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The purpose of this exploratory research was to examine perceptions of mothers with children with disabilities (CWD) in Kuwait in order to understand the meaning of disability from their perspective and to explore the extent to which such perceptions influence rehabilitative services that their children receive. Ten semi-structured interviews were conducted with mothers of CWD receiving services at a large pediatric facility in Kuwait. Four themes emerged from the interviews: (1) mother's perceptions of disability, (2) mother's extended caregiver role, (3) religious beliefs as a coping strategy, and (4) perception of rehabilitation services. Our findings suggest that despite a traditional acceptance of disability as divine intervention or a challenge sent to them by God, mothers were motivated to maximize rehabilitation services in order to improve the functional capacity of their children. Kuwaiti mothers may hold both the fatalistic view of disability, and the belief that the course of disability can be altered through a rehabilitative intervention, in tension. An appreciation of this phenomenon might move toward a rehabilitation delivery model that integrates and harmonizes such beliefs.

Michel D Landry1, Elham Hamdan2, Sabriya Al Mazeedi3, Dina Brooks41Assistant Professor, Department of Physical Therapy at the University of Toronto (Canada), and holds a Career Scientist Award from the Ontario Ministry of Health and Long Term Care; 2Medical Director and Senior Research Fellow, Fawzia Sultan Rehabilitation Institute (Kuwait); 3Physical Therapist and Senior Research Fellow, Fawzia Sultan Rehabilitation Institute (Kuwait); 4Associate Professor, Department of Physical Therapy at the University of Toronto (Canada), and holds a Canada Research Chair in Rehabilitation for Chronic Obstructive Pulmonary DiseaseAbstract: Chronic obstructive pulmonary disease (COPD) is becoming a critical health concern that affects people living in high-, middle-, and low-income countries. Pulmonary rehabilitation (PR) has been demonstrated to be a clinical and cost-effective approach to minimizing the effects of COPD. Despite global predictions of an increased incidence of COPD, there continues to be an important misalignment between the demand and the supply of PR services. In other words, only a small proportion of individuals with COPD who require, or would benefit from, PR programs are receiving them on the global stage. This issue may be even more pronounced in middle- and low-income countries where the burden of disease is reported to be highest, and where access to health services and trained health professionals appears be to lowest. Given this predicament, we suggest that PR services must be viewed as an effective way in which to generate clinical efficiencies within health systems, and has the potential to relieve pressure on acute care systems. Although implementing PR programs require commitment and financial investment, we argue that such investments would yield important social and aggregated financial cost savings in the long term.Keywords: global health, supply, demand, rehabilitation, health reform

Background The prevalence of carpal tunnel syndrome (CTS) is not well understood in many Arabian Peninsula countries. The objective of this study was to investigate the prevalence and factors associated with self-reported CTS in Kuwait. Findings A cross-sectional, self-administered survey of CTS-related symptoms was used in this study. Multivariate logistic regression was also used to estimate adjusted odds ratios for factors of interest. Participants in this study were adult office workers in Kuwait (n = 470, 55.6% males), who worked in companies employing more than 50 people. Self-reported CTS was reported in 18.7% of the group (88/470). CTS was significantly associated with the following demographic factors: female gender, obesity and number of comorbid conditions. Self-identification of CTS was also associated with key symptoms and impairment in daily activities (e.g., wrist pain, numbness, weakness, night pain, difficulty carrying bags, difficulty grasping [Chi-Square Test for Association: P Conclusions Prevalence of self-reported CTS among office workers in Kuwait is 18.7%, and the risk factors for CTS in this population included female gender, obesity and number of related comorbidities. The frequency of symptoms in the sample who did not self report CTS suggest that CTS may be under-recognized, however further research is required to assess the prevalence of clinically diagnosed CTS.