Search

Introduction: Doctors with disability are likely to face major life crises, challenges and distressing emotions from unforeseen circumstances that threaten their physical well-being. We aimed to identify the existence of work-related pain and discomfort that may cause surgeon's disability. Surgeons who were struck with unpredictable disasters leading to disabilities were also reviewed., Methods: We conducted a 10-year literature review. In addition, citations about surgeons' physical disabilities were complemented with commentaries about disabled surgeons from gray literature. The quantitative citations were quality assessed by MERSQI scores and evidence graded according to GRADE. For the qualitative study part, the severely traumatized surgeons were analysed by means of Cullberg's crisis phases (CCP) and analysed from Tedeschi and Calhoun's post-traumatic growth perspective (PTG)., Results: Altogether 3593 citations from PubMed were studied, and 10 citations met inclusion criteria with a total of 11591 participants. We included 6 surgeons subjected to highly traumatic events complicating their medical career. Our quantitative citations' mean MERSQI score was 11.73 (SD .79) and the citations' evidence value completed grade II (moderate quality: 11.26 to 12.00 scores). Work-related musculoskeletal pain and occupational injuries may lead to physical disabilities. The accidentally traumatized surgeons fought through the four CCP phases and reached successfully the PTG stage., Conclusions: The surgical workforce is at high risk of work-related musculoskeletal morbidity which can progress to chronic pain and disruption of surgeon's career. Surgeons with disabilities faced serious barriers in their career. Institutions and healthcare systems must urgently develop support strategies for surgeons with disabilities.

Aims: People with disabilities (PWD) often face more significant oral healthcare needs than the general population. This study, conducted in response to the urgent and pressing need for improved dental care for PWD, aims to assess the infrastructural and work process flow of dental centers in Delhi that provide specialized dental care for PWD., Methods and Results: A descriptive cross-sectional study was conducted across primary, secondary, and tertiary healthcare centers in Delhi, evaluating their infrastructure adaptations and work processes in delivering oral healthcare to PWD. The findings, which highlight the disparities in adaptations and work processes among different healthcare centers, are crucial for understanding the current state of oral healthcare for PWD in Delhi. The study reveals that while secondary and tertiary healthcare centers exhibit better adaptations for PWD than primary centers, challenges persist with insufficient accessibility and smooth functioning of the work process., Conclusion: This study underscores the need for dentists to be equipped with the competence to address the unique needs of PWD. It also highlights the significant potential for improvement in oral healthcare for PWD, as dentists should become more aware of the importance of designing clinics that are accessible for PWD., (© 2024 Special Care Dentistry Association and Wiley Periodicals LLC.)

Background: Oral candidiasis (OC) is an oral health disease that could influence patients' oral health quality of life., Aim: To estimate prevalence of OC among disabled and non-disabled individuals and its potential risk factors in the Al-Baha region, Saudi Arabia., Methods: An observational cross-sectional study was carried out among 148 disabled and non-disabled participants. The technique of concentrated oral rinse employing the Sabouraud Dextrose Agar medium accompanied with 0.05% chloramphenicol was conducted to assess and isolate candida . Oral examination using the World Health Organization guidelines was conducted to examine participants' oral health status. A pre-designed questionnaire was also used to evaluate sociodemographic, medical history, and oral hygiene habits of the studied population., Results: Out of 148 participants ( n = 57, 38%) had colonized candida . None of the studied population had visible Candida lesions. However, Candida was found in the oral rinses without the subject presenting any lesions or issues caused by Candida (asymptomatic colonization). The most common prevalent OC among participants were Candida albicans , Candida glabrata , Candida dubliniensis , Candida krusei , Candida tropicalis , and Candida parapsilosis ( n = 35, 61%; n = 8, 14%; n = 6, 10%; n = 5, 9%; n = 2, 4%; and n = 1, 2%) respectively. Diabetes, smoking, poor plaque, and gingival status were key potential risk factors that significantly associated with candida 's density and presence ( P = 0.001, P = 0.001, P = 0.01, and P = 0.01) respectively. Disability status had no statistically significant effect on presence and density of Candida ., Conclusion: The prevalence of OC is almost third of the studied population; thus, may provoke a need to develop preventive strategies to reduce the OC rate and establish solid treatment plans., Competing Interests: Conflict-of-interest statement: The authors declare no conflicts of interest., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Introduction: The relationship between coaches and athletes with disabilities is critical for enhancing athletes' performance and psychosocial well-being. This study aims to provide evidence-based recommendations for coaches, sports organizations, and policymakers dedicated to supporting athletes with disabilities., Methods: A comprehensive analysis of existing literature was conducted. Five databases were searched, including PubMed, Web of Science, SPORTDiscus, Google Scholar, and China National Knowledge Infrastructure. A total of 22 studies were included for thematic analysis., Results: This systematic review identifies key factors influencing the coach-athlete relationship in disabled sports. These factors are categorized into three main domains: professional, interpersonal, and intrapersonal. In the professional domain, effective coaching requires sport-specific skills and adaptive techniques tailored to the unique needs of athletes with disabilities. Coaches must understand the technical and tactical aspects of each parasport and adapt training plans to optimize performance and foster independence. The interpersonal domain emphasizes communication strategies and team-building practices. Effective communication involves understanding athletes' needs and adapting approaches to maximize strengths. Building rapport, managing conflict, and fostering a supportive team environment are crucial for maintaining a positive coach-athlete relationship. The intrapersonal domain highlights the importance of self-reflection and continuous learning. Coaches who engage in self-reflection and professional development better understand their behaviors and biases, enabling them to tailor coaching strategies to the specific needs of athletes with disabilities. Continuous learning is essential for remaining responsive to the evolving needs of these athletes., Discussion: This review underscores the importance of a holistic approach that integrates professional expertise, interpersonal skills, and intrapersonal awareness. By addressing these factors, it provides a foundation for developing more effective coaching strategies and supports for athletes with disabilities, ultimately enhancing their performance and well-being. Future research should explore cultural differences, the specific coaching needs of athletes with intellectual disabilities, and the impact of policies and structural barriers on the coach-athlete relationship in disabled sports., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 Liu, Yu, Bleakney and Jan.)

Interaction and communication for normal human beings are easier than for a person with disabilities like speaking and hearing who may face communication problems with other people. Sign Language helps reduce this communication gap between a normal and disabled person. The prior solutions proposed using several deep learning techniques, such as Convolutional Neural Networks, Support Vector Machines, and K-Nearest Neighbors, have either demonstrated low accuracy or have not been implemented as real-time working systems. This system addresses both issues effectively. This work extends the difficulties faced while classifying the characters in Indian Sign Language(ISL). It can identify a total of 23 hand poses of the ISL. The system uses a pre-trained VGG16 Convolution Neural Network(CNN) with an attention mechanism. The model's training uses the Adam optimizer and cross-entropy loss function. The results demonstrate the effectiveness of transfer learning for ISL classification, achieving an accuracy of 97.5 % with VGG16 and 99.8 % with VGG16 plus attention mechanism.•Enabling quick and accurate sign language recognition with the help of trained model VGG16 with an attention mechanism.•The system does not require any external gloves or sensors, which helps to eliminate the need for physical sensors while simplifying the process with reduced costs.•Real-time processing makes the system more helpful for people with speaking and hearing disabilities, making it easier for them to communicate with other humans., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Background: There is a consensus among scholars, policymakers, and implementers that addressing the complex nature of intimate partner violence (IPV) requires a collaborative response. However, there is limited literature on how various professionals work collaboratively to address the needs of women with disabilities who experience IPV. This study combines the perspectives of women with disabilities and those of professionals to understand collaboration in providing IPV services to women with disabilities., Methods: Twenty-nine in-depth interviews were conducted with 18 IPV service providers and 11 women with disabilities. The data were analyzed using reflective thematic analysis., Results: The findings are presented under three themes: the first shows a consensus among different IPV service providers and disabled women on the importance of collaboration when supporting victims of IPV with disabilities; the second depicts the common ways in which collaboration occurs when supporting women with disabilities; and the third illuminates the critical elements that boost effective collaboration., Conclusion: Supporting IPV victims with disabilities requires active collaboration at both an internal and external level. Strengthening collaboration among different actors requires trust, specified roles, and the allocation of adequate resources., (© 2024. The Author(s).)

Background: Although malnutrition has been shown to influence the clinical outcome of poststroke disabled patients, the associated factors and the prediction model have yet to be uncovered., Objectives: This study aims to assess the current prevalence and factors associated with malnutrition in poststroke disabled patients and establish a prediction model., Methods: A multicenter cross-sectional survey among Chinese poststroke disabled patients (≥18 y old) was conducted in 2021. Information on patients' basic data, medical history, Barthel Index, dysphagia, and nutritional status was collected. A multivariable logistic regression model was used to identify the factors that influence malnutrition. Nomogram was developed and internal validation was conducted using 5-fold cross-validation. External validation was performed using the data from a preliminary survey. Receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis (DCA) were used to analyze the predictive value of the nomogram., Results: Four hundred fifty-seven cases were enrolled, with the prevalence of malnutrition as 71.77%. Age (aOR = 1.039, 95% CI: 1.006-1.078), pulmonary infection (aOR = 4.301, 95% CI: 2.268-14.464), dysphagia (aOR = 24.605, 95% CI: 4.966-191.058), total intake volume (aOR = 0.997, 95% CI: 0.995-0.999), Barthel Index (aOR = 0.965, 95% CI: 0.951-0.980), and nasogastric tube (aOR = 16.529, 95% CI: 7.418-52.518) as nutrition support mode (compared to oral intake) were identified as the associated factors of malnutrition in stroke-disabled patients (P < 0.05). ROC analysis showed that the area under the curve (AUC) for nomogram was 0.854 (95% CI: 0.816-0.892). Fivefold cross-validation showed the mean AUC as 0.829 (95% CI: 0.784-0.873). There were no significant differences between predicted and actual probabilities. The DCA revealed that the model exhibited a net benefit when the risk threshold was between 0 and 0.4., Conclusions: Age, pulmonary infection, dysphagia, nutrition support mode, total intake volume, and Barthel Index were factors associated with malnutrition in stroke-related disabled patients. The nomogram based on the result exhibited good accuracy, consistency and values., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Zeng Xi reports financial support was provided by Chinese Academy of Medical Sciences. Zeng Xi reports a relationship with The First Affiliated Hospital of Zhengzhou University that includes: employment. Cai Ang reports a relationship with The First Affiliated Hospital of Zhengzhou University that includes: employment. Zeng Hongji reports a relationship with Zhengzhou University that includes: employment. Wu Junfa reports a relationship with Huashan Hospital Fudan University that includes: employment. Ding Yu reports a relationship with Chinese PLA General Hospital that includes: employment. Zhao Weijia reports a relationship with Zhengzhou University that includes: employment. Zeng Xi has patent #CN109172380A with royalties paid to CN109172380A. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Although hepatitis B is vaccine-preventable, it remains a significant health problem. To the best of our knowledge, this is the first hepatitis B outbreak report from Türkiye., Aims: To investigate the cause of hepatitis B outbreak in a nursing home for the disabled and make recommendations for prevention., Methods: An outbreak of acute hepatitis B was declared in a nursing home for the disabled following the admission of 3 patients from the home in a hospital. Collaborative response was initiated with the Provincial Health Directorate through the Public Health Infectious Diseases Department. We began tracking the infection and monitoring active cases. Audits and controls were carried out to determine the source, establish protection and control measures, and prevent further transmission., Results: Six of the 65 nursing home residents were diagnosed with acute hepatitis B. Four of them had diabetes and their blood glucose levels were monitored for at least 12 months. Two of the patients had received dental treatment in the last 6 months. The frequency of both variables, which may be an indication of the transmission route, was statistically significantly greater in the acute hepatitis B group. All the patients who could be sequenced were identified as genotype D. While 3 patients recovered fully, 2 were diagnosed with chronic hepatitis B and one died due to fulminant hepatitis., Conclusion: Standard routine immunization should be implemented as a preventive measure for acute hepatitis B. Frequent supervision and training on hygiene practices and safety precautions should be conducted for care staff working in collective residential facilities., (Copyright: © Authors 2024; Licensee: World Health Organization. EMHJ is an open access journal. All papers published in EMHJ are available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Background: The Apple Watch (AW) Series 1 provides energy expenditure (EE) for wheelchair users but was found to be inaccurate with an error of approximately 30%, and the corresponding error for heart rate (HR) provided by the Fitbit Charge 2 was approximately 10% to 20%. Improved accuracy of estimated EE and HR is expected with newer editions of these smart watches (SWs)., Objective: This study aims to assess the accuracy of the AW Series 4 (wheelchair-specific setting) and the Fitbit Versa (treadmill running mode) for estimating EE and HR during wheelchair propulsion at different intensities., Methods: Data from 20 manual wheelchair users (male: n=11, female: n=9; body mass: mean 75, SD 19 kg) and 20 people without a disability (male: n=11, female: n=9; body mass: mean 75, SD 11 kg) were included. Three 4-minute wheelchair propulsion stages at increasing speed were performed on 3 separate test days (0.5%, 2.5%, or 5% incline), while EE and HR were collected by criterion devices and the AW or Fitbit. The mean absolute percentage error (MAPE) was used to indicate the absolute agreement between the criterion device and SWs for EE and HR. Additionally, linear mixed model analyses assessed the effect of exercise intensity, sex, and group on the SW error. Interclass correlation coefficients were used to assess relative agreement between criterion devices and SWs., Results: The AW underestimated EE with MAPEs of 29.2% (SD 22%) in wheelchair users and 30% (SD 12%) in people without a disability. The Fitbit overestimated EE with MAPEs of 73.9% (SD 7%) in wheelchair users and 44.7% (SD 38%) in people without a disability. Both SWs underestimated HR. The device error for EE and HR increased with intensity for both SWs (all comparisons: P<.001), and the only significant difference between groups was found for HR in the AW (-5.27 beats/min for wheelchair users; P=.02). There was a significant effect of sex on the estimation error in EE, with worse accuracy for the AW (-0.69 kcal/min; P<.001) and better accuracy for the Fitbit (-2.08 kcal/min; P<.001) in female participants. For HR, sex differences were found only for the AW, with a smaller error in female participants (5.23 beats/min; P=.02). Interclass correlation coefficients showed poor to moderate relative agreement for both SWs apart from 2 stage-incline combinations (AW: 0.12-0.57 for EE and 0.11-0.86 for HR; Fitbit: 0.06-0.85 for EE and 0.03-0.29 for HR)., Conclusions: Neither the AW nor Fitbit were sufficiently accurate for estimating EE or HR during wheelchair propulsion. The AW underestimated EE and the Fitbit overestimated EE, and both SWs underestimated HR. Caution is hence required when using SWs as a tool for training intensity regulation and energy balance or imbalance in wheelchair users., (©Marius Lyng Danielsson, Melanie Vergeer, Guy Plasqui, Julia Kathrin Baumgart. Originally published in JMIR Formative Research (https://formative.jmir.org), 07.05.2024.)

The aim of this scoping review was to gather, summarize, and map the knowledge of peoples' experiences on humanoid robots, capable of assisting people with activities of daily living. The review was guided by the framework of Joanna Briggs Institute and PRISMA-ScR. We found 44 papers describing nine robots that could assist with a variety of tasks listed in the International Classification of Functioning, Disability, and Health. The mixed population experienced little or no anxiety toward the robots, and most accepted the robots' ability to monitor for safety reasons. Some participants disliked the robots' large size and slow movements. Most of the participants found the robots easy to use. They wanted improvements in the robots' functionality and the ability to personalize services. Several of the participants found the services interesting and useful, but not for themselves. The experiences of humanoid robotic assistance showed an insufficient level of technical readiness for assisting in physical assistance, a lack of personalization and readiness for use in home settings. The practical relevance of these findings lies in guiding future research and development toward a more individualized approach focusing on user needs and experiences to enhance the efficacy and integration of humanoid robots in health-care.

Background: Stress is faced by every individual in their day-to-day life activities. During pandemic, most people have experienced multiple episodes of depression, anxiety, and insomnia. Several medical and dental problems are reported with stress and the fastest and easiest way to study and investigate is through body fluids, mainly saliva. Hence, we aim to study salivary α amylase in disabled individuals and hypothesize that salivary α amylase could be a reliable stress biomarker in disabled individuals., Materials and Methods: Cross-sectional study was conducted including 200 individuals grouped into controls (100) and disabled individuals (100). Disabled individuals were further grouped into physically (50) and mentally (50) disabled. Stimulated and unstimulated saliva was collected from all the participants and were investigated for salivary α-amylase by direct substrate method. The enzyme activity was analyzed using a spectrophotometer and the obtained were analyzed statistically., Result: Salivary α-amylase showed significant difference between controls and disabled group (p = 0.000). Salivary α-amylase was least in the mentally disabled group compared to physically disabled group. Age related comparison of salivary α-amylase was higher in physically disabled whereas gender related comparison showed females in physically disabled group to be more affected than controls., Conclusion: Saliva, the easy and most researched fluid, is rich in salivary α-amylase. Salivary α-amylase is a potential biomarker to assess stress. Further diagnostic studies are required to know the salivary changes and their influence on individual general health status., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Oral and Maxillofacial Pathology.)

Background: People with disabilities are marginalised in mainstream culture and they also experience increased restrictions in a variety of areas, such as sport. The barriers they encounter may adversely affect their life satisfaction, especially if they have a low perceived sense of autonomy and resilience. The purpose of this study was to investigate the relationship between autonomy, resilience and life satisfaction in para-badminton athletes and the mediating role of resilience in the relationship between autonomy and life satisfaction., Methods: Data were collected from 137 para-badminton athletes (male: 65.0% and female: 35.0%). Self-reported measures were used to assess the participants' autonomy, resilience and life satisfaction levels., Results: A structural equation model analysis was performed; the model had sufficient fit indices (comparative fit index [CFI] = 0.94, root mean square error of approximation [RMSEA] = 0.06, standardised root mean square residual [SRMR] = 0.07). The findings showed that autonomy had a significant effect on resilience ( β = 0.32, P = 0.001). Further, resilience had a significant effect on life satisfaction ( β = 0.19, P = 0.011) and significantly mediated the effect of autonomy on life satisfaction ( β = 021, P = 0.033)., Conclusion: This study revealed that autonomy fosters resilience among athletes, in turn allowing them to achieve greater life satisfaction. Therefore, society and sport communities should actively seek ways to improve the autonomy and resilience levels of athletes with disabilities., Competing Interests: Conflict of Interest: None., (© Penerbit Universiti Sains Malaysia, 2024.)

(1) Background and Methods : This study evaluated characteristics of South Korean patients necessitating home-based primary care (HBPC) from 2018 to 2022, distinguishing between homebound individuals with chronic conditions and those with registered disabilities. (2) Result : Among 171 HBPC recipients, 56.1% were homebound, predominantly older with a median age of 81 years (interquartile range (IQR 68.5-86.0)), while 43.9% were disabled, generally younger with a median age of 39 years (IQR, 28-64). Activities of daily living were assessed, revealing a median score of 14 (IQR, 10-19), indicative of high care dependency. The most common conditions among homebound patients were dementia (27.1%) and physical mobility difficulties (21.9%), whereas mental disabilities (53.3%) and mobility issues (36.0%) prevailed in disabled patients. The primary HBPC needs for homebound patients included management of acute medical conditions (27.1%) and sores (17.7%). Conversely, regular health check-ups (46.7%) and management of neuropsychiatric symptoms (26.7%) were prevalent among the disabled group. (3) Conclusion : Notably, over 90% of HBPC patients required assistance with daily activities, highlighting significant differences in the needs and characteristics between older, homebound individuals with multiple comorbidities and younger, disabled patients receiving medical aid. These insights emphasize the necessity to develop customized HBPC programs to adequately cater to the diverse patient needs within South Korea.

This study investigated the risk of heatwaves for people with disabilities and other socioeconomic attributes using Health Care Bigdata in South Korea. The Health Care Bigdata provides detailed information on heat-related illness (HRI) patients in 2011-2020 from seven major cities. We employed the Distributed Lag Nonlinear Model (DLNM) to measure heat waves' relative risk. Our findings are four-fold. First, the relative risk (RR) of disabled people was 5.075 (95% confidence interval 4.476-5.674), significantly surpassing that of non-disabled people, 3.296 (2.517-4.075). Second, among various personal characteristics studied, disability influenced RR the most, exceeding impacts from elderly (4.457: 3.748-5.166), low-income (3.909: 3.004-4.813), and outdoor (4.052: 2.940-5.164). Third, the disabled young group (5.305: 4.414-6.195) was more vulnerable than the non-disabled elderly group (4.287: 3.576-4.999). Lastly, no significant difference in relative risk was observed between the mild (4.413: 3.855-4.971) and severe disabled groups (4.013: 3.121-4.905)., (© 2024. The Author(s).)

Background: Ocrelizumab is a commonly used anti-CD20 monoclonal antibody with efficacy in the treatment of both relapsing-remitting (RRMS) and primary progressive (PPMS) multiple sclerosis. Real world use of ocrelizumab in MS patients with higher levels of motor disability requiring a walker or a wheelchair is not well characterized as these populations were excluded from initial studies. Higher levels of disability may be a barrier to treatment access. This study aimed to describe the access to, and tolerability and therapeutic outcomes of ocrelizumab in highly disabled MS patients in a real-world setting., Methods: As part of an ongoing study of ocrelizumab treatment access, barriers, and outcomes in MS patients at the Brigham MS Center, we retrospectively reviewed all patients with an Expanded Disability Status Scale (EDSS) of 6.5 or greater at the time of ocrelizumab initiation. All patients were started on ocrelizumab by their treating providers prior to this study initiation. Patients were excluded for recent rituximab exposure, co-treatment with more than one immunosuppressant, or alternative diagnoses contributing to high EDSS. Data was collected on incidence and severity of side effects while on ocrelizumab, persistence of treatment beyond one year, and MS stabilization versus progression while on this treatment., Results: Of the 1219 patients on ocrelizumab between 2017 and 2021, 113 (9.3 %) had EDSS of 6.5 or greater at the time of ocrelizumab initiation. Of the 113, 51 (45.1 %) were excluded: 6 (5.3 %) because they were duplicates or didn't receive ocrelizumab at our center, 25 (22.1 %) due to rituximab treatment in the previous year, 16 (14.2 %) due to lack of at least 1 year of follow up, and 4 (3.5 %) due to relevant comorbidities/treatment with other immunosuppressants. 62 patients were included in the final analysis. At ocrelizumab start, mean age was 62.1 +/- 8.7 years and median EDSS was 7.0 (range 6.5 to 9.5). Ocrelizumab was started in 26 of the included 62 patients (41.9 %) because of objective clinical disease worsening, in 17 (27.4 %) because of subjective worsening, in 8 (12.9 %) to prevent future progression. 32 patients (51.6 %) continued ocrelizumab throughout the study period, with average length of ocrelizumab use of 36.5 +/- 17.0 months. 29 patients (46.8 %) experienced no side effects during the study period. 29 (46.7 %) patients discontinued treatment, and of those, 9 (31.0 %) cited more than one reason for discontinuation: 17 (58.6 %) cited side effects, 12 (41.4 %) cited progression/lack of benefit, 6 (20.7 %) cited the Covid19 pandemic, and 1 (3.4 %) cited financial issues as a reason for discontinuation. Over the course of the study, 16 (25.8 %) patients had disability worsening by EDSS, 5 (8.1 %) had disability improvement, and 41 (66.1 %) remained stable, with a median end EDSS of 7.0 (range 6.5 to 9.5). Importantly, 18 patients (29.0 %) reported subjective disease stability while on ocrelizumab., Conclusions: Ocrelizumab may lead to disease stabilization in a subset of highly disabled MS patients, but possible benefits need to be carefully balanced against the incidence of adverse events in this high-risk patient population., Competing Interests: Declaration of Competing Interest Maria Houtchens has received consulting income from Biogen, Genentech, Novartis, Serono, Genzyme. She also received research support from Biogen, Genzyme, Genentech. Danielle Howard is a clinical fellow funded by the National MS Society, and has received research support from Genentech and Novartis., (Copyright © 2023. Published by Elsevier B.V.)

Background: The study on oral health-related quality of life (OHRQoL) of disabled patients is rare but critical for welfare of patients. The aim of this study was to examine the effect of fixed implants in edentulous areas on OHRQoL in Korean disabled patients., Methods: The OHRQoL of 63 disabled individuals was evaluated using the Oral Health Impact Profile (OHIP)-14 questionnaires and studied by potential affecting variables such as age, sex, disability severity, and time of disability acquisition. Wilcoxon-signed rank tests were used to examine the OHIP-14 scores for those who had pre/post-fixed implants. Multiple linear regression analysis was used to examine the relationships between factors and OHIP-14 scores before and after implants. A partial correlation analysis was also performed to determine which variables influenced OHIP-14 scores before and after treatment. The Mann-Whitney test was employed for sex and time of disability acquisition analysis (α = 0.05)., Results: Significant improvement was found in OHIP-14 post-implant treatment scores (P < .001). After implant treatment, the severity of disability produced significantly different results (P = .009). Pearson's correlation coefficient between severity of disability and pre/post-implant OHIP-14 scores was 0.265 (P = .030). After controlling for severity of disability, the results showed older patients had lower OHIP-14 scores (P = .032). No differences were found for sex or time of disability acquisition (congenital vs. acquired)., Conclusions: Fixed implant treatment improved OHRQoL for disabled patients, and the severity of disability was positively correlated with improvement of OHRQoL. For patients with a similar level of disability, the OHRQoL decreased with age., (© 2023. The Author(s).)

Over the past two decades, there has been a growing shift away from the Social Model of Disability (SMD) in both theory and practice. This article aims to substantiate the relevance of SMD by addressing the main arguments against it and by identifying why and for whom it is still relevant. In the introductory section, we focus on the recent production of multiple disability models in order to contextualize their emergence and elucidate the reasons behind their proliferation. In the main section of the article, we critically engage with three lines of criticism against SMD in order to explain why it remains relevant and for whom. Our main point is that, in the context of the neoliberal capitalist era, the SMD is indispensable for all disabled persons who have been denied their dignity, both in material and cultural terms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Adam and Koutsoklenis.)

Background: Adolescents with disabilities experience alarmingly higher rates of depression and isolation than peers without disabilities. There is a need to identify interventions that can improve mental health and isolation among this underserved population. Innovations in virtual reality (VR) gaming "standalone" headsets allow greater access to immersive high-quality digital experiences, due to their relatively low cost., Objective: This study had three purposes, which were to (1) examine the preliminary effects of a low-cost, home-based VR multiplayer recreation and socialization on depression, socialization, and loneliness; (2) quantify the acceptability of the program as measured by participant adherence, total play time, and exercise time; and (3) identify and describe behavioral mechanisms that affected participant engagement., Methods: This was a single-group, pre- to postdesign trial. The intervention was conducted at home. Participants were recruited from a children's hospital. The intervention lasted 4 weeks and included 2×1-hour sessions per week of supervised peer-to-peer gaming. Participants used the Meta Quest 2 headset to meet peers and 2 coaches in a private party held digitally. Aim 1 was evaluated with the Children's Depression Inventory 2 Short Form and the University of California, Los Angeles Loneliness Scale 20 items, which are measures of social isolation and loneliness, respectively. Aim 2 was evaluated through the following metrics: participant adherence, the types of games played, friendship building and playtime, and program satisfaction and enjoyment., Results: In total, 12 people enrolled (mean age 16.6, SD 1.8 years; male: n=9 and female: n=3), and 8 people completed the program. Mean attendance for the 8 participants was 77% (49 sessions of 64 total possible sessions; mean 6, SD 2 sessions). A trend was observed for improved Children's Depression Inventory 2 Short Form scores (mean preintervention score 7.25, SD 4.2; mean postintervention score 5.38, SD 4.1; P=.06; effect size=0.45, 95% CI -0.15 to 3.9), but this was not statistically significant; no difference was observed for University of California, Los Angeles Loneliness Scale 20 items scores. Most participants (7/8, 88%) stated that they became friends with a peer in class; 50% (4/8) reported that they played with other people. Participants reported high levels of enjoyment and satisfaction with how the program was implemented. Qualitative analysis resulted in 4 qualitative themes that explained behavioral mechanisms that determined engagement in the program., Conclusions: The study findings demonstrated that a brief VR group program could be valuable for potentially improving mental health among adolescents with physical disabilities. Participants built friendships with peers and other players on the web, using low-cost consumer equipment that provided easy access and strong scale-up potential. Study findings identified factors that can be addressed to enhance the program within a larger clinical trial., Trial Registration: ClinicalTrials.gov NCT05259462; https://clinicaltrials.gov/study/NCT05259462., International Registered Report Identifier (irrid): RR2-10.2196/42651., (©Byron Lai, Raven Young, Mary Craig, Kelli Chaviano, Erin Swanson-Kimani, Cynthia Wozow, Drew Davis, James H Rimmer. Originally published in JMIR Formative Research (https://formative.jmir.org), 06.12.2023.)

With an increasing number of developed nations adopting elements of the social model of disability, early childhood intervention practice has evolved to place greater emphasis on an inclusive, ecological, and strength-based framework. Recent music therapy literature seems to align with this shift in policy and demonstrates how family-centered strategies can be promoted in homes. Although music therapy researchers have conducted studies in kindergartens and childcares, which are also fundamental naturalistic settings for children with disabilities, the overall breadth and nature of practice in these settings is unclear and has not been collated. This scoping review aims to identify the key characteristics of music therapy research in preschool settings that include children with disabilities, subsequently identifying key publication details, participants, therapeutic aims, outcome measures, study designs, preschool settings, delivery models, and choice of music therapy methods. A total of 19 peer-reviewed journal articles from 1988 to 2020 met inclusion and exclusion criteria, with more than half of the studies published during the last 15 years. Evaluation of these 19 studies reveals how funding policies and educational systems seem to inherently inform the application of music therapy research in early learning centers. Developmental perspectives and objectivist study designs underpin many of the included sources, with majority of the outcomes demonstrating music therapy's positive impact upon a child's development. Researchers outside of the United States should give greater focus to early childhood and collect data from preschools within their respective countries to broaden awareness on how music therapy can support children with disabilities in naturalistic settings., (© The Author(s) 2023. Published by Oxford University Press on behalf of American Music Therapy Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction and Objective: Disability has an individualized character, both in terms of causes and effects, including limitation of locomotor skills. This is the problem to a great extent determining the level of daily functioning and the quality of life. The aim of the study was assessment of locomotor capabilities according to the demographic, social and health characteristics, and the frequency of problems of daily life according to the scope of locomotor capabilities., Material and Methods: The study included 676 disabled aged 19-98; mean age 64. The survey was carried out using a standardized Disability Questionnaire., Results: Statistically significant differences in categories of locomotor capabilities were observed according to age, education, material standard, housing conditions, legal disability status, and degrees of disability. Ten problems varying in intensity occurred according to the scope of independent moving around: material difficulties, difficulties in settling office matters, loneliness (P<0.0001), too infrequent contacts with the family, negative attitude of surroundings towards disability, material dependence on others, lack of care by relatives and friends, difficult access to environmental nurse, difficult access to services from social worker, necessity of caring for a disabled person., Conclusions: Locomotor capabilities of the disabled decrease over 64. Low level of education, material standard and poor housing conditions are associated with decreased capabilities for independent moving around without limitations. The types and number of problems with which the disabled struggle depends on the scope of their capabilities for independent moving around. In every dimension of functioning disability belongs to the scope of issues of public health.

Background: Although there is a need for gender-specific health care, especially within the context of vocational rehabilitation for youth with disabilities, clinicians, trainees, and community service providers commonly report lacking training in gender-sensitive approaches. Therefore, an educational tool designed for clinicians working with youth, that addresses how to approach such issues, could help clinicians to augment the care they provide., Objective: The objective of our study was to conduct a pilot evaluation of an educational simulation for health care and service providers focusing on gender-sensitive approaches within the context of supporting youth with disabilities in vocational rehabilitation., Methods: We conducted a survey from May to September 2021 to assess the relevance of the simulation content, preliminary perceived impact on gender-sensitive knowledge and confidence, and open-ended feedback of a web-based gender-sensitive educational simulation. A total of 12 health care providers from a variety of professions who had experience working with youth in the context of vocational rehabilitation participated in the survey (11 women and 1 man)., Results: Most participants reported that the content of the simulation was relevant and comprehensive. The majority of participants reported that the simulation helped to increase their perceived knowledge or understanding of the topic, changed their perceived understanding of their intervention or approach, and informed their perceived confidence. Our qualitative findings from the open-ended questions highlighted three main themes: (1) relevance of the simulation content, (2) perceived impact for clinical practice (ie, gender-sensitive language and communication and building rapport with patients), and (3) perceived impact on organizational processes (ie, practices, policy, and privacy)., Conclusions: Our educational simulation shows preliminary potential as an educational tool for service providers working with youth who have a disability within the context of vocational rehabilitation. Further research is needed to assess the impact of the tool with larger samples., (©Sally Lindsay, Nicole Thomson, Sandra Moll, Angela Colantonio, Jennifer Stinson. Originally published in JMIR Formative Research (https://formative.jmir.org), 24.03.2023.)

Background: The aim of this review of the literature was to find and summarize relevant research evidence available within the scientific sources and gray literature in accordance with the JBI recommendations. Search question: What effect does Basal Stimulation have on the cognitive-behavioral functions or temperament of a preterm or disabled infant?, Methods: The following sources were searched: PSYCINFO, MEDLINE, PsycArticles, ERIC, Wiley Online Library, ProQuest Scopus, WOS, JSTOR, Google Scholar, and MedNar. The study contains an analysis of texts that have been published in the English, Czech, and German languages. The search time span was set at 15 years., Results: A total of 15 sources were found for the specified topic., Conclusions: In all cases, there was confirmation about the positive influence of the concept of "Basal Stimulation" on the cognitive-behavioral functions and temperament of premature and disabled children.

Background: The COVID-19 pandemic and other humanitarian emergencies exacerbate pre-existing inequalities faced by people with disabilities. They experience worse access to health, education, and social services, and increased violence in comparison with people without disabilities. Adolescents with disabilities are amongst those most severely affected in these situations. Using participatory research methods with adolescents can be more effective than other methods but may be challenging in such emergency contexts., Objectives: We conducted a scoping review to: 1) describe the literature and methods used in peer-reviewed and grey literature on adolescents (aged ten to nineteen) with disabilities' experience of COVID-19 and other humanitarian emergencies in low- and middle-income countries, and 2) identify research gaps and make recommendations for future research., Methods: The review followed a protocol developed using PRISMA guidelines and the Arksey and O'Malley framework. We searched grey and peer-reviewed literature between 2011 and 2021., Results: Thirty studies were included. Twelve were peer-reviewed, and of those seven used participatory methods. Humanitarian emergencies had adverse effects on adolescents with disabilities across health, education, livelihoods, social protection, and community participation domains. Surprisingly few studies collected data directly with adolescents with disabilities. Twenty-three studies combined data from non-disabled children, caregivers, and disabled adults which made it challenging to understand adolescents with disabilities' unique experience., Conclusions: Our review highlights both the scarcity of literature and the importance of conducting research with adolescents with disabilities in humanitarian contexts. Despite challenges, our review shows that it has been possible to conduct research with adolescents with disabilities to explore their experiences of humanitarian emergencies, and that these experiences were different from those of non-disabled adolescents. There is a need to disaggregate findings and support the implementation and reporting of rigorous research methods. Capacity development through partnerships between non-governmental organisations and researchers may improve reporting of methods.

Introduction: The disabled are a group with heterogeneous structure of causes and needs. Assessment of these causes and needs requires prospective studies in order to use the results within public health actions, indispensable for pursuing the challenges of sustained development. The aim of the study was determination of the problems and needs of the disabled in various areas of their functioning, according to such characteristics as: gender, age, causes of disability, place of residence, level of education, formal status of disability, and socio-economic standard., Material and Methods: The examined population were 676 disabled aged from 19-98, including 56.4% of females, and 43,6% of males; rural inhabitants constituted 38.0%. The study was conducted by the method of purposive sampling, using the following research tools: the Disability Questionnaire, and the Scientific-Research Protocol. Statistical analyses were performed by means of the statistical package IBM SPSS Statistics v. 27; the p values p<0.05 were considered statistically significant., Results: The most frequently occurring problems were material difficulties, lack of rehabilitation in the place of residence, hindered access to a physician, difficulties with settling official matters, loneliness, too infrequent contacts with the family, negative attitudes of the local community towards disability, and family disagreements. Some of these problems were significantly more frequent among rural inhabitants., Conclusions: The majority of the problems hindering daily life of the disabled fell within social rather than medical categories. Age, level of education, degree of disability, legal status, and material standard were most frequent determinants of the occurrence of health and social problems according to the place of residence.

Introduction and Objective: In each society there functions a group of the disabled who need assistance. The number and character of dysfunctional consequences determine the types of support, characteristics of health, medical and social problems, where a part of them are interdependent. The interdependence of these needs determine the consistency of rehabilitation actions, which result in the improvement of quality of life of disabled persons in their living environment, especially among rural inhabitants., Review Methods: The scientific medical, and sociological literature, as well as binding legal Acts from 1978-2021 were reviewed. Materials from Polish and English databases were analysed. Key words related to disability, its definition, models of disability, disability discrimination, inequalities in medical and social care, health and social needs, maps of needs, satisfaction with medical and social care, and quality of life were used., Brief Description of the State of Knowledge: Despite the fact that disability is a medical-social phenomenon, many reports concern only the treatment of the consequences of diseases, injuries, genetic/congenital or environmental defects. Disability is frequently identified with disease, which is inappropriate. Many researchers dealing with disability focus - quite rightly - on studies concerning social consequences, because they decide about the level of functioning of these persons in society and level of participation., Summary: Disability is not only a medical and social problem. Treatment does not end the essence of disability. Only interdisciplinary studies can change the life of these persons regarding great possibilities for their participation.

The article considers social hygienic characteristics of participants in warfare underwent treatment and rehabilitation in specialized medical organization. It is established that patients of neurological profile and with diseases of cardiovascular system predominated in the studied contingent. The high need for medical rehabilitation was determined according results of examination of participants in warfare by multidisciplinary rehabilitation team. The necessity of observance staging and continuity in carrying out rehabilitation measures at all levels is emphasized.

The purpose of this research is to install a handrail on sliding doors used in hospitals and nursing facilities to support the elderly and disabled to walk by themselves. Semi-automatic lifting equipment is utilised for the retractable handrail to make sure people in bad health are able to open the door using minimal force. This paper summarises ergonomic considerations to develop the product above. For example, the maximum opening force should be a certain value or less for the elderly and disabled to open the product effortlessly. Additionally, the initial opening force is required to be a certain degree for safe use. When the product is used as a handrail, the handrail is required to be stable and unshakable in opening or closing directions. The results obtained by having the elderly and disabled use the prototype demonstrated that it improves their walking abilities.

Background: Although robotic manipulators have great potential in promoting motor independence of people with motor impairments, only few systems are currently commercially available. In addition to technical, economic, and normative barriers, a key challenge for their distribution is the current lack of evidence regarding their usefulness, acceptance, and user-specific requirements., Objective: Against this background, a semiautonomous robot system was developed in the research and development project, robot-assisted services for individual and resource-oriented intensive and palliative care of people with amyotrophic lateral sclerosis (ROBINA), to support people with amyotrophic lateral sclerosis (ALS) in various everyday activities., Methods: The developed early-stage demonstrator was evaluated in a task-based laboratory study of 11 patients with ALS. On the basis of a multimethod design consisting of standardized questionnaires, open-ended questions, and observation protocols, participants were asked about its relevance to everyday life, usability, and design requirements., Results: Most participants considered the system to provide relevant support within the test scenarios and for their everyday life. On the basis of the System Usability Scale, the overall usability of the robot-assisted services for individual and resource-oriented intensive and palliative care of people with ALS system was rated as excellent, with a median of 90 (IQR 75-95) points. Moreover, 3 central areas of requirements for the development of semiautonomous robotic manipulators were identified and discussed: requirements for semiautonomous human-robot collaboration, requirements for user interfaces, and requirements for the adaptation of robotic capabilities regarding everyday life., Conclusions: Robotic manipulators can contribute to increase the autonomy of people with ALS. A key issue for future studies is how the existing ability level and the required robotic capabilities can be balanced to ensure both high user satisfaction and effective and efficient task performance., (©Robert Klebbe, Stefan Scherzinger, Cornelia Eicher. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 23.08.2022.)

Background: There are a large number of people suffering from disabilities and this number is rapidly rising. People with disabilities experience various hardships and are more vulnerable to mental health problems. Participating in different types of activities (e.g., leisure, social, etc.) has been shown to ameliorate people's mental health problems such as stress and depression. The aim of this study was to assess the effects of leisure and social activities on the mental well-being of the working disabled population in Korea., Methods: A total of 1521 disabled people aged between 15 and 64 were included in the study. The degree of participation in leisure (i.e., weekends or weekdays) and social activities, as well as stress and depressive symptoms, were measured using single-item questions. The association between participation in different activities (i.e., leisure and social) and mental health (i.e., stress and depression) was analyzed using a generalized estimating equation (GEE) model., Results: In the fully adjusted model, participation in leisure activities was associated with the level of stress, and less leisure participation was significantly associated with higher odds of stress. For example, in the "2 or fewer hours" group (odds ratio [OR] = 1.461, 95% confidence interval [CI] = 1.193-1.789) with the "5 h or more" group used as the reference for weekdays and the "5-9 h" group (OR = 1.223, 95% CI = 1.007-1.486) with the "10 h or more" group used as the reference for weekends. In terms of participation in social activities, increased participation was associated with lower levels of depression. For example, in the "Very much" group (OR = 0.314, 95% CI = 0.156-0.633) compared to the "Not at all" group., Conclusions: Participation in different activities was associated with better mental health outcomes in the working disabled population in Korea.

Purpose: The object of this systematic review is to examine the stigma status of people with disabilities and their families., Design and Methods: The systematic review was prepared based on the preferred reporting items for systematic review and meta-analysis protocols systematic review guidelines. The review was included thirteen studies., Findings: In the results of the study, it was revealed that people with disabilities experienced inequality and social exclusion, negative attitudes were observed regarding their appearance, also their families were subjected to stigmatization by the society, could not participate in social environments., Practice Implication: To prevent stigmatization, it is recommended that awareness in public be raised by providing community educations., (© 2021 Wiley Periodicals LLC.)

Background: The COVID-19 pandemic has inequitably impacted the experiences of people living with ill health/impairments or from minoritized ethnic groups across all areas of life. Given possible parallels in inequities for disabled people and people from minoritized ethnic backgrounds, their existence before the pandemic and increase since, and the discriminations that each group faces, our interest is in understanding the interplay between being disabled AND being from a minoritized ethnic group., Objective: The overarching aim of the Coronavirus Chronic Conditions and Disabilities Awareness (CICADA) project, building on this understanding, is to improve pandemic and longer-term support networks, and access to and experiences of care, services, and resources for these underserved groups, both during the pandemic and longer term, thereby reducing inequities and enhancing social, health, and well-being outcomes., Methods: This mixed methods study involves three "sweeps" of a new UK survey; secondary analyses of existing cohort and panel surveys; a rapid scoping review; a more granular review; and qualitative insights from over 200 semistructured interviews, including social network/map/photo elicitation methods and two subsequent sets of remote participatory research workshops. Separate stakeholder cocreation meetings, running throughout the study, will develop analyses and outputs. Our longitudinal study design enables the exploration of significant relationships between variables in the survey data collected and to the assessment of changes in variables over time, including consideration of varying pandemic contexts. The qualitative data will provide more granular detail. We will take a strengths and assets-based approach, underpinned by the social model of disability and by intersectional considerations to challenge discrimination. Our exploration of the social determinants of health and well-being is framed by the social ecological model., Results: The CICADA project was funded by the Health and Social Care Delivery Research (HSDR) Programme of the United Kingdom (UK) National Institute for Health and Care Research (NIHR) in March 2021 and began in May 2021. Further work within the project (84 interviews) was commissioned in March 2022, a substudy focusing on mental health, specifically in Northeast England, Greater Manchester, and the Northwest Coast of the United Kingdom. Data collection began in August 2021, with the last participants due to be recruited in September 2022. As of January 2022, 5792 survey respondents and 227 interviewees had provided data. From April 2022, the time of article submission, we will recruit participants for the substudy and wave 2 of the surveys and qualitative work. We expect results to be published by winter 2022., Conclusions: In studying the experiences of disabled people with impairments and those living with chronic conditions who come from certain minoritized ethnic groups, we are aiming for transformative research to improve their health and well-being., International Registered Report Identifier (irrid): DERR1-10.2196/38361., (©Carol Rivas, Kusha Anand, Alison Fang-Wei Wu, Louise Goff, Ruth Dobson, Jessica Eccles, Elizabeth Ball, Sarabajaya Kumar, Jenny Camaradou, Victoria Redclift, Bilal Nasim, Ozan Aksoy. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 01.07.2022.)

Medicare readmissions from the 5% national sample of Medicare Fee For Service claims were assessed to identify the contribution of various demographic or personal health history risk factors to the liklihood of readmission within 30 days of discharge. The Medicare population was evaluated as 2 cohorts based on their eligibility status: age (71.9%) or disability (18.1%). Roughly 12% of admissions for the aged population resulted in a readmission within 30 days, whereas ∼18% was true of the disabled population. Patients with a history of frequent emergency department visits or an urgent index admission had an increased risk for a readmission in both groups of beneficiaries. An important indicator for readmission risk was discharge status from the index hospital stay. In both categories of beneficiaries, individuals who were discharged against medical advice were 1.6 times more likely to experience a readmission. Most importantly, personal and social determinants of health (SDOH) documented preadmission and postdischarge were more evident for the disabled population than the aged. Furthermore, when pre- and postadmission spans for SDOH conditions were examined, (6 months before initial admission to 30 days postadmission), both the aged and disabled populations were statistically significantly more likely to experience readmissions if they had an SDOH diagnosis.

Background: There have been concerns regarding increased perioperative mortality, length of hospital stay, and rates of graft loss in kidney transplant recipients with functional limitations. The application of machine learning consensus clustering approach may provide a novel understanding of unique phenotypes of functionally limited kidney transplant recipients with distinct outcomes in order to identify strategies to improve outcomes. Methods: Consensus cluster analysis was performed based on recipient-, donor-, and transplant-related characteristics in 3205 functionally limited kidney transplant recipients (Karnofsky Performance Scale (KPS) < 40% at transplant) in the OPTN/UNOS database from 2010 to 2019. Each cluster’s key characteristics were identified using the standardized mean difference. Posttransplant outcomes, including death-censored graft failure, patient death, and acute allograft rejection were compared among the clusters Results: Consensus cluster analysis identified two distinct clusters that best represented the clinical characteristics of kidney transplant recipients with limited functional status prior to transplant. Cluster 1 patients were older in age and were more likely to receive deceased donor kidney transplant with a higher number of HLA mismatches. In contrast, cluster 2 patients were younger, had shorter dialysis duration, were more likely to be retransplants, and were more likely to receive living donor kidney transplants from HLA mismatched donors. As such, cluster 2 recipients had a higher PRA, less cold ischemia time, and lower proportion of machine-perfused kidneys. Despite having a low KPS, 5-year patient survival was 79.1 and 83.9% for clusters 1 and 2; 5-year death-censored graft survival was 86.9 and 91.9%. Cluster 1 had lower death-censored graft survival and patient survival but higher acute rejection, compared to cluster 2. Conclusion: Our study used an unsupervised machine learning approach to characterize kidney transplant recipients with limited functional status into two clinically distinct clusters with differing posttransplant outcomes.

The promotion of physical activity (PA) in various subgroups of the population such as people with physical disabilities has been spotlighted in the revised guidelines of The World Health Organization (WHO), Geneva, Switzerland. In order to update public health interventions, there is a need to identify factors that may promote or prevent engagement in PA for special subgroups of the population. This study aims to calculate the PA levels of individuals with and without physical disabilities in Saudi Arabia, their assessment of the environmental (EQoL), and the predictive role of EQoL in PA. The International Physical Activity Questionnaire (IPAQ) and the EQoL domain in standardized WHOQoL Questionnaire were administered on both groups of the population. The study sample comprised 116 individuals with physical disabilities and 243 individuals without any form of disability as a control group. A regression analysis was performed to analyze the predictors of PA in both groups. Findings showed that among the individuals with disabilities, older people were more likely to engage in PA as compared to the younger age group (p < 0.05) and males were significantly less likely to meet the PA criteria. Some of the EQoL features such as safety increased the likelihood of PA up to 2.3 times (p < 0.05) in individuals with physical disabilities. In addition, opportunities for leisure activities were a significant predictor of PA among both groups of individuals with and without physical disabilities (p < 0.05). Our findings suggest that upcoming public health interventions should focus on improving various dimensions of EQoL for the promotion of physical activity among individuals with physical disabilities. Additional studies are needed to further explore various sociodemographic and environmental factors which can affect the PA status of disabled groups.

Background: Developing machine learning models to support health analytics requires increased understanding about statistical properties of self-rated expression statements used in health-related communication and decision making. To address this, our current research analyzes self-rated expression statements concerning the coronavirus COVID-19 epidemic and with a new methodology identifies how statistically significant differences between groups of respondents can be linked to machine learning results., Methods: A quantitative cross-sectional study gathering the "need for help" ratings for twenty health-related expression statements concerning the coronavirus epidemic on an 11-point Likert scale, and nine answers about the person's health and wellbeing, sex and age. The study involved online respondents between 30 May and 3 August 2020 recruited from Finnish patient and disabled people's organizations, other health-related organizations and professionals, and educational institutions (n = 673). We propose and experimentally motivate a new methodology of influence analysis concerning machine learning to be applied for evaluating how machine learning results depend on and are influenced by various properties of the data which are identified with traditional statistical methods., Results: We found statistically significant Kendall rank-correlations and high cosine similarity values between various health-related expression statement pairs concerning the "need for help" ratings and a background question pair. With tests of Wilcoxon rank-sum, Kruskal-Wallis and one-way analysis of variance (ANOVA) between groups we identified statistically significant rating differences for several health-related expression statements in respect to groupings based on the answer values of background questions, such as the ratings of suspecting to have the coronavirus infection and having it depending on the estimated health condition, quality of life and sex. Our new methodology enabled us to identify how statistically significant rating differences were linked to machine learning results thus helping to develop better human-understandable machine learning models., Conclusions: The self-rated "need for help" concerning health-related expression statements differs statistically significantly depending on the person's background information, such as his/her estimated health condition, quality of life and sex. With our new methodology statistically significant rating differences can be linked to machine learning results thus enabling to develop better machine learning to identify, interpret and address the patient's needs for well-personalized care., (© 2022. The Author(s).)

(1) Background: Virtual reality (VR) technology is a widely used training tool in medical education. The present study aimed to evaluate the effectiveness of VR training of oral hygiene students on providing oral healthcare to disabled elderly persons. (2) Methods: A randomized controlled trial was conducted. In 2021, oral hygiene students were randomly assigned to a VR experimental group (EG; n = 11) and a control group (CG; n = 12). The EG received two-hour, thrice-repeated VR-based training interventions at 2-week, 4-week, and 6-week follow-ups. The CG received no VR-based interventions. Data were collected using a self-administered questionnaire before and immediately after each intervention. We performed generalized estimating equations to compare the responses. (3) Results: The EG exhibited a more significant improvement in oral care-related knowledge, attitude, self-efficacy, and intention at the 6-week follow-up than the CG. The students' intention to assist the elderly in using interdental brushes (β = 0.91), with soft tissue cleaning (β = 0.53), and with oral desensitization (β = 0.53), and to have regular dental visits (β = 0.61) improved significantly at the 6-week follow-up. (4) Conclusions: VR training positively affected students' knowledge, attitude, self-efficacy, and intentions on providing oral healthcare to disabled elderly persons.

The COVID-19 quarantine in Mexico has meant that household members spend more time inside the home, increasing the demand for direct and indirect care by minors, the elderly, chronically ill and disabled. This forced a reconfiguration of the provision of these services by household members. The aim of the document is twofold: first, to describe socioeconomic and demographic aspects of Mexican households around care activities during the quarantine and second, to estimate the determinants of the provision of care in the quarantine. The information was obtained from the Survey of Care and COVID-19 in Mexican Homes during Quarantine (SCCMHQ). The propensity score-matching technique is used as a quasi-experimental procedure to estimate the causal effects of a treatment variable (presence of minors, elderly, chronically ill, disability, or domestic service in the home) in Mexican households. The Probit model shows that age and economic dependency are determinants of caregiving for treatment groups with minors, disability and chronic disease. In addition, sex, home income, and current employment situation are significant for treatment groups with a disability, paid domestic work, and minors, respectively. A positive "net" effect of the treatment variables in the probability of care provision was also observed. Particularly, the existence of minors at home was highly effective to promote direct and indirect care. The confinement solution is characterized by a balance between genders, except in the case of households with disabilities. This shows that a cultural and functional change is possible in the distribution of care responsibilities, which can be consolidated through public policies., Competing Interests: Conflict of interestNo potential conflict of interest was reported by the authors., (© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022.)

Introduction and Objective: The disabled are a group with a heterogeneous structure of causes and needs. The occurring physical, health, and social barriers constitute areas of public health. Assessment of these barriers requires systematic studies in order to use results supporting the tasks of public health, indispensable for pursuing the challenges of sustainable development. The aim of the study was to discuss the selected demographic, social, living and housing, as well as economic characteristics of the disabled rural and urban inhabitants, which are important for shaping the tasks of public health., Material and Methods: The study group consisted of 676 disabled aged 19 - 98 years, including 56.4% of females and 43.6% of males, 38.0% of whom lived in rural areas. The disabled were qualified into a study group by the method of targeted sampling. The research instruments were an author-constructed Disability Questionnaire, and the Research Protocol. Statistical analysis was performed using the software IBM SPSS Statistics v. 27. The p values p < 0.05 were considered statistically significant., Results: The level of risk of the phenomenon of disability was similar among both males and females. Higher risk was observed among widows and widowers, females with a low level of education, the disabled in older age groups, as well as those living in rural areas, maintaining themselves on non-earned sources of income, and running a single person household. The main causes of disability were diseases., Conclusions: 1. The majority of the population in the study were disabled with a legal grade of disability. 2. The analyzed characteristics fell within two groups: demographic and social, and health characteristics with difficult to separate health and social problems. 3. The most important problems in the area of public health were specified. 4. It is necessary to conduct studies considering demographic and social variables in order to level-up health inequalities between the disabled and those able-bodied. Effective solving of barriers and risks embedded in the social, family, and occupational situation prevents secondary disability, and also provides an opportunity for sustainable development in this population group.

Objective: To investigate prevalence, incidence and profile of musculoskeletal injuries in para athletes., Design: Systematic review., Data Sources: Searches were conducted in MEDLINE, EMBASE, AMED, SPORTSDiscus, CINAHL and hand searching., Eligibility Criteria: Studies were considered if they reported prevalence or incidence of musculoskeletal injuries in para athletes. Study selection, data extraction and analysis followed the protocol. Meta-analyses were conducted to estimate the prevalence and incidence rate among studies and subgroup analyses investigated whether methodological quality and sample size of the studies influenced on the estimated injury prevalence and incidence. The Grading of Recommendations Assessment, Development and Evaluation system determined the strength of evidence., Results: Forty-two studies were included. The prevalence of musculoskeletal injuries was 40.8% (95% CI 32.5% to 49.8%). Because of imprecision, indirectness and inconsistency, the strength of evidence was very low quality. The incidence of musculoskeletal injuries was 14.3 injuries per 1000 athlete-days (95% CI 11.9 to 16.8). The strength of evidence was low quality because of imprecision and indirectness. The subgroup analyses revealed that the sample size influenced on estimated injury prevalence and methodological quality influenced on estimated incidence. Injuries were more prevalent in the shoulder, for non-ambulant para athletes, and in the lower limbs, for ambulant para athletes., Summary/conclusion: Para athletes show high prevalence and incidence of musculoskeletal injuries. Current very low-quality and low-quality evidence suggests that future high-quality studies with systematic data collection, larger sample size and specificities of para athletes are likely to change estimates of injury prevalence and incidence in para athletes., Prospero Registration Number: CRD42020147982., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Although the phenomenon of disability-related abuse has been well-documented in adults with disabilities, the occurrence of disability-related abuse in childhood has not been studied. Therefore, the purpose of this study was to establish proof of concept for childhood disability-related abuse. American adults ( n = 485) retrospectively report on physical, sexual, and disability-related abuse that they experienced before the age of 18. The sample consisted of 382 participants with no disability, 55 participants with an adult-onset disability, and 48 participants with a childhood-onset disability. Disability-related abuse was conceptualized as involving either (a) the denial of assistive technology or (b) the denial of care, permission, or assistance with an activity of self-care. Childhood denial of assistive technology was rare in all groups (1.3%-2.1%), but denial of care, assistance, or permission was significantly higher in the childhood-onset disability group (20.8%) than either the adult-onset (7.3%) or no-disability (6.5%) groups. The three groups did not significantly differ in the rates of reported childhood physical or sexual abuse. This study provides preliminary proof-of-concept evidence for childhood disability-related abuse, particularly denial of care.

Background: People with disabilities (PWD) often face structural and other barriers to community involvement and may therefore be at risk of loneliness. Yet, so far, this issue has received little attention., Objective: This cross-sectional study aimed to examine the association between disability and loneliness in nine countries of the former Soviet Union (FSU)., Methods: Data were analyzed from 18000 respondents aged ≥18 that came from the Health in Times of Transition (HITT) survey that was undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2010/11. Respondents reported on whether they had a disability (no/yes) and its severity. A single-item question was used to assess loneliness. Logistic regression analysis was used to examine the associations., Results: Across the countries, 6.8% of respondents reported being disabled. In a fully adjusted combined country analysis, disability was associated with higher odds for loneliness (odds ratio: 1.30, 95% confidence interval: 1.06-1.60). In an analysis restricted to PWD, individuals in the most severe disability category (Group 1) had over two times higher odds for loneliness when compared to those in the least severe disability category (Group 3)., Conclusions: Disability is associated with higher odds for reporting loneliness in the FSU countries and this association is especially strong among those who are more severely disabled. An increased focus on the relationship between disability and loneliness is now warranted given the increasing recognition of loneliness as a serious public health problem that is associated with a number of detrimental outcomes., Competing Interests: Conflicts of interest The authors declare that they have no conflicts of interest., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: People with disabilities (PWD) are at increased risk of poor mental health. However, this association and the pathways involved remain under-researched in many parts of the world. This study examined the association between disability and psychological distress in nine countries of the former Soviet Union (FSU)., Methods: Data were analysed from 18,000 adults aged ≥18 years collected during the Health in Times of Transition (HITT) survey undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine in 2010 and 2011. Information was obtained on disability status, the severity of the disability and psychological distress. Logistic regression analysis was used to estimate associations., Results: In a fully adjusted combined country analysis, disability was associated with over two times higher odds for psychological distress (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.86-2.58). The strength of the association varied across the individual countries. Among PWD more severe disability was associated with significantly higher odds for psychological distress (OR: 2.12, 95%CI: 1.26-3.55)., Limitations: The data were cross-sectional and disability status was self-reported, possibly resulting in underreporting., Conclusions: Disability is associated with worse psychological health in FSU countries, especially among those with more severe disabilities. As poor mental health may also increase the risk of negative outcomes in PWD, this finding highlights the importance of the early detection and treatment of mental disorders in PWD in these countries., (Copyright © 2021. Published by Elsevier B.V.)

The article considers the problem of access to stomatological care, in particular to prosthetic dentistry, for people with limited health capacities in conditions of the COVID-19 pandemic. The range of factors impeding to get quality dental services in state stomatological polyclinics and at home was established by empirical study organized in two Subjects of the Russian Federation located in the Central Federal Okrug.

This study aimed to compare rates of participation in physical activity according to the type of disability, sex, point of disability diagnosis (congenital vs. acquired), and ability to walk independently. The study involved individuals who were registered as disabled based on the 2020 Sports Survey for the Disabled project of the Korea Ministry of Health and Welfare. Participants (mean age: 49.94 ± 12.35 years) included those with physical disabilities ( n = 889), visual impairments ( n = 523), hearing/speech impairments ( n = 412), intellectual disabilities ( n = 561), and disabilities associated with brain lesions ( n = 364). Rates of severe (100%) and congenital disability (65.95%) were highest in the intellectual disability group. Acquired disability was most frequent in the physical disability group (94.71%). The highest frequency of independent walking ability was observed in the hearing/speech impairment group (99.27%). The rate of participation in physical activity was significantly higher in the acquired (odds ratio [OR] = 1.46, 95% confidence interval [CI] = 1.12-1.87, p = 0.005) and independent walking (OR = 1.43, 95% CI = 1.11-1.84, p = 0.005) hearing/speech impairment groups than in the corresponding physical disability groups after adjusting for age, sex, and severity. Our findings highlight the need to promote physical activity for people with physical and intellectual disabilities based on the factors examined in this study.

Background: The coronavirus pandemic, in particular the introduction of masks, presented a huge challenge for the UK's D/deaf community, many of whom rely on visual cues in lipreading and sign language. This particularly affected D/deaf healthcare professionals (HCPs), who faced significant communication challenges at work due to the lack of transparent masks or other reasonable adjustments., Aims: To determine the impact that a lack of transparent masks and reasonable adjustments had on communication, confidence at work and well-being among D/deaf HCPs during the coronavirus pandemic., Methods: A survey was sent to all members of the 'UK Deaf Healthcare Professionals Group' on Facebook, the 'Healthcare Professionals with Hearing Loss' listserver and promoted on Social Media., Results: Eighty-three responses were received. Nine (11%) individuals had access to transparent masks. Over three-quarters of respondents reported feeling anxious and fearful of making a mistake due to communication difficulties. Fourteen (17%) were removed from clinical roles due to a lack of reasonable adjustments. One-third felt they would need to consider an alternative career if improvements were not made. Seventy-eight per cent felt the communication needs of D/deaf HCPs had not been met during the pandemic., Conclusions: D/deaf HCPs felt left behind, isolated and frustrated by a lack of transparent masks and reasonable adjustments to meet their communication needs. Loss of experienced, qualified HCPs has a significant economic and workforce impact, particularly during a pandemic. Urgent action is needed to ensure D/deaf HCPs are provided with the workplace support required under the Equality Act (2010)., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Participatory action research (PAR) provides an opportunity for academic researchers and adolescents to co-conduct research within an area of shared interest. Reciprocal learning occurs as co-researchers acquire research skills and knowledge, and academic researchers gain understanding of the issue being examined, from the perspective of those with lived experience. All members of the research team have a shared responsibility for the research and decision-making processes. PAR has predominantly involved adults as co-researchers. However, in recent years more effort has been made to co-conduct research with adolescents. The aim of this review is to interrogate the practices of academic researchers employing a PAR approach when working along-side disabled adolescents. Methods/design: A critical interpretive synthesis (CIS) will be conducted, allowing for a diverse range of evidence to be drawn from. A systematic search of nine databases, from 1990 onwards, will be conducted first. Reference checking will occur to elicit further relevant data. Following screening, further purposive sampling will be completed to facilitate the development of concepts and theory in line with the on-going analysis and synthesis of findings. Data analysis will involve interpretation of included papers in relation to the principles of PAR and a 'best-practice' framework will be developed. During analysis particular emphasis will be given to the identification of potential social barriers to the participation of disabled adolescents in PAR.    Discussion: PAR is widely employed but little is known about its use when working with disabled adolescents. This current CIS will critically question the current practices of academic researchers employing PAR when working along-side disabled adolescents and future research through the best practice framework we will develop., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 McDonald F et al.)

The article analyzes dynamics of main indices of disability in population older than able-bodied age in the Rostov Oblast. The trend of decreasing of scope of examinations of individuals of the mentioned age group, including decreasing the number of first and iteratively recognized as the disabled, against the background of increasing in the population structure of percentage of individuals older than able-bodied age. At the same time, increasing of accumulated disability was established in the studied category of population.

Background: The mental health impact of the COVID-19 pandemic and quarantining on children and young people (CYP) living in low- and middle-income countries (LMICs) has yet to be fully comprehended. CYP in LMICs are at utmost risk, given the COVID-19-related restrictions and social distancing measures, resulting in reduced access to school-based services for nutritional and mental health needs. This study examined mental health of CYP during the first COVID-19 lockdown in Zambia and Sierra Leone., Method: A total of 468 disabled and disadvantaged CYP aged 12 to 25 completed a planning tool that comprised the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), as well as open-ended questions covering social connectedness, physical distancing and educational challenges during the lockdown. The community coaches screened individuals and families who could be eligible to receive emergency aid, and based on a convenience sample following distribution of aid, recipients were invited to complete the planning tool., Results: The data showed that participants in the global south have increasing anxieties and fears centred on accessing offline educational resources and income loss in the family effecting food security and their ability to return to education. Mean (SD) SWEMWBS scores for all participants in Zambia and Sierra Leone, were 19.61 (3.45) and 21.65 (2.84), respectively. Mental well-being scores were lower in females, children aged 12-14 and participants with two or more disabilities. Factors significantly associated with poor mental wellbeing in the sample were: type of disability, nationality, peer relationships, connection to others during the pandemic, knowledge about COVID-19, worry about the long-term impact of COVID-19, and the types of self-isolating., Conclusion: The study shows that participants who self-reported low levels of COVID-19 health literacy also scored low on the mental wellbeing self-assessment. Yet, despite undoubted limited resources, these CYP are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health.

Competing Interests: Conflicts of interest None disclosed.

There has been an increased emphasis on the voice of the child since the ratification of the United Nations Convention on the Rights of the Child in 1991. Since that time, health and social care researchers have increasingly involved disabled children and young people in research, rather than relying on the views of adults as proxies, for example, parents and professionals. Drawing on doctoral research and the extensive experience of the authors, the aim of this article is to critically reflect on "what worked" along with the challenges of interviewing the children and young people who took part. Practical and methodological issues, such as the need for thorough preparation, the interview process, understanding the children and young people and managing the presence of others are discussed. Finally, recommendations are made for future researchers, including making participation fun, using a sensitive and individualized approach and conducting multiple visits. It is only by considering these factors that we can meaningfully involve disabled children and young people and facilitate their participation in research interviews. Emphasis here is on the practical issues rather than ethical issues that have been published elsewhere.