chronic exposure to air pollutants was associated with an increased risk of stroke, especially in populations at high genetic risk.
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Affiliation(s)
- Yudiyang Ma
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Zhang
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People's Hospital (J.Z., J.Y.)
- Institute of Cardiovascular Diseases, China Three Gorges University, Yichang (J.Z., J.Y.)
- Hubei Clinical Research Center for Ischemic Cardiovascular Disease, Yichang, China (J.Z., J.Y.)
| | - Dankang Li
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Linxi Tang
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yimeng Li
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, CT (Y.L.)
| | - Feipeng Cui
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianing Wang
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chen Wen
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan, China (C.W.)
| | - Jian Yang
- Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People's Hospital (J.Z., J.Y.)
- Institute of Cardiovascular Diseases, China Three Gorges University, Yichang (J.Z., J.Y.)
- Hubei Clinical Research Center for Ischemic Cardiovascular Disease, Yichang, China (J.Z., J.Y.)
| | - Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Maternal and Child Health (Y.M., D.L., L.T., F.C., J.W., Y.T.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Chitapi UM, van Niekerk L, Blank A. Scoping review of women with disabilities' livelihood occupation experiences: An equity perspective. Work 2024; 77:735-753. [PMID: 37781835 DOI: 10.3233/wor-220348] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Globally, persons with disabilities are faced with unemployment and reduced income opportunities. Barriers to employment tend to be severe for women with disabilities who occupy marginalized positions in labor markets. 'Livelihood occupations' are conceptualized for this review to denote everyday activities that are done for subsistence and survival, and to broaden presentations of activities normally termed 'work', 'employment', 'job' or 'productivity' that people do to earn money and non-monetary gain. OBJECTIVE This scoping review, undertaken as part of a broader interpretive phenomenological analysis of livelihood occupations of women with disabilities, maps research on the subject of livelihood occupations for women with disabilities. METHODS The Arksey and O'Malley framework and PRISMA extension for scoping reviews were utilized to guide the five stage scoping strategy used to screen and select sources. Data from selected sources were synthesized using deductive qualitative content analysis to fit experiential components into equity categories determined a-priori from the Equitable Total Rewards model, to determine if these experiences connote equity or lack thereof. RESULTS Nineteen sources, mainly from high income countries, are identified. Aspects of benefit and career inequity were largely evident in the experiences of the women across all sources. CONCLUSION There is considerable lack of research on experiences of livelihood occupations in low and middle income countries contexts justifying further research. Women with disabilities report experiencing inability to realize career goals and occupational choice.
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Affiliation(s)
- Unity M Chitapi
- Ingutsheni Central Hospital, Bulawayo, Zimbabwe
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lana van Niekerk
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Alison Blank
- Department of Occupational Therapy, Physiotherapy and Nutritional Therapy, University of Worcester, Worcester, UK
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Kołłątaj WP, Kołłątaj B, Cipora E, Sygit K, Karwat ID. Relationship between the components of disability definition and the effectiveness of rehabilitation measures as a process. Ann Agric Environ Med 2023; 30:595-601. [PMID: 38153059 DOI: 10.26444/aaem/177341] [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: 12/29/2023]
Abstract
INTRODUCTION AND OBJECTIVE The number of disabled persons is most often only estimated. The disabled require multidirectional, effective support in almost every field of functioning. There is no arbitrarily accepted definition of disability, and those currently available outline the ranges of support for which rehabilitation measures are necessary. OBJECTIVE The aim of the review is to present the problem areas that contribute to the definition of disability and their interdependence and effectiveness in relation to rehabilitation interventions, as well as identification of the most frequent medical and social problems interdependent on the quality and feasibility of rehabilitation interventions. REVIEW METHODS Scientific literature in Polish and English for 1993-2023 and legal acts concerning the definition of disability, definition of rehabilitation and the problem of employment were reviewed. The following key words were used to search the NIZP-PZH, MZ, JAHEE and ISAP databases: disabled persons, definitions of disability, rehabilitation as a process, synchronization of thematic groups of disability definitions with the rehabilitation process. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE Disability is a public health problem. The actual determination of the extent, medical and social needs of people with disabilities involves methods and measures for classifying people as disabled. The effects of treatment and rehabilitation are assessed by the level of functioning of the disabled in society. SUMMARY The multiplicity of characteristics included in the definitions of disability account for all problems in health and social terms. In view of the social, environmental and cultural changes, the scope of needs of people with disabilities is also changing, which can be seen in newly-developed definitions, including rehabilitation.
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Affiliation(s)
- Witold Piotr Kołłątaj
- Department of Paediatric Endocrinology and Diabology with Endocrine - Metabolic Laboratory, Medical University, Lublin, Poland
| | - Barbara Kołłątaj
- Chair and Department of Epidemiology and Clinical Research Methodology, Medical University, Lublin, Poland
| | - Elżbieta Cipora
- Medical Institute, Jan Grodek State University, Sanok, Poland Jan Grodek State University, Sanok, Poland
| | - Katarzyna Sygit
- Medical Institute, Jan Grodek State University, Sanok, Poland Jan Grodek State University, Sanok, Poland
- Calisia University, Kalisz, Poland
| | - Irena Dorota Karwat
- Medical Institute, Jan Grodek State University, Sanok, Poland Jan Grodek State University, Sanok, Poland
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Wang R, Xiao X, Tao Y, Luo W, Zhou T, Wu Y, Zhou J, Yang L, Zhang M, Lin X, Chen X, Wang Y, Zhou C. Health empowerment and health-related quality of life in older individuals with disabilities and their spouse carers: A cross-sectional study. Res Nurs Health 2023; 46:616-626. [PMID: 37821227 DOI: 10.1002/nur.22345] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/29/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Abstract
The stress of disability significantly impacts an individual's quality of life and that of a spouse. Health empowerment, based on the idea that individuals may be successful despite disability, may be meaningful to disabled persons and their spouse carers. This cross-sectional survey study aimed to explore the effect of health empowerment on the health-related quality of life (HRQOL) of older individuals with disabilities and their spouse carers on both a personal (actor effect) and interpersonal level (partner effect). A total of 1092 dyads of older individuals with disabilities and their spouse carers residing in communities were recruited from seven provinces in China. Two separate Actor-Partner Interdependence Model analyses were conducted to examine the impact of health empowerment on the two domains of HRQOL: the Physical Component Score (PCS) and the Mental Component Score (MCS). The results revealed that health empowerment had actor effects on the PCS and MCS of older individuals with disabilities, as well as on the PCS and MCS of their spouse carers. However, no significant partner effects of health empowerment on the PCS and MCS of either the individuals with disabilities or their spouse caregivers were observed. Empowering individuals with disabilities and their spouse carers may help them enhance their own HRQOL, both physically and mentally. However, more research is required to determine the interpersonal effect of health empowerment on the HRQOL.
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Affiliation(s)
- Run Wang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Xiuying Xiao
- Zhuhai Fifth People's Hospital, Zhuhai, Guangdong, PR China
| | - Yanling Tao
- Longgang Central Hospital of Shenzhen, Shenzhen, Guangdong, PR China
| | - Weixiang Luo
- Shenzhen People's Hospital, Shenzhen, Guangdong, PR China
| | - Tao Zhou
- Peking University Shenzhen Hospital, Shenzhen, Guangdong, PR China
| | - Yanni Wu
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Jungui Zhou
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Lingli Yang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Mi Zhang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Xiaolu Lin
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Xuan Chen
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Yiling Wang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
| | - Chunlan Zhou
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, PR China
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Sardana D, Ritto FP, Ciesla D, Fagan TR. Evaluation of oral health education programs for oral health of individuals with visual impairment: An umbrella review. Spec Care Dentist 2023; 43:751-764. [PMID: 37154703 DOI: 10.1111/scd.12873] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/17/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
AIM To exemplify, summarize and critically appraise the systematic reviews (SRs) that evaluated different oral health education (OHE) interventions in individuals with visual impairment (VI). METHODOLOGY Six electronic databases were searched for SRs evaluating OHE programs in individuals with VI. The internal validity of the included SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2) tool. The degree of overlap of the primary studies in the included SRs was calculated using the "corrected covered area (CCA)" approach. RESULTS Seven SRs were included in this umbrella review that included 30 primary studies with a CCA of 26% (very high overlap). Six of the included SRs were assessed to have critically low confidence in the results, whereas only one had moderate confidence. CONCLUSIONS A combination of various OHE methods for individuals with VI might be better than using one method alone to improve oral hygiene. There is no conclusive evidence that one OHE method is superior to others. However, the evidence of OHE in improving the outcomes related to dental trauma or caries is inconclusive. Furthermore, it appears that most of the evaluations of oral health programs come from limited parts of the world, and data from many other regions is lacking.
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Affiliation(s)
- Divesh Sardana
- Division of Pediatric Dentistry, Department of Developmental Sciences, University of Oklahoma College of Dentistry, Oklahoma City, Oklahoma, USA
| | - Fernanda P Ritto
- Division of Operative Dentistry, Department of Restorative Sciences, University of Oklahoma College of Dentistry, Oklahoma City, Oklahoma, USA
| | - David Ciesla
- Division of Pediatric Dentistry, Department of Developmental Sciences, University of Oklahoma College of Dentistry, Oklahoma City, Oklahoma, USA
| | - Timothy R Fagan
- Division of Pediatric Dentistry, Department of Developmental Sciences, University of Oklahoma College of Dentistry, Oklahoma City, Oklahoma, USA
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Carneiro JDB, Pereira APCDM, Bousquat A, Frazão P. Dental care for persons with disabilities: discretion on the frontline. Rev Saude Publica 2023; 57:74. [PMID: 37878860 PMCID: PMC10547384 DOI: 10.11606/s1518-8787.2023057005318] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/22/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To depict the influence of discretionary actions exercised by frontline professionals and organizations on the implementation of diverse modalities of access to specialized dental care within the Care Network for Persons with Disabilities. METHODS A case study conducted in two Brazilian health regions characterized by distinct means of access to specialized dental care employing documentary analysis and interviews with key stakeholders across the period spanning from July to December 2019. RESULTS In the referenced access region, there was a notable centrality of Primary Health Care (PHC) in caregiving, wherein planning and assessment were integral components of institutional routines. Where spontaneous demand scheduling was accepted, sporadic exchanges of information were evident between PHC units and specialized facilities. The coordination role in caregiving was not vested in PHC teams, and activities such as planning and assessment were not assimilated into organizational routines. CONCLUSIONS The implementation of policies for specialized dental care for persons with disabilities relied on the coordination furnished by PHC and the orchestration of planning and assessment endeavors aimed at establishing an integrated care network. This implementation proved subject to the discretionary authority of frontline professionals and organizations, highlighting the significant role of relational and institutional environments in the context of public policy implementation within a decentralized and regionalized healthcare system.
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Affiliation(s)
- Joana Danielle Brandão Carneiro
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de Política, Gestão e SaúdeSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Política, Gestão e Saúde. São Paulo, SP, Brasil
| | - Ana Paula Chancharulo de Moraes Pereira
- Universidade Estadual da BahiaDepartamento de Ciências da VidaBahiaBABrasil Universidade Estadual da Bahia. Departamento de Ciências da Vida. Bahia, BA, Brasil
| | - Aylene Bousquat
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de Política, Gestão e SaúdeSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Política, Gestão e Saúde. São Paulo, SP, Brasil
| | - Paulo Frazão
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de Política, Gestão e SaúdeSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Política, Gestão e Saúde. São Paulo, SP, Brasil
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22
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Aitken Z, Emerson E, Kavanagh AM. COVID-19 vaccination coverage and vaccine hesitancy among Australians with disability and long-term health conditions. Health Promot J Austr 2023; 34:895-902. [PMID: 36565293 PMCID: PMC9880664 DOI: 10.1002/hpja.691] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 09/29/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022] Open
Abstract
ISSUE ADDRESSED COVID-19 vaccination is the cornerstone of managing Australia's COVID-19 pandemic and the success of the vaccination program depends on high vaccination coverage. This paper examined differences in COVID-19 vaccination coverage and vaccine hesitancy for people with disability, long-term health conditions, and carers - subgroups that were prioritised in Australia's vaccination program. METHODS Using data from 2400 Australians who participated in two waves of the Taking the Pulse of the Nation survey in April and May 2021, we described vaccination coverage and hesitancy among people with disability, severe mental health conditions, severe long-term health conditions, frequent need for assistance with everyday activities, and carers. RESULTS Vaccination coverage was estimated to be 8.2% in the population overall and was similar for people with disability, those with frequent need for assistance, and carers. It was higher for people with severe long-term health conditions (13.4%) and lower for people with severe mental health conditions (4.3%). Vaccine hesitancy was high overall (35.6%) and was similarly high across the priority groups, with only small differences for people with disability, severe long-term health conditions and frequent need for assistance. CONCLUSIONS This study highlights a lack of difference in vaccination coverage for people with disability, long-term health conditions, and carers compared to the general population. So what? Sub-optimal vaccination coverage for people in the priority groups leaves many people at significant risk of serious disease or death if exposed to COVID-19, particularly in light of easing of disease-control restrictions across Australia and the emergence of new variants.
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Affiliation(s)
- Zoe Aitken
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | - Eric Emerson
- Faculty of Health and MedicineLancaster UniversityLancasterUK
| | - Anne Marie Kavanagh
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
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23
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LaBerge NB, Detterbeck A, Nooijen CFJ. Comorbidities and medical complexities of mobility device users: a retrospective study. Disabil Rehabil Assist Technol 2023; 18:1035-1042. [PMID: 34472994 DOI: 10.1080/17483107.2021.1969453] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 08/13/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine the medical complexities and comorbidities of individuals who utilise wheeled mobility devices. As well as, to examine costly events including the number of urinary tract infections (UTIs), hospitalizations, urgent care(UC)/emergency department (ED) visits that are commonly seen in this population over a period of time one year prior to and one year post receiving their wheeled mobility equipment. DESIGN/SETTING A retrospective data review of 857 individual medical charts at a Level 1 Trauma Hospital and Clinic System. PARTICIPANTS 330 male and female (24-92 years old) mobility device users with a wide range of diagnoses, of which: 56 used manual wheelchairs (MWC),138 scooters (POV), 123 power wheelchairs without integrated standing (PWC), and 13 power wheelchairs with integrated standing (iS-PWC). RESULTS Overall, 92% (n = 304) had at least three medical comorbidities and medical complexities. The most common comorbidity was pain (91%). A change was noted in a lower incidence of UTIs in those using an iS-PWC, respectively 23% with at least 1 UTI in the year prior to and 8% in the year after the mobility device evaluation. CONCLUSIONS The large number of comorbidities and medical complexities amongst all mobility device users is concerning. The burden and the accompanying healthcare costs of this population is high. The potential that iS-PWC and other interventions could have on reducing these issues should be explored further.Implications of rehabilitationRegardless of a person's primary diagnosis or the wheeled mobility device they use, 100% have at least one and 92% have at least three comorbidities and medical complexities if they spend the majority of their day sittingThe high healthcare cost situations such as Emergency Department visits, Urgent Care visits, hospitalizations, and Urinary Tract Infections are present across those that use all mobility device types and the means to potentially reduce these incidences should be further exploredThe introduction of integrated standing within a power wheelchair, as a means to minimize the frequency of comorbidities and medical complications, should also be investigated further.
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Affiliation(s)
- Nicole B LaBerge
- Hennepin Healthcare, Physical Therapy Department, Hennepin Research Institute IRB approval HSR, Minneapolis, MN, USA
| | | | - Carla F J Nooijen
- Permobil AB, Research and Innovation, Stockholm, Sweden
- Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
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24
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Brown HK, Forbes SM, Evans M, Tarasoff LA. Pregnancy Outcomes in Canadian Women With Disabilities: Results From Linked Survey and Health Administrative Data. J Obstet Gynaecol Can 2023; 45:102179. [PMID: 37394098 DOI: 10.1016/j.jogc.2023.06.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023]
Abstract
We compared maternal, labour/delivery, and birth outcomes in women with versus without disabilities using a linkage of 2003-2014 Canadian Community Health Survey (CCHS) and 2003-2017 Discharge Abstract Database data. Modified Poisson regression was used to compare 15-49-year-old women with (n = 2430) and without (n = 10 375) disabilities with a singleton birth ≤5 years after their CCHS interview. Women with disabilities were at elevated risk of prenatal hospitalization (10.3% vs. 6.6%; adjusted prevalence ratio 1.33, 95% CI 1.03-1.72). They were also at elevated risk of preterm birth (8.7% vs. 6.2%), but this was attenuated after adjustment. Women with disabilities could benefit from tailored prenatal care.
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Affiliation(s)
- Hilary K Brown
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON; Dalla Lana School of Public Health, University of Toronto, Toronto, ON.
| | - Samantha M Forbes
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Meredith Evans
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON
| | - Lesley A Tarasoff
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON
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25
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Molena KF, Paulo AC, Borsatto MC, Torres CP, Díaz-Serrano KV, Bezerra Segato RA, de Queiroz AM. Auriculotherapy in a patient with Arnold Chiari malformation type II: Case report. Spec Care Dentist 2023; 43:701-707. [PMID: 36529889 DOI: 10.1111/scd.12812] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
AIMS Auriculotherapy is a therapeutic method of traditional Chinese Medicine in which a stimulus is exerted on the ear and activates energy channels throughout the body, helping to control anxiety, stress, pain, inflammation, illnesses chronic, and possibly can be used in patient with Arnold Chiari Malformation type II who have painful symptoms that are difficult to resolve. Thus, the aim of this article is to present a case in a patient with Chiari Malformation II where auriculotherapy and effect of laser therapy were performed, to relieve symptoms of agitation, anxiety and healing of self-mutilation injuries. CASE REPORT Data from medical records were used to collect medical and dental history, complaints and treatments performed. Eight sessions of auriculotherapy and one of laser therapy were carried out in order to heal the lesions. The patient presented lower levels of anxiety, agitation and ceased the habit of self-mutilation and, consequently, the pain. CONCLUSIONS The use of auriculotherapy led to a considerable improvement in the patient's painful condition and reduced anxiety, also benefiting the interaction with her family members and laser therapy promoted wound healing.
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Affiliation(s)
- Kelly Fernanda Molena
- Pediatric Dentistry Program at the School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Alana Cândido Paulo
- Pediatric Dentistry Program at the School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Maria Cristina Borsatto
- Department of Children's Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Carolina Paes Torres
- Department of Children's Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Kranya Victoria Díaz-Serrano
- Department of Children's Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Raquel Assed Bezerra Segato
- Department of Children's Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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26
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Silva FL, Tavares SJDO, Silveira FM, Assaf AV. Educational strategies in oral healthcare for the disabled and their effects on dental students' training. J Dent Educ 2023; 87:1226-1233. [PMID: 37160682 DOI: 10.1002/jdd.13241] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/27/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE To evaluate the effects of didactic and clinical training of dental students in treating Persons with Disabilities (PwD) on their self-perceptions about treating PWD. METHODS A pre-and postevaluation of a didactic-clinical educational strategy targeting oral health care of PwD was conducted among fourth-year undergraduate dental students at a Brazilian dental school. Semi-structured questionnaires were used to assess the following work environment parameters: technical, organizational, social, ethical, and managerial acumen. Data were analyzed using Fisher's exact and chi-square tests, with a significance level of 5% (p < 0.05), to verify possible associations between the quantitative variables. A qualitative analysis was conducted through collective subject discourse. RESULTS Significant differences were found in the self-perception of students' knowledge and abilities in providing low-complexity care for PwD before and after the training program (p = 0.025). Students were more confident about managing and organizing the work environment (p = 0.007) and providing humanized care to PwD (p = 0.042) posttraining program. Additionally, a decrease in the feeling of insecurity (p = 0.014) and feelings of pity, fear, or prejudice toward PwD (p < 0.001) were observed posttraining program. CONCLUSIONS Didactic and clinical training interventions for treating PwD improved the work environment of undergraduate dental students in technical, managerial, organizational, and ethical/social dimensions.
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Affiliation(s)
- Fernanda Luiza Silva
- School of Dentistry, Fluminense Federal University (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | | | - Flávia Maia Silveira
- School of Dentistry, Fluminense Federal University (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Andréa Videira Assaf
- School of Dentistry, Fluminense Federal University (UFF), Nova Friburgo, Rio de Janeiro, Brazil
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27
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dos Santos L, Aidar FJ, Souza RLM, de Matos DG, Cataldi S, Greco G, Getirana-Mota M, Marçal AC, Souza LMV, dos Santos JL, de Almeida-Neto PF, Cabral BGDAT, Badicu G, Nobari H, de Souza RF. Evaluating the Asymmetry of Muscle Activation and Strength in Paralympic Powerlifting Athletes. Eur J Investig Health Psychol Educ 2023; 13:1645-1654. [PMID: 37754458 PMCID: PMC10528492 DOI: 10.3390/ejihpe13090119] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/10/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Strength training is a complex task, as it requires a combination of many variables. In paralympic powerlifting (PP) asymmetries for the evaluation of activation, and static force indicators have been increasingly studied. OBJECTIVE To investigate the asymmetries in the strength and muscle activation indicators, before and after a training session of PP athletes. METHODOLOGY Twelve elite athletes from the PP participated in the study, and asymmetry was evaluated through surface electromyography (sEMG) and static strength indicators. Evaluations were made before and after a protocol of five series of five repetitions (5 × 5), with 80% of 1-Maximum Repetition (1RM). RESULTS In the pectoral muscles, there were differences in the non-dominant limbs between the before and after in the sEMG. There were differences in the pectoralis muscle in the non-dominant limb between moments before (110.75 ± 59.52%) and after (130.53 ± 98.48%, p < 0.001), and there was no difference in triceps activation. In the Maximum Isometric Strength (MIF), there was a difference in the non-dominant limb between before (710.36 ± 129.36) and after (620.27 ± 69.73; p < 0.030). There was a difference before in the dominant (626.89 ± 120.16; 95% CI 550.55-703.24) and non-dominant (710.36 ± 129.36; p = 0.011) limbs. There was no difference in time to MIF. CONCLUSION PP athletes showed small levels of asymmetry before and after training, and adaptation to training tends to promote fewer asymmetries.
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Affiliation(s)
- Leonardo dos Santos
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.d.S.); (M.G.-M.); (A.C.M.); (L.M.V.S.); (J.L.d.S.); (R.F.d.S.)
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
| | - Felipe J. Aidar
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.d.S.); (M.G.-M.); (A.C.M.); (L.M.V.S.); (J.L.d.S.); (R.F.d.S.)
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Graduate Program of Physiological Science, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Rafael Luiz Mesquita Souza
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
- Graduate Program of Physiological Science, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Dihogo Gama de Matos
- Cardiovascular & Physiology of Exercise Laboratory, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
| | - Stefania Cataldi
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Study of Bari, 70124 Bari, Italy; (S.C.); (G.G.)
| | - Gianpiero Greco
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Study of Bari, 70124 Bari, Italy; (S.C.); (G.G.)
| | - Márcio Getirana-Mota
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.d.S.); (M.G.-M.); (A.C.M.); (L.M.V.S.); (J.L.d.S.); (R.F.d.S.)
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
- Graduate Program of Physiological Science, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Anderson Carlos Marçal
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.d.S.); (M.G.-M.); (A.C.M.); (L.M.V.S.); (J.L.d.S.); (R.F.d.S.)
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
| | - Lucio Marques Vieira Souza
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.d.S.); (M.G.-M.); (A.C.M.); (L.M.V.S.); (J.L.d.S.); (R.F.d.S.)
| | - Jymmys Lopes dos Santos
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.d.S.); (M.G.-M.); (A.C.M.); (L.M.V.S.); (J.L.d.S.); (R.F.d.S.)
| | - Paulo Francisco de Almeida-Neto
- Department of Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil; (P.F.d.A.-N.); (B.G.d.A.T.C.)
| | | | - Georgian Badicu
- Department of Physical Education and Special Motricity, Transilvania University of Brasov, 500068 Brasov, Romania;
| | - Hadi Nobari
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
| | - Raphael Frabrício de Souza
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.d.S.); (M.G.-M.); (A.C.M.); (L.M.V.S.); (J.L.d.S.); (R.F.d.S.)
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
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28
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Adamson B, Wyatt N, Key L, Boone C, Motl RW. Results of the MOVE MS Program: A Feasibility Study on Group Exercise for Individuals with Multiple Sclerosis. Int J Environ Res Public Health 2023; 20:6567. [PMID: 37623153 PMCID: PMC10454660 DOI: 10.3390/ijerph20166567] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
Abstract
Exercise improves a wide range of symptoms experienced by those living with multiple sclerosis (MS) and may foster community and a positive sense of disability identity. However, exercise rates remain low. Sustained exercise participation has the greatest likelihood of improving symptoms and requires a theory-based approach accounting for the barriers faced by people with MS that impede exercise participation long-term. MOVE MS is a once weekly group exercise program based on Social Cognitive Theory supporting long-term exercise participation through peer instruction, behavior change education, multiple exercise modalities, and seated instruction. This feasibility study evaluated MOVE MS with a 7-month trial. The primary scientific outcome was exercise participation and the secondary outcomes were MS symptoms/impact, self-efficacy, depression, anxiety, disability identity, and quality of life, among others. We further conducted semi-structured formative interviews post-intervention. Thirty-three participants began the program. The onset of COVID-19 necessitated a shift toward online delivery. Seventeen participants completed the program. There were non-significant improvements in exercise participation (Godin Leisure-Time Exercise Questionnaire, baseline mean = 14.2 (SD = 11.8), post-intervention mean = 16.6 (SD = 11.2), F-value = 0.53 (Partial Eta2 = 0.08), and several secondary outcomes (including the MS Impact Scale, MS Walking Scale, and the Leeds MS Quality of Life Scale). Sixteen participants were interviewed, and analysis yielded five themes on program components and feedback. MOVE MS-delivered in-person or online-may be a feasible option for long-term exercise programming for people with MS.
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Affiliation(s)
- Brynn Adamson
- Department of Health Sciences, University of Colorado Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO 80907, USA
| | - Nic Wyatt
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 506 S. Wright St., Urbana, IL 61801, USA
| | - Latashia Key
- Department of Recreation, Sport, and Tourism, University of Illinois at Urbana-Champaign, 506 S. Wright St., Urbana, IL 61801, USA
| | - Carrena Boone
- Department of Health Sciences, University of Colorado Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO 80907, USA
| | - Robert W. Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1200 West Harrison St., Chicago, IL 60607, USA
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29
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Santos LCV, Aidar FJ, Villar R, Greco G, de Santana JL, Marçal AC, de Almeida-Neto PF, de Araújo Tinoco Cabral BG, Badicu G, Nobari H, de Souza RF, da Silva Júnior WM. Evaluation of the Training Session in Elite Paralympic Powerlifting Athletes Based on Biomechanical and Thermal Indicators. Sports (Basel) 2023; 11:151. [PMID: 37624131 PMCID: PMC10459933 DOI: 10.3390/sports11080151] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Paralympic powerlifting (PP) is performed on a bench press, aiming to lift as much weight as possible in a single repetition. PURPOSE To evaluate thermal asymmetry and dynamic force parameters with 45 and 80% 1 Repetition Maximum (1 RM) in PP athletes. METHODS Twelve elite PP male athletes were evaluated before and after a training session regarding skin temperature (thermography) and dynamic force indicators (Average Propulsive Velocity-MPV, Maximum Velocity-VMax, and Power). The training consisted of five series of five repetitions (5 × 5) with 80% 1 RM. The force indicators and dynamics before and after (45% 1 RM) were evaluated in series "1" and "5" with 80% 1 RM. RESULTS The temperature did not present asymmetry, and there were differences between the moment before and after. In MPV, Vmax, and Power, with 45% 1 RM, there were differences both in asymmetry and in moments (p < 0.005). With 80% 1 RM, asymmetry was observed, but no differences between moments (p < 0.005). CONCLUSION No thermal asymmetry was observed. There were reductions in MVP and VMax at 45 and 80% 1 RM but without significant differences between time points (before and after). However, there was asymmetry in the moments before and after within a safety standard, where Paralympic powerlifting was safe in terms of asymmetries.
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Affiliation(s)
- Larissa Christine Vieira Santos
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.C.V.S.); (A.C.M.); (R.F.d.S.); (W.M.d.S.J.)
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Felipe J. Aidar
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.C.V.S.); (A.C.M.); (R.F.d.S.); (W.M.d.S.J.)
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Graduate Program of Physiological Science, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Cardiorespiratory & Physiology of Exercise Research Laboratory, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (R.V.); (J.L.d.S.)
| | - Rodrigo Villar
- Cardiorespiratory & Physiology of Exercise Research Laboratory, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (R.V.); (J.L.d.S.)
| | - Gianpiero Greco
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Study of Bari, 70124 Bari, Italy;
| | - Jefferson Lima de Santana
- Cardiorespiratory & Physiology of Exercise Research Laboratory, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (R.V.); (J.L.d.S.)
| | - Anderson Carlos Marçal
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.C.V.S.); (A.C.M.); (R.F.d.S.); (W.M.d.S.J.)
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Paulo Francisco de Almeida-Neto
- Department of Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil; (P.F.d.A.-N.); (B.G.d.A.T.C.)
| | | | - Georgian Badicu
- Department of Physical Education and Special Motricity, Transilvania University of Brasov, 500068 Brasov, Romania;
| | - Hadi Nobari
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
| | - Raphael Frabrício de Souza
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.C.V.S.); (A.C.M.); (R.F.d.S.); (W.M.d.S.J.)
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports (GEPEPS), Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
- Department of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
| | - Walderi Monteiro da Silva Júnior
- Graduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (L.C.V.S.); (A.C.M.); (R.F.d.S.); (W.M.d.S.J.)
- Graduate Program of Health Science, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil
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Abstract
Medical assistance in dying, which includes voluntary euthanasia and assisted suicide, is legally permissible in a number of jurisdictions, including the Netherlands, Belgium, Switzerland and Canada. Although medical assistance in dying is most commonly provided for suffering associated with terminal somatic illness, some jurisdictions have also offered it for severe and irremediable psychiatric illness. Meanwhile, recent work in the philosophy of psychiatry has led to a renewed understanding of psychiatric illness that emphasises the role of the relation between the person and the external environment in the constitution of mental disorder. In this paper, I argue that this externalist approach to mental disorder highlights an ethical challenge to the practice of medical assistance in dying for psychiatric illness. At the level of the clinical assessment, externalism draws attention to potential social and environmental interventions that might have otherwise been overlooked by the standard approach to mental disorder, which may confound the judgement that there is no further reasonable alternative that could alleviate the person's suffering. At the level of the wider society, externalism underscores how social prejudices and structural barriers that contribute to psychiatric illness constrain the affordances available to people and result in them seeking medical assistance in dying when they otherwise might not have had under better social conditions.
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Affiliation(s)
- Hane Htut Maung
- Department of Politics Philosophy and Religion, Lancaster University, Lancaster, UK
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Newby-Kew A, Horner-Johnson W. Healthy and Respectful Relationship Education: Differences by Disability Status and Associations With Sexual Abuse. J Sch Health 2023; 93:565-572. [PMID: 36815452 DOI: 10.1111/josh.13317] [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] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Education about healthy and respectful relationships (HRR) is a key component of comprehensive sexual health curricula and is supposed to be universally provided in Oregon. This study: (1) assesses the extent to which high school students with disabilities received HRR education, and (2) examines associations between HRR education and experiences of sexual abuse. METHODS Using data from the 2019 Oregon Healthy Teens survey, we conducted multivariable Poisson regression to compare 11th grade students with and without disabilities on self-reported receipt of school based HRR instruction (N = 10,992), and to measure associations between HRR education and sexual abuse experiences among teens with (N = 3736) and without (N = 7256) disabilities. RESULTS Students with disabilities were 41% more likely than students without disabilities to say they had never been taught in school about HRR (adjusted prevalence ratio 1.41, 95% confidence interval: 1.25-156). Experiences of sexual abuse victimization were more common for all students who did not receive HRR education (34.1% vs 21.6% among students with disabilities; 16.2% vs 7.5% among students without disabilities). CONCLUSIONS Students with disabilities are less likely to have received school-based HRR education than their peers without disabilities. Providing inclusive HRR education may help reduce risk of sexual abuse and is essential for addressing health disparities affecting youth with disabilities.
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Affiliation(s)
- Abigail Newby-Kew
- Oregon Health Science University and Portland State University School of Public Health, Portland, OR
| | - Willi Horner-Johnson
- Oregon Health Science University and Portland State University School of Public Health; Institute on Development and Disability, School of Medicine, OHSU, Portland, OR
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Vainder M, Ray JG, Lunsky Y, Fung K, Vigod SN, Havercamp SM, Parish SL, Brown HK. Physical disability and venous thromboembolism during pregnancy and the postpartum period: a population-based cohort study. J Thromb Haemost 2023; 21:1882-1890. [PMID: 37031753 DOI: 10.1016/j.jtha.2023.03.035] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/06/2023] [Accepted: 03/26/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Pregnancy and the postpartum period are a high-risk time for venous thromboembolism (VTE). Decreased mobility is also a major risk factor. However, the risk of peripregnancy VTE among individuals with physical disabilities is unknown. OBJECTIVES To compare the risk of peripregnancy VTE between people with a physical disability and those without a physical disability. METHODS This population-based cohort study comprised all births in Ontario, Canada, from 2007 to 2018. Physical disability was defined as a condition diagnosed before conception that was likely to result in restricted mobility. Modified Poisson regression was used to compare the risk of VTE during pregnancy and up to 6 weeks postpartum between people with a physical disability and those without a physical disability. Adjusted relative risks (aRRs) were calculated, controlling for demographics, history of VTE, thrombophilia, and other comorbidities. An additional analysis was used to evaluate the risk of peripregnancy VTE among people with physical disabilities who used a mobility aid. RESULTS Of 1 220 822 eligible people, 13 791 (1.1%) had a physical disability. VTE occurred during pregnancy or up to 6 weeks of the postpartum period in 0.85% of the individuals with a physical disability and 0.47% of those without a physical disability (aRR, 1.52; 95% CI, 1.26-1.83). The rate of VTE was notably higher in those with a physical disability requiring a mobility aid (3.0%), generating an aRR of 3.05 (95% CI, 1.45-6.41), than in those without a physical disability. CONCLUSION Pregnant people with a physical disability, especially those using a mobility aid, are at an increased risk of VTE. Anticoagulant prophylaxis could be considered in this group, especially in the presence of additional risk factors.
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Affiliation(s)
- Marina Vainder
- Department of Obstetrics & Gynaecology, University of Toronto, Toronto, Ontario, Canada. https://twitter.com/MVainder
| | - Joel G Ray
- ICES, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Yona Lunsky
- ICES, Toronto, Ontario, Canada; Azrieli Adult Neurodevelopmental Centre, Centre for Addiction & Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Simone N Vigod
- ICES, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Susan M Havercamp
- Center for Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, Ohio, USA
| | - Susan L Parish
- College of Health Professions, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hilary K Brown
- ICES, Toronto, Ontario, Canada; Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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Silva SVD, Reichenberger V, Vieira GI, Clemente KAP, Ramos VD, Brito CMMD. [Repercussions of the COVID-19 pandemic on health services for people with disabilities: report from rehabilitation professionals]. CAD SAUDE PUBLICA 2023; 39:e00223822. [PMID: 37377301 PMCID: PMC10494701 DOI: 10.1590/0102-311xpt223822] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/21/2023] [Accepted: 04/13/2023] [Indexed: 06/29/2023] Open
Abstract
Several healthcare processes, including rehabilitation, require prompt initiation and cannot be interrupted. Therefore, these processes underwent important adaptations during the COVID-19 pandemic. However, it is not fully known how healthcare facilities adapted their strategies and what the results were. This study investigated how rehabilitation services were affected during the pandemic and what strategies were employed to maintain the provided services. From June 2020 to February 2021, 17 semi-structured interviews were conducted with healthcare professionals working in rehabilitation services from the Brazilian Unified National Health System (SUS), who work at one of the three levels of care, in the municipalities of Santos and São Paulo, state of São Paulo, Brazil. The interviews were recorded, transcribed, and analyzed via content analysis. The professionals reported organizational changes in their services, with the initial interruption of appointments and, subsequently, the adoption of new sanitary protocols and the gradual return to in-person and/or remote appointments. Working conditions were directly impacted, as there was a need for staffing, training, increased workloads, as well as physical and mental exhaustion among professionals. The pandemic caused a series of changes in healthcare services, some of which were interrupted due to the suspension of numerous services and appointments. Some in-person appointments were maintained exclusively for patients who presented a risk of short-term deterioration. Preventive sanitary measures and strategies for continuity of care were adopted.
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Affiliation(s)
| | - Veronika Reichenberger
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, U.K
| | - Gislene Inoue Vieira
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
- Prefeitura Municipal de São Paulo, São Paulo, Brasil
| | | | - Vinícius Delgado Ramos
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Christina May Moran de Brito
- Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira, São Paulo, Brasil
- Hospital Sírio-Libanês, São Paulo, Brasil
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Tarasoff LA, Lunsky Y, Welsh K, Havercamp S, Vigod SN, Brown HK. The disability-related education and training experiences of perinatal care providers in Ontario. J Obstet Gynaecol Can 2023:S1701-2163(23)00412-7. [PMID: 37271344 DOI: 10.1016/j.jogc.2023.05.032] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/06/2023]
Abstract
We describe the disability-related education and training experiences of perinatal care providers in Ontario. Twenty perinatal care providers (e.g., obstetricians, midwives) participated in semi-structured interviews. Using a content analysis approach, we found most acquired disability-related training through their own initiative as opposed to education through professional training programs. Barriers to training included lack of data on disability and pregnancy, and limited experiential learning opportunities. Providers recommended that future training focus on experiential learning and social determinants of health, with people with disabilities involved in developing and delivering training. These efforts are vital to optimize pregnancy outcomes for people with disabilities.
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Affiliation(s)
- Lesley A Tarasoff
- Department of Health and Society, University of Toronto Scarborough, Scarborough, Ontario, Canada; Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kate Welsh
- Department of Health and Society, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Susan Havercamp
- Nisonger Center, The Ohio State University, Columbus, Ohio, USA
| | - Simone N Vigod
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Hospital and Research Institute, Toronto, Ontario, Canada
| | - Hilary K Brown
- Department of Health and Society, University of Toronto Scarborough, Scarborough, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Hospital and Research Institute, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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35
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Henríquez M, Ramirez-Campillo R, Cristi-Montero C, Reina R, Alvarez C, Ferrari G, Aguilar-Farias N, Sadarangani KP. Alarming low physical activity levels in Chilean adults with disabilities during COVID-19 pandemic: a representative national survey analysis. Front Public Health 2023; 11:1090050. [PMID: 37333554 PMCID: PMC10272572 DOI: 10.3389/fpubh.2023.1090050] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Background People with disabilities usually face barriers to regularly engaging in physical activities. Estimating physical activity patterns are necessary to elaborate policies and strategies to facilitate active lifestyles, considering the particular access difficulties experienced by this population. Purpose This study aimed (i) to describe the prevalence of physical activity levels and (ii) to examine the associations of physical activity levels with socio-demographic variables and type of disability in the 2020 Chilean National Physical Activity and Sports Habits in Populations with Disabilities (CNPASHPwD) survey during the coronavirus disease 19 (COVID-19) pandemic. Methods Cross-sectional data from 3,150 adults (18-99 years old), 59.8% female, were analyzed from November to December 2020. Self-reported age, gender, type of disability (i.e., physical, visual, hearing, intellectual, or mixed), socio-economic status, area and zone of residence, and physical activity levels (0 min/week, < 150 min/week, ≥ 150 min/week) were obtained. Results 11.9% of the participants were classified as active (≥ 150 min/week), and 62.6% declared no involvement in physical activity. A larger proportion of females (61.7%) did not meet the current guidelines (≥ 150 min/week of physical activity) in comparison with males (p < 0.001). Participants with visual and hearing disabilities were more likely to be active than those with other types of disabilities. Those living in the central and southern regions of Chile were more likely to be physically active than those from the northern region. Also, older participants, women, and those from lower socio-economic statuses were less likely to meet the physical activity guidelines. Conclusion Alarmingly, nine out of ten participants were categorized as physically inactive, particularly women, older adults, and those with a low socioeconomic status. If the pandemic context moderated, the considerable prevalence of reduced physical activity levels deserves future exploration. Health promotion initiatives should consider these aspects, emphasizing inclusive environments and increasing opportunities to favor healthy behaviors, countering the COVID-19 effects.
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Affiliation(s)
- Matías Henríquez
- Escuela de Kinesiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Providencia, Chile
| | - Rodrigo Ramirez-Campillo
- Faculty of Rehabilitation Sciences, School of Physical Therapy, Exercise and Rehabilitation Sciences Institute, Universidad Andres Bello, Santiago, Chile
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Raul Reina
- Sports Research Centre, Miguel Hernández University, Elche, Spain
| | - Cristián Alvarez
- Faculty of Rehabilitation Sciences, School of Physical Therapy, Exercise and Rehabilitation Sciences Institute, Universidad Andres Bello, Santiago, Chile
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile
| | - Nicolas Aguilar-Farias
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco, Chile
| | - Kabir P. Sadarangani
- Escuela de Kinesiología, Universidad Autónoma de Chile, Santiago, Chile
- Faculty of Health and Dentistry, School of Kinesiology, Universidad Diego Portales, Santiago, Chile
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Ribeiro KSQS, Saldanha JHS, Zanela ÂK, Ferrari FP, Freitas GKF, Barroso RB, Silva SLAD, Chaves SCL, Aquino VDS, Schmitt ACB, Fernandes TG. [Evaluation of the implementation of the Care Network for People with Disabilities in the Brazilian Unified National Health System: a multiple case study]. CAD SAUDE PUBLICA 2023; 39:e00186122. [PMID: 37162117 PMCID: PMC10549978 DOI: 10.1590/0102-311xpt186122] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 05/11/2023] Open
Abstract
The Care Network for People with Disabilities (RCPCD) was implemented in 2012 as a consequence of the actions of the Viver sem Limite (Living without Limits) plan and has been the research object of recent studies. However, no published studies address the degree of implementation of this network. This study aimed to evaluate the degree of implementation of the RCPCD in eight states in the five regions of Brazil. This multiple case study performed evaluative research of the degree of implementation of the RCPCD in the states of Amazonas, Bahia, Espírito Santo, Mato Grosso do Sul, Minas Gerais, Paraíba, Rio Grande do Sul, and São Paulo. A logical model of the policy and a measurement matrix were developed. The degree of implementation of seven states was moderate, but Amazonas had an incipient degree of implementation. The evaluation of each stage of the process showed important differences, as the regional diagnosis and network adhesion stages presented moderate to advanced degrees of implementation in most states. In the service contracting stage, no state had an advanced degree of implementation, and the stage of follow-up and monitoring of the RCPCD was not even reached. The measurement matrix helps evaluate the degree of implementation of the RCPCD, and, by recognizing its results, the state steering groups and technical area recommend its use. Actions to improve this implementation, such as strengthening regionalization, establishing regional steering groups, ensuring contracting mechanisms, and defining criteria for certification of the care points, are necessary.
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Moreno-Mayorga B, Vélez-Botero H, Fandiño-Franky J, Pérez-Almanza N, Agudelo-Hernández F, González-González NY. [Quality of life in people with epilepsy: beyond seizures]. Rev Neurol 2023; 76:257-264. [PMID: 37046394 PMCID: PMC10478138 DOI: 10.33588/rn.7608.2023052] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION People with epilepsy have multiple barriers to recovery: access to medication, comorbidities and social problems. The aim of this study is to determine psychosocial factors associated with the perception of quality of life in people with epilepsy in the department of Bolivar, Colombia, in the year 2022. SUBJECTS AND METHODS Descriptive cross-sectional study, correlational, with a sample stratified with a margin of error of 5%, according to the calculation of the average number of people treated for epilepsy in Colombia. 174 people participated with a mean age of 39.55 years, 50% men and 50% women. An instrument was used that determined sociodemographic data, quality of life (Quality of Life in Epilepsy Inventory-10), adherence to treatment (Morisky test), self-care behaviors, perception of disability and provision of health services. All the instruments showed a Cronbach's Alpha greater than 0.686 for this population. RESULTS 21.3% had focal onset epilepsy; 41% with generalized epilepsy without focal onset; 18.4% with focal onset that generalized; 12.6% did not know their type of epilepsy; and 6.3% reported that they were not informed about their type of epilepsy. Based on correlations, an explanatory model of quality of life is shown, with pillars such as drug adherence, self-care habits, time without seizures, and perceived disability. CONCLUSIONS Although time without seizures is a fundamental element in recovery, living conditions and mental health problems are key elements to achieve a better quality of life in epilepsy.
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Affiliation(s)
- B Moreno-Mayorga
- Ministerio de Salud y Protección Social de Colombia, Bogotá, Colombia
| | | | - J Fandiño-Franky
- Fundación Centro Colombiano de Epilepsia - FIRE, Cartagena de Indias, Colombia
| | - N Pérez-Almanza
- Fundación Centro Colombiano de Epilepsia - FIRE, Cartagena de Indias, Colombia
| | - F Agudelo-Hernández
- Universidad de Manizales, Manizales, Colombia
- Ministerio de Salud y Protección Social de Colombia, Bogotá DC, Colombia
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Han N, Park SY, Bang JB. Pharmacy Students' Attitudes Toward Persons With Disabilities and Perceptions of Right to Self-Determination. Am J Pharm Educ 2023; 87:ajpe9109. [PMID: 36347542 PMCID: PMC10159025 DOI: 10.5688/ajpe9109] [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: 03/30/2022] [Accepted: 07/24/2022] [Indexed: 05/03/2023]
Abstract
Objective. As the number of persons with disabilities increases, pharmacists are responsible for providing optimal pharmaceutical care services to more patients in this population. The purpose of this study was to assess pharmacy students' perceptions of the right of persons with disabilities to self-determination and to identify factors that affect pharmacists' attitudes and perceptions.Methods. A survey of 370 pharmacy students was conducted. The revised Korean versions of the Scale of Attitudes Towards Disabled Persons (SADP) and the Attitudes Toward Disabled Persons Form O (ATDP-O) were used to measure attitudes toward persons with disabilities. Pharmacy students' perception of the right of persons with disabilities to self-determination was measured in 2 subdomains developed by education and ethics experts: absoluteness of right and social support.Results. Responses from 363 pharmacy students were included in the analysis. We found that the more contact students had with persons with disabilities in the past, the more positive attitudes they had toward this patient group. In addition, students' understanding of self-determination and positive attitudes toward persons with disabilities were determined to be statistically significant factors affecting pharmacy students' perceptions of both the absoluteness of right of persons with disabilities and the level of social support that should be given to this patient group.Conclusion. Since experience relating to people with disabilities is associated with pharmacy students' positive perceptions about the right of persons with disabilities to self-determination, education and activities are needed in the pharmacy curriculum to ensure students have experiences with this patient group.
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Affiliation(s)
- Nayoung Han
- Jeju National University, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Jeju Special Self-Governing Province, Republic of Korea
| | - So-Youn Park
- Kyung Hee University School of Medicine, Department of Medical Education and Medical Humanities, Seoul, Republic of Korea
| | - Jae Beum Bang
- Kyung Hee University School of Dentistry, Department of Dental Education, Seoul, Republic of Korea
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Kuroda MM, Iwasaki N, Mutsuzaki H, Yoshikawa K, Takahashi K, Nakayama T, Nakayama J, Takeuchi R, Mataki Y, Ohguro H, Tomita K. Benefits of a Wearable Cyborg HAL (Hybrid Assistive Limb) in Patients with Childhood-Onset Motor Disabilities: A 1-Year Follow-Up Study. Pediatr Rep 2023; 15:215-226. [PMID: 36976724 PMCID: PMC10057157 DOI: 10.3390/pediatric15010017] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 03/29/2023] Open
Abstract
Rehabilitation robots have shown promise in improving the gait of children with childhood-onset motor disabilities. This study aimed to investigate the long-term benefits of training using a wearable Hybrid Assistive Limb (HAL) in these patients. Training using a HAL was performed for 20 min a day, two to four times a week, over four weeks (12 sessions in total). The Gross Motor Function Measure (GMFM) was the primary outcome measure, and the secondary outcome measures were gait speed, step length, cadence, 6-min walking distance (6MD), Pediatric Evaluation of Disability Inventory, and Canadian Occupational Performance Measure (COPM). Patients underwent assessments before the intervention, immediately after the intervention, and at 1-, 2-, 3-month and 1-year follow-ups. Nine participants (five males, four females; mean age: 18.9 years) with cerebral palsy (n = 7), critical illness polyneuropathy (n = 1), and encephalitis (n = 1) were enrolled. After training using HAL, GMFM, gait speed, cadence, 6MD, and COPM significantly improved (all p < 0.05). Improvements in GMFM were maintained one year after the intervention (p < 0.001) and in self-selected gait speed and 6MD three months after the intervention (p < 0.05). Training using HAL may be safe and feasible for childhood-onset motor disabilities and may maintain long-term improvements in motor function and walking ability.
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Affiliation(s)
- Mayumi Matsuda Kuroda
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ibaraki 300-0394, Japan
| | - Nobuaki Iwasaki
- Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, 4733 Ami, Ibaraki 300-0331, Japan
- Center for Medical Science, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ibaraki 300-0394, Japan
| | - Hirotaka Mutsuzaki
- Center for Medical Science, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ibaraki 300-0394, Japan
- Department of Orthopedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, 4733 Ami, Ibaraki 300-0331, Japan
| | - Kenichi Yoshikawa
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, 4733 Ami, Ibaraki 300-0331, Japan
| | - Kazushi Takahashi
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, 4733 Ami, Ibaraki 300-0331, Japan
| | - Tomohiro Nakayama
- Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, 4733 Ami, Ibaraki 300-0331, Japan
| | - Junko Nakayama
- Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, 4733 Ami, Ibaraki 300-0331, Japan
| | - Ryoko Takeuchi
- Department of Orthopedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, 4733 Ami, Ibaraki 300-0331, Japan
| | - Yuki Mataki
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, 2-1-1 Tsukuba, Ibaraki 305-8576, Japan
| | - Haruka Ohguro
- Department of Pediatrics, Ibaraki Prefectural University of Health Sciences Hospital, 4733 Ami, Ibaraki 300-0331, Japan
| | - Kazuhide Tomita
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ibaraki 300-0394, Japan
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Fagerlund P, Salmela J, Pietiläinen O, Salonsalmi A, Rahkonen O, Lallukka T. Life-course socioeconomic circumstances in acute, chronic and disabling pain among young employees: a double suffering. Scand J Public Health 2023; 51:257-267. [PMID: 34965800 PMCID: PMC9969306 DOI: 10.1177/14034948211062314] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pain is known to be socioeconomically patterned and associated with disability. However, knowledge is scarce concerning life-course socioeconomic circumstances and pain among young adults. Our aim was to examine the associations of childhood and current socioeconomic circumstances with acute pain and chronic pain with low and high disability levels among young Finnish municipal employees. METHODS We analysed questionnaire data retrieved from the Young Helsinki Health Study (n=4683) covering 18-39-year-old employees of the City of Helsinki, Finland. We included multiple indicators of childhood and current socioeconomic circumstances and examined their associations with acute pain and with chronic pain with low and high disability levels. The level of chronic pain-related disability was assessed by the chronic pain grade questionnaire. Multinomial logistic regression analyses were conducted with stepwise adjustments for sociodemographic, socioeconomic and health-related covariates. RESULTS Childhood and current socioeconomic disadvantage were associated with acute and chronic pain, particularly with chronic pain with high disability level. The strongest associations after adjustments for covariates remained between chronic pain with high disability level and low educational level (odds ratio (OR) 3.38, 95% confidence interval (CI) 2.18-5.24), manual occupation (OR 3.75, 95% CI 1.92-7.34) and experiencing frequent economic difficulties (OR 3.07, 95% CI 2.00-4.70). CONCLUSIONS
Pain is a common complaint that contributes to disability among young employees, particularly the most socioeconomically vulnerable. There is a socioeconomic gradient in both pain chronicity and the level of chronic pain-related disability. Life-course socioeconomic factors should be considered in pain-preventing strategies and in clinical practice.
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Affiliation(s)
- Pi Fagerlund
- Pi Fagerlund, Department of Public Health,
University of Helsinki, P.O. Box 20, Tukholmankatu 8 B, 00014 Helsinki, Finland.
E-mail:
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41
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Weiler R, Ahmed OH, Mechelen WV, Verhagen E, Bolling C. Concussion through my eyes: a qualitative study exploring concussion experiences and perceptions of male English blind footballers. Br J Sports Med 2023; 57:578-589. [PMID: 36792363 DOI: 10.1136/bjsports-2022-106256] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 02/17/2023]
Abstract
OBJECTIVES Athletes with impairments play sports with a risk of sustaining head injuries and concussions. However, the scientific knowledge needed to improve care is lacking. This qualitative study explores English blind 5-a-side footballers' perceptions of concussion, concussion risks and prevention to improve para concussion care. METHODS Nine semi-structured interviews were conducted with male English blind footballers (six current and three retired). Data were analysed by thematic analysis using a six-stage approach. RESULTS Blind footballers were not sure about the number of concussions they had sustained. They lacked an understanding of what to experience when concussed, and they perceived the diagnosis and experience of a concussion to be different for a person without vision. Perceived concussion severity and previous concussion experiences were key concepts affecting their concussion reporting behaviours. Participants mentioned spatial orientation and sleep are important to function in daily life and were affected by concussions. However, these factors are not adequately included in current assessment tools or clinical guidance for sports-related concussions. CONCLUSION Blind footballers suggested the quality and accuracy of reported concussions were impacted by lack of concussion experience, knowledge and concomitant impairment. A better understanding of concussion symptoms and injury mechanisms will improve concussion reporting for athletes with visual impairments. These athlete insights should guide future studies and para sports governing body initiatives to improve concussion reporting, diagnosis and management in para athletes.
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Affiliation(s)
- Richard Weiler
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands .,Para Football Foundation, Arnhem, The Netherlands.,Fortius Clinic, London, UK
| | - Osman Hassan Ahmed
- University Hospitals Dorset NHS Foundation Trust, Poole, UK.,School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK.,The Football Association, Burton-upon-Trent, UK
| | - Willem van Mechelen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia.,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Caroline Bolling
- Amsterdam Collaboration on Health & Safety in Sports, Department of Orthopaedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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42
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Faulks D, Bogner MS, Hamon S, Eschevins C, Pereira B. Identifying Persons with Special Healthcare Needs in Dentistry-Development and Validation of the French Case Mix Tool. Int J Environ Res Public Health 2023; 20:2997. [PMID: 36833693 PMCID: PMC9957372 DOI: 10.3390/ijerph20042997] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Providing dental care for certain patient groups is complicated due to difficulties with cooperation, communication, health conditions, and social context, amongst others. The majority of dentists in France work within a public fee-per-item system. A new measure has been introduced providing a financial supplement to dentists for each episode of care for a patient with a severe disability. This supplement is justified by completion of the French Case Mix tool (FCM), a new measure designed to retrospectively identify episodes of dental care that have required adaptation and additional time or expertise. The aim of this study was to investigate the validity and psychometric properties of the FCM. The content validity of the tool was improved at each round of pilot development, involving 392 patient encounters. Test-retest data at 2 weeks for 12 fictional patient treatment episodes were collected from 51 dentists. This phase confirmed inter- and intra-dentist reproducibility, criterion validity, and interpretability. Retrospective analysis of 4814 treatment episodes nationally demonstrated high reliability, internal consistency, and construct validity. Overall, the FCM showed high validity and good psychometric properties. However, the impact of providing a financial supplement on improving access to care for persons with special needs has yet to be evaluated.
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Affiliation(s)
- Denise Faulks
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63100 Clermont-Ferrand, France
- Service d’Odontologie, CHU Clermont-Ferrand, 63000 Clermont Ferrand, France
| | - Marie-Sophie Bogner
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, 63100 Clermont-Ferrand, France
- Service d’Odontologie, CHU Clermont-Ferrand, 63000 Clermont Ferrand, France
| | - Solenn Hamon
- Dental Surgery, 2 Rue de la Poudrette, 69100 Villeurbanne, France
| | - Caroline Eschevins
- Service d’Odontologie, CHU Clermont-Ferrand, 63000 Clermont Ferrand, France
| | - Bruno Pereira
- Direction de la Recherche Clinique et de l’Innovation, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
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43
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Faulks D. Oral health inequalities and disability: Closing the gap. Community Dent Oral Epidemiol 2023. [PMID: 36732929 DOI: 10.1111/cdoe.12843] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/03/2023] [Accepted: 01/17/2023] [Indexed: 02/04/2023]
Abstract
The social determinants of health impact disproportionately on disabled people creating a cumulative risk of unequal oral health outcomes, compounded by impairment. Problems in early life, education and employment, poor social status and support, social exclusion, poverty and stress characterize the life course of many disabled people. Ableism and exclusion combine to ensure that disabled voices are rarely heard, ignorance and indifference lead to prejudice in policy-making and enforcement and negative media attitudes fuelled by political austerity lead to stigmatization. Yet, the health disparities experienced by disabled people are still perceived as being uniquely caused by a medical condition or impaired body function, excluding disabled people from the inequalities discourse. In parallel, the influence of medical conditions within other marginalized groups are minimized (e.g. mental health), leading to the underestimation of the impact of disability on oral health generally. The common ground between all groups subject to oral health inequalities can be conceptualized using the WHO International Classification of Functioning. Outcomes for all might be improved by emphasizing this common ground; by considering disability as a primary variable, such as gender or age; by identifying disabled people within existing inequalities research; and by explicitly including disabled people in future research.
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Affiliation(s)
- Denise Faulks
- Université Clermont Auvergne, Centre de Recherche en Odontologie Clinique (CROC), Clermont-Ferrand, France.,CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
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44
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Rennane S, Dick A. Effects of Medicaid Automatic Enrollment on Disparities in Insurance Coverage and Caregiver Burden for Children with Special Health Care Needs. Med Care Res Rev 2023; 80:65-78. [PMID: 35788159 DOI: 10.1177/10775587221106116] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We analyze how Medicaid automatic enrollment policies for children with special health care needs (CSHCN) who are enrolled in Supplemental Security Income (SSI) reduce disparities in health insurance coverage and caregiving burden. Using the 2009-2010 National Survey of Children with Special Health Care Needs, we implement a difference-in-differences regression model comparing insurance enrollment rates between CSHCN receiving SSI and CSHCN not receiving SSI, in states with and without automatic enrollment policies. We find that Medicaid automatic enrollment has a meaningful impact on insurance enrollment for low-income CSHCN who participate in SSI and can be an effective method for mitigating disparities in insurance coverage (reducing uninsurance by 38%). Medicaid automatic enrollment also reduces caregiver burden among socioeconomically disadvantaged families with CSHCN. The effects of these policies are largest families who might be on the margin of eligibility or who face high administrative burden.
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45
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Franco Buitrago M, Muñoz Jara LM, Vargas Pérez ND, García García N. Adaptation Strategies in Students with Motor Functional Diversity. Invest Educ Enferm 2023; 41. [PMID: 37071868 PMCID: PMC10152915 DOI: 10.17533/udea.iee.v41n1e13] [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: 05/03/2023]
Abstract
OBJECTIVES The work sough to know the adaptation strategies of students from Universidad del Quindío with motor functional diversity. METHODS Descriptive qualitative study with a phenomenological approach. Data were collected through an in-depth interview with nine undergraduate students with moderate motor functional diversity, in face-to-face class attendance modality during the period 2022-2 at Universidad del Quindío (Colombia) with age ≥ 18 years and having scored from 20 - 40 in the Barthel index. The definition of the number of participants was conducted through theoretical saturation. RESULTS Seven categories emerged from the descriptive analysis of the interviews: 1) support; 2) affection; 3) life project; 4) personal growth; 5) spirituality; 6) autonomy, and 7) education. Together, they reveal important aspects on the way students have adapted to the university campus and how interpersonal relations can contribute to promoting resilience processes. CONCLUSIONS Support and affection provided by the social setting play a fundamental role in the adaptation of students with motor functional diversity, improving their mental health, generating resilience, and increasing their self-esteem. Noting that in spite of lifestyle changes after the acquisition of the diversity, the students set novel goals and develop new abilities that contribute to complying with their life project; likewise, they have set into practice and can recognize their coping mechanisms, acquiring qualities, like resilience and autonomy.
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Affiliation(s)
| | - Luisa María Muñoz Jara
- Undergraduate nursing student,Research Group: GRIEEQ, Universidad del Quindío, Colombia.
| | | | - Nancy García García
- Nurse, M.Sc. Profesora, Research Group: GRIEEQ, Universidad del Quindío, Colombia
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Skuban-Eiseler T, Orzechowski M, Steger F. Access to healthcare for disabled individuals: An analysis of judgments of the European Court of Human Rights from an ethical perspective. Front Public Health 2023; 10:1015401. [PMID: 36703847 PMCID: PMC9871461 DOI: 10.3389/fpubh.2022.1015401] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Individuals with disabilities (ID) suffer from restricted access to healthcare. This contributes to their poorer health status and constitutes an ethical challenge. The aim of this research was to systematically analyze judgments of the European Court of Human Rights (ECtHR) to illustrate examples of restricted access to healthcare for ID. Methods Through a search in the ECtHR's database we identified judgments dealing with access to healthcare for ID. The search resulted in n = 329 judgments, of which n = 55 were included in the analysis. A descriptive statistic was performed on Articles of the European Convention on Human Rights and violation of these articles. Qualitative thematic analysis was conducted to group the judgments in thematic categories. Results Most applications were filed against Russia (n = 23), followed by Poland (n = 8) and Ukraine (n = 7). The youngest applicant was 18, the oldest 72 years old. An overwhelming majority of cases dealt with disabled prisoners. Most of the judgments involved Article 14 and Article 8. We identified seven partially overlapping categories representing thematic patterns in the analyzed judgments. Discussion Any restriction of access to healthcare can be considered a violation of human rights. However, the results show a relatively low total number of judgments dealing with limited access to healthcare for ID. This could be a further confirmation of the fact that ID still experience too little attention in our societies. Especially in the context of detention, ID is restricted from receiving the healthcare they require. Indirect ways of a restricted access to healthcare should not be overseen.
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Affiliation(s)
- Tobias Skuban-Eiseler
- Faculty of Medicine, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany,kbo-Isar-Amper-Klinikum Region München, München-Haar, Germany,*Correspondence: Tobias Skuban-Eiseler ✉
| | - Marcin Orzechowski
- Faculty of Medicine, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Florian Steger
- Faculty of Medicine, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
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47
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Benz C, Dantas J, Welsh M, Norman R, Hendrie D, Robinson S. Telepractice implementation experiences during the COVID-19 pandemic, a qualitative exploration of Australian disability allied health providers: A diamond in the rough. Digit Health 2023; 9:20552076231211283. [PMID: 37936961 PMCID: PMC10627019 DOI: 10.1177/20552076231211283] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 10/13/2023] [Indexed: 11/09/2023] Open
Abstract
Telepractice has existed for decades, but as a result of the COVID-19 pandemic, it gained value and increased desirability across the disability service and health sectors, as a mitigation strategy for the viral transmission risk. The increased desirability of telepractice encouraged organisations to invest and correspondingly enhance access to services delivered remotely via digital technology including allied health therapy interventions. The investment and uptake of telepractice provided greater learning opportunities and ability to investigate telepractice implementation in specific contexts such as disability services, enabling service providers the ability to tailor to specific population needs. Methods This study investigated the experience of telepractice implementation during the COVID-19 pandemic from 13 allied health clinicians and managers of disability organisations across Australia between November 2021 and February 2022. A contextualist and critical realist theory was applied through the study, with reflective thematic analysis used as the data analysis method and findings described using a metaphor method centring on diamond formation. The method selection aimed to produce findings grounded in qualitative methodology and methods while remaining accessible to the disability community. Results An exploration and analysis of the data by the authors identified six themes addressing the experiences of participants and used the metaphor of diamond formation to describe changes in allied health clinicians and disability organisations during the COVID-19 influenced telepractice implementation. Conclusion The allied health clinicians and managers who participated in this study demonstrated an overall sense of hope that telepractice would be a viable and sustainable delivery pathway for services in the future. This article endorses the integration of a planned telepractice delivery pathway that capitalises on the momentum created by the COVID-19 pandemic in a purposeful and accessible way that looks to enhance rather than replace current practices.
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Affiliation(s)
- Cloe Benz
- School of Population Health, Curtin University, Bentley, Australia
| | - Jaya Dantas
- School of Population Health, Curtin University, Bentley, Australia
| | - Mai Welsh
- Clinical Department, Rocky Bay, Mosman Park, Australia
| | - Richard Norman
- School of Population Health, Curtin University, Bentley, Australia
| | - Delia Hendrie
- School of Population Health, Curtin University, Bentley, Australia
| | - Suzanne Robinson
- School of Population Health, Curtin University, Bentley, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Melbourne, Australia
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Fuentes K, Ragunathan S, Lindsay S. Varieties of 'new normal': Employment experiences among youth with and without disabilities during the reopening stages of the COVID-19 pandemic. Work 2023; 76:1293-1310. [PMID: 37355931 DOI: 10.3233/wor-230011] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Working and volunteering in the reopening stages of the COVID-19 pandemic has looked different depending on the location, employment sector and nature of the job. Although researchers have begun exploring the impacts on adults, little is known about what the transition to a 'new normal' in the reopening stages has been like for youth, especially those with disabilities. OBJECTIVE To explore and compare the experiences and perspectives of youth with and without disabilities who were working, volunteering or seeking work during the re-opening stages of the COVID-19 pandemic in Canada. METHODS We used a qualitative design involving semi-structured interviews with 16 youth (seven with a disability, nine without), aged 15-29 (mean 22 years). Thematic analysis was used to analyze the data. RESULTS Five main themes were identified: (1) Mixed views on being onsite in the reopening stages; (2) Mixed views on remaining remote; (3) Hybrid model as the best of both worlds; (4) Mixed views on COVID-19 workplace safety in the reopening stages; and (5) Hopes, dreams and advice for the future. Apart from the first main theme, there were more similarities than differences between youth with and without disabilities. CONCLUSION Our study highlights that youth encountered various work and volunteer arrangements during the reopening stages of the pandemic, and the personal preferences for particular models depend largely on their employment sector. The areas of agreement among youth highlight some longer-term impacts of the pandemic shutdowns and point to the need for greater mental health and career supports.
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Affiliation(s)
- Kristina Fuentes
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON,Canada
| | - Sharmigaa Ragunathan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON,Canada
| | - Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON,Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON,Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON,Canada
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Park S, Park JH. Disability and Emergency Department Visits: A Path Analysis of the Mediating Effects of Unmet Healthcare Needs and Chronic Diseases. Inquiry 2023; 60:469580231182863. [PMID: 37335048 DOI: 10.1177/00469580231182863] [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] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Previous studies identified disabilities and unmet healthcare needs, especially those related to primary healthcare, as predictors of ED use. This study examined the relationship between disability, unmet healthcare needs, chronic diseases, and ED visits in South Korea. This study was a cross-sectional study using the Korean Health Panel Survey collected in 2018. A path analysis was used. Our research found a significant association between disability and ED visits mediated by unmet healthcare needs and chronic diseases. Disability had a significant direct effect on unmet healthcare needs (β = .04, P ≤ .001) and chronic diseases (β = .10, P ≤ .001). However, there was no mediating effect of unmet healthcare needs between disability and ED visits. While barriers to access to care among people with disabilities are widely acknowledged, this study suggests that interventions or programs to reduce ED visits should consider the unique healthcare needs of people with disabilities.
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D'Cunha NM, Isbel S, Goss J, Pezzullo L, Naumovski N, Gibson D. Assistive technology, information asymmetry and the role of brokerage services: a scoping review. BMJ Open 2022; 12:e063938. [PMID: 36574986 PMCID: PMC9806033 DOI: 10.1136/bmjopen-2022-063938] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Access to assistive technologies (ATs) is a human right for people with disabilities, but there are a range of barriers, including lack of adequate information. This review aimed to explore the implications of information asymmetry on the delivery of AT and to investigate if there are effective and equitable ways of providing AT brokerage services to people needing AT. DESIGN Scoping review. DATA SOURCES EBSCO Medline, EBSCO Cinahl, Academic Search Ultimate, Business Source Ultimate, Proquest Central, Scopus, Web of Science, PsychINFO, EconLit and JSTOR were searched through 18 July 2021. ELIGIBILITY CRITERIA Intervention and observational studies and articles directly related to information asymmetry and brokerage in the context of AT were included. In addition, a scan of web-based resources and services was undertaken. DATA EXTRACTION AND SYNTHESIS Four authors independently screened the articles for inclusion and performed a narrative synthesis. RESULTS Thirty-three articles were identified. The narrative synthesis showed that: (1) AT users want access to impartial information sources; (2) users want to be involved in AT selection; (3) users benefit from access to demonstration sites; (4) users want access to training and ongoing support in their use of AT; and (5) users want access to information on new and emerging technologies. Access to information and user engagement, we produced better outcomes and satisfaction. Web-based repositories are valuable for user research and peer feedback, while demonstration sites address the need for expert advice, trial use of equipment, training and support in equipment use and maintenance. CONCLUSIONS Access to impartial information brokerage is critical to optimise AT selection. The implications of information asymmetry include lower user satisfaction, equipment underutilisation or abandonment. Aspects such as access to demonstration sites and web-based resources were also important.
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Affiliation(s)
- Nathan Martin D'Cunha
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Stephen Isbel
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - John Goss
- Health Research Institute, University of Canberra, Kaleen, Australian Capital Territory, Australia
| | - Lynne Pezzullo
- Well and Wise Health, Australian Capital Territory, Canberra, Australian Capital Territory, Australia
| | - Nenad Naumovski
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Diane Gibson
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
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