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In this scoping review, we explore the literature pertaining to intergenerational trauma and assess its impact on the expression of disability

Background: To determine whether population-adjusted rates of physical rehabilitation need (ie, disability-related epidemiological data) are associated with the workforce supply (ie, combined rates of practicing physical therapists (PTs) and occupational therapists (OTs) per 10 000 population) across high-income countries (HICs), adjusted for socio-demographic and economic covariates. Methods: This is a cross-national ecological study. Hierarchical, multiple linear regressions analyzed current international data across 35 HICs using: current PTs and OTs supply data obtained from the international professional federations (outcome variable); needs data obtained from the Global Burden of Disease 2017 (GBD 2017); and finally relevant socio-demographic variables and supply-side covariates extracted from the World Bank, GBD 2017, the supply data sources, and the Global Health Expenditure Database. Results: The PTs and OTs per capita varied greatly across the 35 HICs, differing by as much as 40-fold. Denmark had the greatest supply per capita. Physical rehabilitation need was not a significant, independent predictor of workforce supply regardless of the multiple regression model used (P >.10). In the final model, after Bonferroni correction, 3 covariates were significant, independent predictors of the supply variable: gross national income (GNI) per capita and the current health expenditure in % of gross domestic product (GDP) were positive factors for workforce supply, while population size was a negative factor (all P

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Background: This study analyzes the current and evolving physical rehabilitation needs of BRICS nations (Brazil, Russian Federation, India, China, South Africa), a coalition of large emergent economies increasingly important for global health. Methods: Secondary, cross-national analyses of data on Years Lived with Disability (YLDs) were extracted from the Global Burden of Disease Study 2017. Total physical rehabilitation needs, and those stratified per major condition groups are analyzed for the year 2017 (current needs), and for every year since 1990 (evolution over time). ANOVAs are used to detect significant yearly changes. Results: Total physical rehabilitation needs have increased significantly from 1990 to 2017 in each of the BRICS nations, in every metric analyzed (YLD Counts, YLDs per 100,000 people, and percentage of YLDs relevant to physical rehabilitation; all p < 0.01). Musculoskeletal & pain conditions were leading cause of physical rehabilitation needs across the BRICS nations but to varying degrees: from 36% in South Africa to 60% in Brazil. Country-specific trends include: 25% of South African needs were from HIV-related conditions (no other BRICS nation had more than 1%); India had both absolute and relative growths of pediatric rehabilitation needs (p < 0.01); China had an exponential growth in the per-capita needs from neurological and neoplastic conditions (p < 0.01; r2 = 0.97); Brazil had a both absolute and relative growth of needs coming from musculoskeletal & pain conditions (p < 0.01); and the Russian Federation had the highest neurological rehabilitation needs per capita in 2017 (over than three times those of India, South Africa or Brazil). Conclusions: total physical rehabilitation needs have been increasing in each of the BRICS nations, both in absolute and relative values. Apart from the common growing trend, each of the BRICS nations had own patterns for the amount, typology, and evolution of their physical rehabilitation needs, which must be taken into account while planning for health and physical rehabilitation programs, policies and resources. publishersversion published

Background: Health policy, systems and services research (HPSSR) is increasingly needed to enable better access to, and value of, rehabilitation services worldwide. We aim to quantify the growth of Rehabilitation HPSSR publications since 1990, compared to that of overall rehabilitation research and overall HPSSR. Methods: Quantitative, comparative analysis of publication trends using the PubMed database and its indexation system. Comprehensive search filters, based on Medical Subject Headings (MeSH), were built and calibrated to locate research articles with content on HPSSR and rehabilitation of physical impairments. Additional filters were used for locating research publications declaring funding support, publications in rehabilitation journals, and finally publications focused on high-income (HICs) or low-and middle-income countries (LMICs). The same approach was used for retrieving data on comparator fields—overall HPSSR and overall rehabilitation research. Linear regressions, with ANOVA, were used for analyzing yearly publication growths over the 28-year time frame. Results: Rehabilitation HPSSR publications in PubMed have grown significantly from 1990 to 2017 in the percentage of all rehabilitation research (from 11% to 18%) and all HPSSR (from 2.8% to 3.9%; both p < 0.001). The rate of Rehabilitation HPSSR published in rehabilitation journals did not change significantly over time (p = 0.47). The rates of publications with declared funding support increased significantly, but such growth did not differ significantly from that of the comparator fields. Finally, LMICs accounted for 9.3% of the country-focused rehabilitation HPSSR since 1990, but this percentage value increased significantly (p < 0.001) from 6% in 1990 to 13% in 2017. Conclusion: Rehabilitation HPSSR publications, i.e., those indexed in PubMed with related MeSH terms, have grown in both absolute and relative values. Rehabilitation HPSSR publications focused on LMICs also grew significantly since 1990, but still remained a tiny portion of the Rehabilitation HPSSR publications with country-specific MeSH terms. publishersversion published

New Brunswick, a bilingual Canadian province without a medical school, negotiated an agreement in 1967 in which places were reserved for francophone medical students in the province of Quebec. In 2006, the Centre de Formation Médicale du Nouveau-Brunswick (CFMNB), a regional medical campus (RMC) of Université de Sherbrooke for its provincial francophone medical students, was established to increase the likelihood of graduates setting up practice in the region. Practice locations of the initial 5 cohorts of CFMNB were analysed to compare data with francophone students trained in Quebec.Practice locations were determined through Scott's Medical Database and provincial public registries. Chi-square and relative risk probability were used to examine the relationship between training location and practice location.Doctors trained at CFMNB were 1.4 times more likely to be practicing in Atlantic Canada compared to those trained at Université de Sherbrooke (main campus) before 2006. Those trained at CFMNB were 1.3 times more likely to go on to practice in the region compared to those trained at Université Laval or Université de Montréal.This study supports the hypothesis that individuals completing a medical program in a Francophone RMC in New Brunswick increases the likelihood of them later practicing in the province or in the wider Atlantic Canada region.Le Nouveau-Brunswick, une province canadienne bilingue ne possédant pas de Faculté de médecine, a négocié en 1967 une entente avec le Québec afin de réserver des places pour ses étudiants francophones souhaitant étudier la médecine. En 2006, le Centre de formation médicale du Nouveau-Brunswick (CFMNB), un campus médical régional (CMR) de l’Université de Sherbrooke, a été créé afin de permettre aux Néo-Brunswickois d’étudier la médecine en français dans leur province. L’un des objectifs principaux du CFMNB était d’augmenter les probabilités que les diplômés en médecine s’établissent dans la région. Les lieux de pratique des médecins issus des 5 premières cohortes du CFMNB ont été analysés afin de les comparer avec ceux des médecins francophones d’origine néo-brunswickoise formés au Québec.Les lieux de pratique ont été déterminés via le répertoire des médecins Scott’s et les registres publics provinciaux. Des tests de Chi carré et des analyses de risque ont été conduits afin d’étudier la relation entre le lieu de formation et le lieu de pratique.Les médecins formés au CFMNB étaient 1.4 fois plus enclins à travailler au Canada atlantique comparativement à ceux formés au campus principal de l’Université de Sherbrooke avant 2006. Les médecins formés au CFMNB étaient également 1.3 fois plus enclins à travailler dans la région que ceux formés à l’Université Laval ou à l’Université de Montréal.Cette étude supporte l’hypothèse selon laquelle le fait de compléter un programme de médecine francophone dans un CMR francophone au Nouveau-Brunswick augmente les chances de pratiquer au Nouveau-Brunswick ou dans la grande région du Canada atlantique.