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Using data from Vietnamese-origin older immigrants/refugees in the Houston, Texas area, we assessed their overall health, chronic conditions, disability, depressive symptoms, and cognitive impairment, and examined the association between their chronic conditions and disability by comorbidity clusters. The mean age of the sample was 76 years old. The majority were married in fair/poor health with several chronic conditions and disabilities and lived with families in low-income households. Hypertension and arthritis were the most common health conditions, but cognitive impairment had the most significant impact on their disability. They experienced similar health conditions to other older Americans but had higher rates of depressive symptoms and cognitive impairment possibly due to cultural factors that may have delayed mental health treatment. Culturally and linguistically tailored services created by policymakers, healthcare professionals, and local social service agencies are recommended for the well-being of immigrants/refugees who migrated to the U.S. for a better life.

The prevalence rates and correlates of mental or physical disability among recently resettled refugees, who undergo strenuous journeys before arriving in the US, remain unknown, masking potential health disparities. Self-reported disability was measured by the 2018 Annual Survey of Refugees (ASR), and defined as having a physical, mental, or other health condition for more than 6 months that precluded one from working. Prevalence rates of self-reported disability and sample correlates were investigated using descriptive and logistic regression analyses. Of N = 4259 participating refugees in ASR (Mean Age = 28.2, SD = 17.2; 52.5% male), 2875 responded to the disability question and 21.4% reported disability. About 33.7% were born in the Middle East region, 29.5% had no formal education, and 35% had an income of less than $15,000. Age (OR = 1.06, 95% Confidence Interval (CI) [1.06,1.07], p

BACKGROUND: Health disparities in osteoarthritis (OA) outcomes exist both in the occurrence and treatment of functional limitation and disability for Mexican Americans. Although the effect of self-management of chronic illness is well established, studies demonstrate little attention to self-management of function or disability, despite the strong potential effect on both and, consequently, on patients' lives. OBJECTIVE: The purpose of this study pilot was to develop and test key variable relationships for a measure of disability self-management among Mexican Americans. METHODS: In this sequential, two-phased, mixed-methods, biobehavioral pilot study of Mexican American women and men with OA, a culturally tailored measure of disability self-management was created, and initial relationships among key variables were explored. RESULTS: First, a qualitative study of 19 adults of Mexican American descent born in Texas (United States) or Mexico was conducted. The Mexican American Disability Self-Management Scale was created using a descriptive content analysis of interview data. The scale was tested and refined, resulting in 18 items and a descriptive frequency of therapeutic management efforts. Second, correlations between study variables were estimated: Disability and function were negatively correlated. Disability correlated positively with social support and activity effort. Disability correlated negatively with disability self-management, pain, and C-reactive protein. Function was positively correlated with age, pain, and depression. Liver enzymes (alanine transaminase) correlated positively with pain and anxiety. DISCUSSION: This mixed-methods study indicates directions for further testing and interventions for disability outcomes among Mexican Americans.

We present an overview of the Conference on Transformative Opportunities for Modeling in Neurorehabilitation held in March 2023. It was supported by the Disability and Rehabilitation Engineering (DARE) program from the National Science Foundations Engineering Biology and Health Cluster. The conference brought together experts and trainees from around the world to discuss critical questions, challenges, and opportunities at the intersection of computational modeling and neurorehabilitation to understand, optimize, and improve clinical translation of neurorehabilitation. We organized the conference around four key, relevant, and promising Focus Areas for modeling: Adaptation & Plasticity, Personalization, Human-Device Interactions, and Modeling In-the-Wild. We identified four common threads across the Focus Areas that, if addressed, can catalyze progress in the short, medium, and long terms. These were: (i) the need to capture and curate appropriate and useful data necessary to develop, validate, and deploy useful computational models (ii) the need to create multi-scale models that span the personalization spectrum from individuals to populations, and from cellular to behavioral levels (iii) the need for algorithms that extract as much information from available data, while requiring as little data as possible from each client (iv) the insistence on leveraging readily available sensors and data systems to push model-driven treatments from the lab, and into the clinic, home, workplace, and community. The conference archive can be found at (dare2023.usc.edu). These topics are also extended by three perspective papers prepared by trainees and junior faculty, clinician researchers, and federal funding agency representatives who attended the conference.

A disability is a significant issue that has posed and continues to pose a challenge. Disability is a basis of frustration because it can be observed as a mental, constraint, cognitive, and physical handicap that inhibits the individual’s growth and involvement. Consequently, significant effort has been put into removing these kinds of restrictions. These initiatives address the trouble that disabled people encounter. People with disabilities often need to rely on others to meet their requirements. Machine learning (ML) is excelling in producing smart cities and offering a secure environment for disabled individuals. Emotional detection is an important research domain that can expose many appreciated inputs. Emotion is expressed differently through speech and facial expressions, gestures, and written text. Emotion detection in a text document is fundamentally a content-based classification task, utilizing models from deep learning (DL), complex systems and natural language processing (NLP). This paper presents an Optimal Self-Attention DL-based Recognition of Textual Emotions (OSADL-RTE) technique for Disabled Persons. The presented OSADL-RTE technique focuses on identifying distinct types of emotions in the textual data. As a primary preprocessing step, the OSADL-RTE technique comprises different phases to transform the input in a useful way. For word embedding, the bag of words (BoWs) approach is exploited. The OSADL-RTE technique derives self-attention long short-term memory (SA-LSTM) approach to identify emotions. Lastly, the arithmetic fractals optimization algorithm (AOA) approach correctly tunes the hyperparameter selection of the SA-LSTM approach. The experimental study of the OSADL-RTE approach occurs on the emotion database. The investigational outcome of the OSADL-RTE approach portrayed a superior accuracy outcome of 99.59% over existing methods. [ABSTRACT FROM AUTHOR]

Purpose: This scoping review was conducted to understand the barriers, facilitators, and education and training needs of rehabilitation clinicians in their use of mainstream wireless technologies (MWT) to support people with disabilities and older adults. It was also conducted to understand the functional skills of clients that were targeted with MWT use. Materials and methods: This scoping review was reported using PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) and the Population (or Participants)/Concept/Context) framework. We searched PubMed; ProQuest to access APA PsycINFO; Web of Science Core Collection; and EBSCOhost to access Cumulated Index to Nursing and Allied Health Literature (CINAHL), Ovid MEDLINE ALL, and Education Resources Information Center (ERIC). Articles published between 2015–2022 were retrieved. Results: A total of 90 articles were included. Most interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills. An infographic on barriers and facilitators was generated as a decision support tool for clinicians when implementing MWT. The topic, format, timing, and source of information clinicians need are also delineated. Conclusion: MWT such as apps, smartphones and tablets are being used by rehabilitation clinicians to address motor, cognitive, and speech skills, most commonly in adults. Clinicians voice a need for more education and training. Barriers and facilitators exist at the clinician-, technology-, client-, institution-, and policy levels. IMPLICATIONS FOR REHABILITATION: A total of 90 articles from 2015–2022 were included in this scoping review Most interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills. An infographic was generated as a decision support tool for clinicians when implementing mainstream wireless technologies in clinical practice. Clinicians' education and training needs with regard to mainstream wireless technologies are broad. Materials on a variety of topics, in different formats, from multiple sources are needed. This review also discusses implications of findings on policy, technology development, and future research. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe handbike configurations and the prevalence of experienced sitting and riding-related problems among recreational handcyclists training for a mountain time trial (HandbikeBattle). In this cross-sectional study, 150 participants of the HandbikeBattle, who used an arm-power (recumbent) handbike, filled out a questionnaire (on comfort, stability and power generation) while handbike characteristics were measured. Crank width was variable among handcyclists and was wider than the shoulder width (median crank/shoulder width ratio: 1.19). About 60% of the participants found sitting in the handbike never fatiguing or painful and 74–76% indicated to sit stable in the handbike when sitting or when generating power. About 80% of the participants thought that their pedal position was optimal. Although the overall scores regarding sitting position and riding settings were high (both questions median: 8.0 on 1.0–10.0 scale), 50% and 31% of the participants, respectively, believed that their sitting position and riding settings could be improved. In addition, 10% of the participants thought that the configuration could lead to an injury and had an injury at the time of filling out the questionnaire. It can be concluded that although the majority of the participants seemed to be satisfied with their handbike configurations a large variety in handbike configurations was seen. There is a need for the development of evidence-based guidelines for handbike fitting in the future. IMPLICATIONS FOR REHABILITATION: A large variety in handbike configurations is seen in recreationally-active handcyclists. Although the majority of the recreationally-active handcyclists seemed to be satisfied with their handbike configurations, 31–50% of them thought that their handbike configuration could be improved. Evidence-based guidelines for handbike fitting should be developed in the future. [ABSTRACT FROM AUTHOR]

Despite existing revised legislation on the accessibility of public buildings in the United States, people with disabilities continue to experience barriers that limit their participation and engagement in the context of the community. This researcher developed, cross-sectional survey study, explored trends in accessing public buildings, accessibility problems encountered, and approaches for accessing information and resources for accessibility of specific buildings among people with disabilities (n = 109). Respondents largely reported on accessibility barriers encountered in communal spaces and how having prior knowledge of accessibility may have influenced their plans to access the community. Despite having knowledge that accessibility guidelines exist, a majority of respondents were not particularly familiar with how to retrieve this information and reported interest in web- and mobile-based technology to locate and share accessibility information. This study highlights how people with disabilities experience accessibility challenges and the implications for web-based resources to provide accessibility information. Points of interest: This article highlights that despite legislation to improve accessibility, many public buildings continue to not be accessible creating major barriers to community living in persons with disabilities. Persons with disabilities are largely unaware of how to locate information about the accessibility of public buildings in the community. Persons with disabilities believe that acquiring accessibility information about buildings before planning an outing would be beneficial. Accessing information about the accessibility of public buildings through websites or apps appear to be an approach that people with disabilities are interested in using in their everyday life. Persons with disabilities are interested in sharing comments and ratings about the accessibility of public buildings. [ABSTRACT FROM AUTHOR]

The purpose of this scoping review was to identify existing strategies to reduce modifiable risk factors for musculoskeletal (MSK) injury in adaptive athletes. Medline, Embase, Web of Science, and CINAHL were searched. Inclusion criteria required studies written in English, samples of adaptive athletes, and evaluation of any injury prevention programs that would reduce risk factors associated with MSK injury. The literature search resulted in 785 unique articles. Thirty-two full text articles were screened for inclusion. Four studies of wheelchair basketball and wheelchair rugby injury prevention programs were included in the final analysis, and these studies demonstrated increase in shoulder range of motion, decreased shoulder pain, and decreased cumulative traumatic disorders; all of which was proposed to reduce risk of shoulder injury. However, these studies were small and did not include control groups. Future research is needed to implement programs that reduce risk factors of MSK injuries and reduce health disparities for adaptive athletes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Since the beginning of the COVID-19 pandemic, protection and isolation measures established by the Canadian and Quebec governments have directly affected the work of health and social professionals (HSPs). These measures have added pressure on HSPs, complexified their work and added tasks to their already busy workload. However, few studies have explored in depth the impacts of the pandemic on HSPs working with people with disabilities. OBJECTIVE: The objective of this study was to qualitatively explore the experiences of HSPs working among people with disabilities in the province of Quebec, Canada, during the COVID-19 pandemic (January and February 2021), including the impact on their work, the relationships with their colleagues, and on their immediate social and familial environment. METHODS: HSPs participated in a semi-structured interview. A mixed thematic analysis approach, combining inductive and deductive coding, was carried out using N'Vivo 12. RESULTS: Fifty-five HSPs participated in the interviews (mean [SD] age, 42 [9]). They mostly identified as women (91%). Three main themes representing the impacts of the pandemic were identified, including 1) Health and Well-being; 2) Family and social networks including the subthemes; 2.1) Fear of being a vector of contamination for their loved ones; 2.2) Work-family balance; 2.3) Social Network, and finally 3) Work, highlighting, including 3.1) Workload and adaptative strategies developed; 3.2) Relationship with colleagues; 3.3) Perceived support received at work, and 3.4) Services offered to patients. CONCLUSIONS: These findings highlight the importance of closely tracking and supporting the well-being of HSPs. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusion Trial Registration This qualitative study aimed to explore the experience and perception of the mouth, oral health, functioning and the social environment amongst adults with disabilities and complex health conditions.Purposive sampling using the maximum variation strategy was performed to select participants with a wide range of experiences in terms of demographics, disability and health conditions. Consent was sought, and semi‐structured interviews were conducted, recorded and transcribed verbatim. Within the interpretivist tradition, a phenomenological approach was used to describe the lived, contextualised experience of people in relation to their mouths, as described by participants. Thematic analysis was undertaken.Eighteen participants with disabilities and complex health conditions were interviewed. Twelve individuals had an intellectual disability. Three main themes were identified: perception of the mouth and oral health; symptomatic perceptions and responses to oral health problems; and inter‐relationships between the mouth, oral health and the socio‐medical environment. The mouth had a central place in the lives of the participants, but its importance was only recognised when oral health problems interfered with daily life, function, social relationships, family life or autonomy. Certain social determinants of health were identified: social exclusion, financial insecurity, lack of autonomy, nutrition and negotiation of services. Oral problems were perceived as an additional burden to those with disabilities or complex health conditions.This study provided insight into the daily lives of adults with disabilities and complex health conditions. It helps to fill the gaps in the existing literature regarding the perceptions of the mouth and oral health, connecting oral function, general health and social environment for this population.This study was registered into ClinicalTrials.gov (NCT04815434) [ABSTRACT FROM AUTHOR]

Background: Loss of the ability to perform activities of daily living (ADLs) leads to negative health outcomes such as reduced quality of life, institutionalization, and mortality. In Korea, the proportion of older adults with disabilities is increasing along with rapid population aging. Therefore, providing a comprehensive approach to the prevention and management of ADL limitations in people with disabilities is necessary. This can be accomplished by understanding the trends and factors affecting these limitations over time. Purpose: This study was developed to examine the longitudinal trend and factors affecting ADL limitations over time among people with disabilities in Korea. Methods: Data from 346 people with disabilities in the 2008–2020 Korean Welfare Panel Study were used. Bivariate analysis and a Kendall trend test were performed to determine the longitudinal trends for ADL limitations, and multiple logistic regression was used to evaluate whether relevant variables could predict these limitations. Results: The prevalence of ADL limitations among people with disabilities increased by 16.5% over the 12 years of the study. The highest rate of increase in these limitations over time was found in people with mental disorders (27.8%), those over 65 years of age (27.3%), and those with depression (25.6%). In multiple logistic regression, the odds ratios of the variables were slightly different at each survey wave. However, severe disability and low educational level were consistently found to be associated with ADL limitations over time. Conclusions: The findings provide evidence of a significant relationship between level of disability and/or educational status and ADL limitations in people with disabilities in Korea. To prevent the development of ADL limitations in people with disabilities, comprehensive identification of longitudinal trends and factors affecting ADL limitations is necessary. Early intervention, including integrated services such as home rehabilitation services to prevent ADL limitations, especially for disabled people with severe disabilities and low educational levels, has the potential to delay ADL limitations. [ABSTRACT FROM AUTHOR]

Background: Historical marginalisation and ongoing trust deficits in health and government systems shape present-day vaccine perceptions among marginalised communities. This paper sought to understand the role of trust in decision-making about COVID-19 vaccine uptake in the transgender and disability communities in India. Methods: Using a participatory approach we interviewed 24 community representatives, identifying themselves as transgender individuals or as persons with disability, and 21 key informants such as vaccine programme managers, vaccine providers, and community advocates. We undertook an inductive thematic analysis of the data using a socio-ecological model. Results: Fear of side effects in relation to specific needs of the two communities and mistrust of systems involved in vaccination shaped four different pathways for vaccine decision-making. Mistrust of systems was influenced by past negative experiences with the health system, creating contexts in which information and misinformation are shared and interpreted. Participants negotiated their doubts about safety and mistrust of systems by interacting with different sources of influence showing patterns of decision-making that are dynamic, context-dependent, and intersectional. Conclusion: These findings will help in determining the content, strategies and approaches to equitable vaccine communication for these two communities. The two communities ought to be included in vaccine trials. Vaccine information must respond to the specific needs of these two communities which could be enabled by collaboration and engagement with community members and influencers. Finally, long-term investment towards the needs of marginalised communities is vital to dismantle cycles of marginalisation and distrust and in turn improve vaccine acceptance and uptake. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Data Sources Methods Results Conclusions Impact Patient or Public Contribution To identify the use of telehealth for people with disabilities in community or primary care settings and to explore effective telehealth interventions for this group.Systematic literature review and narrative synthesis.The literature search was conducted in January 2024 using five electronic databases including PubMed, EMBASE, CINAHL, Cochrane library and PsycINFO.The review followed the Tawfik's guideline and adhered to the Preferred Reporting Items for Systematic Review and Meta‐Analyses guidelines for reporting. Out of 7363 retrieved articles, 1871 duplicates were removed, 5389 were excluded after title and abstract review, and 4 were excluded due to unavailable full text. One additional article was obtained through citation and hand searching. Thirteen studies were quality assessed using the Mixed Methods Appraisal Tool. Quantitative data were narratively synthesised.Thirteen quantitative studies were selected including three quasi‐experimental studies and ten randomised controlled trials. The types of telehealth included telemonitoring, computerised intervention, virtual reality, telephone care, mHealth tools, decision support tools, digital storytelling and technology‐assisted language interventions. The most common type of disability was intellectual disability, and the most common telehealth provider was the digital device itself. Most studies used surveys as the data collection method and the interventions were mostly conducted individually. Computer‐based telehealth interventions demonstrated significant improvement in attention, health knowledge and psychological well‐being. Telephone, virtual reality and tablet interventions also had positive impacts on body weight, motor coordination and pragmatic language skills. Telemonitoring was also beneficial.This systematic review examined the current state and effectiveness of telehealth interventions for people with disabilities. However, few intervention studies were found, and some studies were of poor quality. Continued interest and efforts from the government and researchers are needed targeting people with disabilities.Results provide valuable insights for healthcare providers, policymakers and researchers. They raise awareness about the potential of telehealth to address healthcare disparities and improve access to care for people with disabilities.No patient or public contribution: Systematic review. [ABSTRACT FROM AUTHOR]

Lors de l'activité physique, les sportifs atteints d'une lésion de la moelle épinière doivent faire face à des problèmes de thermorégulation. En fonction des conditions climatiques et du niveau de la lésion médullaire, les répercussions sur la température corporelle sont différentes. Cette étude a pour objectif d'obtenir une vue d'ensemble sur les techniques de refroidissement et de réchauffement mise en place par les paraplégiques et les tétraplégiques lors de la pratique d'une activité physique. Utilisation de la méthode PICO (participants, intervention/exposition, comparaison, outcomes) afin de mettre en évidence les termes à utiliser pour la recherche des articles scientifiques. Lors d'une activité physique en ambiance chaude, différentes techniques de refroidissement ont été mises en évidence : vestes de refroidissement, pulvérisation d'eau sur le corps, ingestion de substances froides, refroidissement des mains et des pieds ou combinaison de plusieurs de ces techniques. Toutes ces techniques permettent de freiner l'augmentation de la température centrale comparée à un groupe contrôle. En ambiance froide, les sportifs tentent de se réchauffer à l'aide de vêtements chauds ou par la mise en place de stratégies efficaces pour maintenir leur température centrale entre la période de l'échauffement et la compétition. En ce qui concerne le sport en ambiance chaude, il existe différentes stratégies de refroidissement qui sont utilisées. Cependant, il y a un manque de preuves quant à la plus efficace. Pour le sport en ambiance froide, il n'y a que très peu d'études qui traitent de ce sujet. Des recherches doivent encore être réalisées afin de pouvoir objectiver quelles sont les meilleures techniques pour se réchauffer. During physical activity, athletes with a spinal cord injury have to face thermoregulation problems due to an alteration of their nervous system. The repercussion of the core body temperature depends on the climate. The aim of this revue was to obtain an overview of the cooling and warming techniques used by paraplegics and tetraplegics when practicing a physical activity. We used the PICO (participants, intervention/exposition, comparison, outcomes) method to highlight the terms we need for the search of scientific articles. During a physical activity in a hot environment, different cooling techniques have been demonstrated: cooling jackets, spraying water on the body, ingestion of cold substances, cooling of hands and feet or a combination of several of these techniques. All of these techniques have been shown to slow down the increase in core temperature compared to a control group. In a cold environment, athletes try to warm-up with warm clothes or by implementing effective strategies to maintain their core temperature between the warm-up period and the competition. Regarding sports in hot environments, there are different cooling strategies that are used. However, there is a lack of evidence as to which is most effective. For sport in a cold environment, there are very few studies that deal with this subject. Research is still needed to establish which techniques are the best to warm-up. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to explore the instruction of social determinants of health (SDOH) for people with disabilities (PWD) in doctor of physical therapy (DPT) education programs. Methods A sequential mixed methods study informed by a five-member disability community advisory panel was conducted. Qualitative semi-structured interviews with educators (n  = 10) across 4 DPT programs in the Midwest were conducted and analyzed thematically. The qualitative findings formed the basis of the quantitative phase. An online survey was conducted with faculty of DPT programs in the United States (n  = 254) with the most knowledge of instruction of SDOH and health equity for PWD (n  = 74; 29% response rate). Quantitative data were analyzed with descriptive statistics and triangulated with qualitative data. Results SDOH for PWD is an emerging component of instruction in DPT curricula. Five themes included: emerging instruction of SDOH for PWD; conceptual frameworks informing instruction; instructional strategies; barriers to integration of SDOH for PWD; and facilitators to integration of SDOH for PWD. Quantitative analysis revealed that 71 respondents (95.9%) included disability in health equity discussions primarily focused on health care access. Limited time (n  = 49; 66.2%) was the most frequently reported barrier, and educator interest in disability health equity was the most frequently reported facilitator (n  = 62; 83.7%) to inclusion of the SDOH for PWD in health equity discussions. Conclusion Opportunities exist in DPT curricula to build on instructional strategies, integrate SDOH frameworks, and amplify facilitators to integration of SDOH for PWD. Impact To meet the needs of the 67 million Americans living with disabilities, students must have the knowledge and skills to address the complex needs of this historically marginalized population. Understanding the DPT education landscape around SDOH for PWD can guide DPT educators to more fully prepare their students to recognize and ameliorate health disparities faced by PWD. [ABSTRACT FROM AUTHOR]

Background: As chronic diseases and the aging population increase, exercise is becoming more and more essential along with medical treatment for recovering and maintaining individuals' physical health. Furthermore, the demand for exercise-based interventions in this context is growing. Although most healthcare professionals recognize the effectiveness and necessity of exercise, the "Exercise is Medicine" initiative has not been established in clinical settings. We aim to discuss the effectiveness and importance of exercise in the treatment and management of diseases and how exercise should be considered a key therapeutic tool in medicine. Current Concepts: Exercise-related mechanisms and their influence on body structure and function should be considered in disease management. It is necessary to understand these interactions and monitor their effects on the entire body. During recovery after an injury, exercise rehabilitation is provided as program customized according to the phase and function levels, the clinical pathway of which is feasible and effective. Exercise programs for maintaining the functioning and physical and mental health of people with disabilities should be developed by considering individuals' functional levels, disability types, and conditions. Correct posture, microbreaks, and regular exercise are key to managing musculoskeletal pain. Discussion and Conclusion: To ensure the effectiveness of the "Exercise is Medicine" initiative, exercise should be included in the National Health Insurance System after clarifying the indications and clinical effectiveness of exercise therapy and defining specific procedures. Furthermore, increased awareness and changes in the attitude of healthcare professionals and patients toward exercise are necessary. It is now time for the medical community to ponder over and pool its wisdom on how to adopt exercise as a key therapeutic tool. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Patients indicated for palliative care may have losses in functional capacity and quality of life, but there is little information about these conditions in primary health care. OBJECTIVE: To characterize the functional and symptomatic aspects of individuals indicated for palliative care in primary care. METHODS: This cross-sectional descriptive study involved six family health teams from three basic health units in Londrina, Paraná, Brazil that indicated patients with palliative care needs. The patients were assessed with the Karnofsky Performance Scale (KPS), the Edmonton Symptom Assessment Scale (ESAS) and a sociodemographic and clinical questionnaire. RESULTS: 73 patients (30 men and 43 women) whose mean age was 77.2 ± 12.1 years were included. Dementia and cerebrovascular diseases were the most frequent conditions, with 20 (27%) and 19 (26%) patients, respectively. The mean KPS score was 47.9 ± 13.9 points (44 ± 11.3 points for men and 51 ± 11.3 for women), with a significant difference between the sexes (p = 0.023). Cancer patients had better functionality than those with neurological diseases. The ESAS, whose mean score was below 3 points (mild intensity), indicated that the most frequent symptoms were impaired well-being, pain, fatigue and drowsiness. Patients without caregivers had better functional status, but greater pain and fatigue intensity. CONCLUSION: All patients had some functional limitations, and those with neurological diseases were the most affected. The symptoms were generally mild. The presence of caregivers may positively influence symptom control.

Persons outside of disability communities often have negative perceptions of disabilities, yet such beliefs may create more problems for people with disabilities than the disability itself. Folklore produced in disability communities can serve as a reaction to those misconceptions and can allow us to better understand what disability means to disabled individuals and how it affects their ways of being and interpreting the world. Folklorists undertaking such research must approach collaborators with respect, care, and background knowledge so they don't risk reproducing harmful stereotypes. Through this disability studies lens, folklorists have an opportunity to build on and complicate our understanding of disability experiences through exploring how disabled people use folklore to (re)present their identities. Keywords: (from the AFS Ethnographic Thesaurus), blind persons, disability identity, discrimination against people with disabilities, fieldwork ethics, humor, personal narratives, physical disability, I'M BLIND IN MY RIGHT EYE, BUT THAT HAS BEEN THE SHAPE of my normal since I can remember. I was born 3 months prematurely, before my eyes were fully [...]

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Adolescents with physical disabilities experience common psychological distress that interacts with impaired physical function. While cognitive‐based interventions have been implemented for adolescents with physical disabilities, their effects on enhancing psychological health remain uncertain. This systematic review aimed to synthesise the effects of cognitive‐based interventions on the psychological distress of this population and identify optimal components for evidence‐based interventions. Following the PRISMA guideline, nine databases were searched to identify eligible randomised controlled trials examining the effects of cognitive‐based interventions for adolescents with physical disabilities from inception to October 2023. Data syntheses were performed using the R software, employing random‐effects models. Twelve trials involving 1201 participants were identified. The pooled results revealed that cognitive‐based interventions did not yield noticeable effects in reducing anxiety (g = −0.43 for postintervention; −0.14 for medium term; −0.37 for long term), depression (g = −0.05 for postintervention; −0.02 for medium term; −0.15 for long term) and stress levels (g = −0.15) over time. The secondary outcome (physical function) improved significantly in the long term compared to the control groups (g = 0.31). Furthermore, this review identified variations in the effectiveness of CBIs among different recipients, durations and modes of delivery. Given the limited number and overall low quality of identified studies for each outcome, conducting high‐quality randomised controlled trials is recommended to validate the effectiveness of cognitive‐based interventions in reducing psychological distress among adolescents with physical disabilities. [ABSTRACT FROM AUTHOR]

Equitable access means that timely, sensitive and respectful treatment is offered to all people. Adults with disability access ED care more frequently than the general population. However, in Australia and internationally, people with disability experience poorer healthcare access and outcomes than the general population. There is acknowledgement that ED environments and processes of care could be better designed to promote equitable access, so as not to further disadvantage, disable and create vulnerability. This systematic review aimed to locate and describe evaluated strategies implemented to improve care for people with disability (aged 18–65 years) in the ED. Four databases were searched from inception to June 2024. 1936 peer‐reviewed papers were reviewed by pairs of independent reviewers. Four studies met our inclusion criteria, demonstrating the limited peer‐reviewed literature reporting on evaluated strategies to improve ED care for adults aged 18–65 years. Three studies focused on the needs of people with intellectual disability, and one created a specific treatment pathway for people experiencing status epilepticus. No studies evaluated across patient experience, patient outcomes, system performance and staff experience, with limited evaluation of patient outcomes and system performance measures. We have referenced helpful resources published elsewhere and drawn from our previous reviews of ED care to provide guidance for the development and evaluation of targeted initiatives. [ABSTRACT FROM AUTHOR]

Background: This study aimed to analyze trends in oral health research among people with disabilities. Methods: Data were obtained from 70 oral studies on individuals with disabilities from 2000 to 2024. Keywords were analyzed. Frequency, betweenness centrality, and cluster analyses were performed using NetMiner. Results: The main keywords for oral health research on disabled people were oral health, dental caries, DMFT (decayedmissing- filled-teeth), dental treatment, oral health centers, and disabled children. As a result of the centrality analysis, DMFT had the highest connectivity, followed by disabled children, special care dentistry, oral health behavior, periodontitis, and health insurance. Cluster analysis results of research on disabled people: Group 1, oral diseases and functions of disabled people; Group 2, oral care for disabled children; Group 3, dental treatment for disabled people; Group 4, oral health policy; Group 5, oral care by dental hygienists; and Group 6, conservative dentistry. Conclusion: Considering the increase in the number of disabled people in a super-aging society, research on ways to promote oral health for disabled people, oral health policies, and training of oral health experts for disabled people is required.

Disability is associated with alcohol misuse and drug overdose death, however, its association with alcohol-induced death remains understudied. To quantify the risk of alcohol-induced death among adults with different types of disabilities in a nationally representative longitudinal sample of US adults. Persons with disabilities were identified among participants ages 18 or older in the Mortality Disparities in American Communities (MDAC) study (n = 3,324,000). Baseline data were collected in 2008 and mortality outcomes were ascertained through 2019 using the National Death Index. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated for the association between disability type and alcohol-induced death, controlling for demographic and socioeconomic covariates. During a maximum of 12 years of follow-up, 4000 alcohol-induced deaths occurred in the study population. In descending order, the following disability types displayed the greatest risk of alcohol-induced death (compared to adults without disability): complex activity limitation (aHR = 1.7; 95% CI = 1.3–2.3), vision limitation (aHR = 1.6; 95% CI = 1.2–2.0), mobility limitation (aHR = 1.4; 95% CI = 1.3–1.7), ≥2 limitations (aHR = 1.4; 95% CI = 1.3–1.6), cognitive limitation (aHR = 1.2; 95% CI = 1.0–1.4), and hearing limitation (aHR = 1.0; 95% CI = 0.9–1.3). The risk of alcohol-induced death varies considerably by disability type. Efforts to prevent alcohol-induced deaths should be tailored to meet the needs of the highest-risk groups, including adults with complex activity (i.e., activities of daily living – "ALDs"), vision, mobility, and ≥2 limitations. Early diagnosis and treatment of alcohol use disorder within these populations, and improved access to educational and occupational opportunities, should be considered as prevention strategies for alcohol-induced deaths. [ABSTRACT FROM AUTHOR]

To analyze the clinical profile and functional classification of the population with physical and/or sensory disabilities in the municipalities of Marajó using the International Classification of Diseases and International Classification of Functioning, Disability, and Health. This descriptive, exploratory study was carried out in all Marajó municipalities. The prevalence of disabilities acquired after birth involving diseases of the nervous system and impairment of the lower and upper extremities of the body was verified. Deficiency in joint mobility, strength, and tonus were the most affected body functions, which impacted mobility and self-care activities, as well as interpersonal relationships with healthcare professionals and immediate family, representing a social barrier. Thus, based on the results found, the influence of social, educational, economic, and geographical contexts on the clinical condition and functional performance of people with disabilities is understood. [ABSTRACT FROM AUTHOR]

Introduction: People with disabilities face many challenges on a daily basis. Despite legislative advances and inclusion policies, discrimination against people with disabilities persists in various areas of life, including access to health services. Aim: This study aims to conduct an integrative literature review to investigate the factors associated with discrimination faced by people with disabilities in health services. Materials and Methods: The search was conducted in February 2024 in the IBECS, Lilacs, BDEnf, Medline (PubMed), Scopus, and Web of Science databases. The health descriptors (DeCS) “people with disabilities,” “social discrimination,” and “health services” were used. Original articles available in full, from the last five years, and in any language were included. The exclusion criteria were duplicate articles and those that did not answer the guiding question. Results: A total of 162 records were identified, from which 17 studies were selected, resulting in a final sample of 10 articles. The main factors associated with the discriminatory experiences faced by people with disabilities when accessing and using the health system were “stigmatization,” “negligence,” “prejudice,” and “access difficulties.” Conclusions: Significant drivers of discrimination were identified, including financial barriers, lack of training for health professionals, and other gaps that generate prejudice, stigmatization, and neglect. It is essential to implement public policies to ensure service accessibility, provide financial assistance for people with disabilities, establish training programs for health professionals, and conduct more research on this subject. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of musculoskeletal disorders in the primary caregiver of patients with physical disabilities at the Central Military Hospital. Methodology: Participants who were caregivers of patients with a disability were sought to complete the questionnaire. A sociodemographic questionnaire was applied to each person, the Nordic questionnaire for the detection of musculoskeletal symptoms and the Zarit questionnaire to assess the caregiver's burden, descriptive statistics of these questionnaires were performed. Results: The final sample was 29 people, the sociodemographic questionnaire showed that the primary caregiver is usually a single woman aged 40 (± 11.5) years, with a daughter relationship, who is dedicated to household activities. The Nordic questionnaire showed that 21% of the caregivers reported pain, the largest areas with pain were back (45 %), shoulder and neck (both with 21 %). The Zarit questionnaire indicated that nearly 90 % of the patients did not present activity overload. Limitations of the study: Being a study carried out in a military hospital, the results may not be representative of the Mexican population. Originality: Few are the works focused on the study of the Primary Caregiver both nationally and internationally. Conclusions: The informal primary caregiver is usually a vulnerable population with a low educational level and without any economic remuneration, and which contributes a lot to the care of patients with disabilities, therefore measures must be implemented to help train them to care for their integrity and that of their relatives. [ABSTRACT FROM AUTHOR]

The article presents the discussion on greater contribution from folklore and folklorists in global health, international development, social justice, and human rights efforts. Topics include emphasizing the value of folklore in understanding communities and addressing disability issues; and intersection of folklore and anthropology, the unique insights folklore brings to disability research, and the universal presence of disability and its cultural narratives.

The article presents the discussion on disability advocate Imani Barbarin's assertion that COVID-19 is a significant disabling event, fundamentally altering life and emphasizing the impact of Long COVID. Topics include prevalence and symptoms of Long COVID, the disproportionate effects of COVID-19 on marginalized communities; and the ongoing high death rates among vulnerable populations despite the declaration that the pandemic is "over."

To describe the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) staff experiences, perceptions, and training needs surrounding the provision of infant feeding support for parents with intellectual and developmental disabilities (IDD). We conducted in-depth semistructured interviews between October and November 2021 with Maryland WIC staff (N = 10) who provide infant feeding counseling and support. We analyzed interviews using conventional content analysis. Three themes were identified: identifying and documenting IDD, facilitating effective communication and infant feeding education, and assessing WIC staff competence and readiness. The interviews suggested the need to explore the risks and benefits of routine and compassionate processes for identifying and documenting disability, create accessible teaching materials that facilitate understanding and engagement, and educate and train staff to provide tailored support in WIC. Engaging parents with IDD to better understand their perspectives and experiences should guide future efforts to improve inclusivity and accessibility. [ABSTRACT FROM AUTHOR]

Objectives: To analyze relationships between Medicaid automatic enrollment for child Supplemental Security Income (SSI) recipients and health insurance coverage during transitions. Data Sources and Study Setting: Medical Expenditure Panel Study, 2000–2020 and National Survey for Children with Special Health Care Needs, 2001–2010. Study Design: Leveraging variation in SSI‐Medicaid automatic enrollment status across regions and over time, we estimate a regression model to quantify associations between automatic enrollment and insurance coverage. We validate our findings in the NS‐CSHCN. Data Collection: Our sample includes children receiving SSI for a disability. We also analyze a subsample of children newly enrolled in SSI. Principal Findings: Automatic enrollment is associated with a statistically significant increase in insurance coverage. Expanding automatic enrollment to all states is associated with increases in Medicaid enrollment of 3% (CI 0.9%–6.7%) among all SSI children and 7% (CI 1.1%–13.9%) among children newly enrolled in SSI. We find similar decreases in uninsurance. Analysis in the NS‐CSHCN replicates these findings. Conclusions: Medicaid automatic enrollment policies are associated with increased insurance coverage for SSI children, particularly those transitioning into the program. Medicaid policy defaults could play an important role in reducing administrative burdens to improve children's coverage and access to care. [ABSTRACT FROM AUTHOR]

Sign language (SL) recognition for individuals with hearing disabilities involves leveraging machine learning (ML) and computer vision (CV) approaches for interpreting and understanding SL gestures. By employing cameras and deep learning (DL) approaches, namely convolutional neural networks (CNN) and recurrent neural networks (RNN), these models analyze facial expressions, hand movements, and body gestures connected with SL. The major challenges in SL recognition comprise the diversity of signs, differences in signing styles, and the need to recognize the context in which signs are utilized. Therefore, this manuscript develops an SL detection by Improved Coyote Optimization Algorithm with DL (SLR-ICOADL) technique for hearing disabled persons. The goal of the SLR-ICOADL technique is to accomplish an accurate detection model that enables communication for persons using SL as a primary case of expression. At the initial stage, the SLR-ICOADL technique applies a bilateral filtering (BF) approach for noise elimination. Following this, the SLR-ICOADL technique uses the Inception-ResNetv2 for feature extraction. Meanwhile, the ICOA is utilized to select the optimal hyperparameter values of the DL model. At last, the extreme learning machine (ELM) classification model can be utilized for the recognition of various kinds of signs. To exhibit the better performance of the SLR-ICOADL approach, a detailed set of experiments are performed. The experimental outcome emphasizes that the SLR-ICOADL technique gains promising performance in the SL detection process. [ABSTRACT FROM AUTHOR]

Background: People with intellectual and developmental disabilities (IDD) are at high risk for unmet health care needs and face barriers to equitable care, yet few health professions students receive adequate training to meet these needs. Objectives: An interactive panel discussion with Special Olympics Pennsylvania (SOPA) athletes and staff was planned and implemented so that health professions students/trainees would gain knowledge of IDD, health barriers, SOPA resources, and volunteer opportunities. Methods: Panelists included two SOPA athletes and their mentors; questions solicited responses about personal health care experiences (Fall 2019). Attendees completed a mixed-methods post-event survey capturing event satisfaction, reflections, and interest in learning more about patients with IDD. Results: Sixty individuals attended, and 43 (72%) completed post-event evaluation. Attendees reported high satisfaction (88%), desire for future trainings (100%), and interest in learning about communicating (88%), providing care (88%), and addressing IDD health barriers (91%). Conclusions: Collaborative community panels could be effective in engaging health care students in discussion about caring for patients with IDD. [ABSTRACT FROM AUTHOR]

BACKGROUND: Social support and social networks have long been postulated to impact health outcomes but their impact on life expectancy and disability in older adults remains poorly quantified. METHODS: As part of the Cardiovascular Health Study, we followed 5,749 adults aged 65 years and older from 4 US field centers for 25 years. We assessed the Lubben social network score [range 0-50] and a social support score [range 0-24] derived from the Interpersonal Support Evaluation List (ISEL-12) in two consecutive years starting at study recruitment. We used remaining years of life (YOL) from study enrollment to death to approximate life expectancy. We defined years of active life (YAL) as the number of study years in which participants lived without any difficulties in activities of daily living. We used compression of disability to reflect the proportion of life lived able (YAL/YOL). We used linear regression to adjust for socio-demographics and comorbidity. RESULTS: The mean (standard deviation [SD]) scores were 32.3 ± 6.8 points for social network score and 8.3 ± 2.4 points for social support score. For every 1-SD increase in social network score, adjusted participant life expectancy was 0.40 years higher (95% CI 0.22-0.58; p

Abstract This study aimed to analyze the profile and level of satisfaction of users served in the dental specialty for patients with special healthcare needs (SHCN), based on the Brazilian Program for Improving Access and Quality (“PMAQ”) of the Centers for Dental Specialties (“CEO”). This observational, quantitative study used a national secondary database in the public domain. Data were analyzed using the chi-squared test with Bonferroni correction, Student’s t-test, and log-linear Poisson regression. Most users of the specialty “SHCN” interviewed were female (74.1% in 2014 and 68.8% in 2018), with a mean age of 41.7 (2014) and 44.9 (2018) years. For every 100 respondents who considered it regular or bad, 171 considered it good, and 199 considered it very good. Regarding satisfaction with the host of the “CEO,” there were differences between the regions of Brazil (Midwest, Northeast, Southeast, and South). There has been an increase in the number of “CEO” that serve users with autism spectrum disorder. Generally, the “CEO” network provides humanized and welcoming services, presenting better performance in the second evaluation cycle, according to user perception.

BackgroundThe COVID-19 pandemic has disproportionately impacted disabled people, especially those who are members of marginalized communities that were already denied access to the resources and opportunities necessary to ensure health equity before the pandemic.ObjectiveCompare COVID-19 impact on basic needs access among households with and without disabled adults.MethodsAn online survey was distributed to households with children enrolled in one of 30 socially vulnerable elementary or middle schools in San Diego County, California. We measured disability using the single-item Global Activities Limitations Indicator. We measured pandemic impacts on basic needs access using the RADx-UP common data elements toolkit. We then assessed number of impact items reported by household disability using multivariable linear regression, adjusting for household income, household size, education, parent gender, and child's ethnicity.ResultsOf 304 participants, 41% had at least one disabled household member. Participants reporting a disabled household member were more likely to report challenges accessing basic needs, such as food, housing, healthcare, transportation, medication, and stable income during the pandemic (all p

BackgroundRemote activity monitoring has the potential to evaluate real-world, motor function, and disability at home. The relationships of daily physical activity with spinal cord white matter and gray matter (GM) areas, multiple sclerosis (MS) disability and leg function, are unknown.ObjectiveEvaluate the association of structural central nervous system pathology with ambulatory disability.MethodsFifty adults with progressive or relapsing MS with motor disability who could walk >2 minutes were assessed using clinician-evaluated, patient-reported outcomes, and quantitative brain and spinal cord magnetic resonance imaging (MRI) measures. Fitbit Flex2, worn on the non-dominant wrist, remotely assessed activity over 30 days. Univariate and multivariate analyses were performed to assess correlations between physical activity and other disability metrics.ResultsMean age was 53.3 years and median Expanded Disability Status Scale (EDSS) was 4.0. Average daily step counts (STEPS) were highly correlated with EDSS and walking measures. Greater STEPS were significantly correlated with greater C2-C3 spinal cord GM areas (ρ = 0.39, p = 0.04), total cord area (TCA; ρ = 0.35, p = 0.04), and cortical GM volume (ρ = 0.32, p = 0.04).ConclusionThese results provide preliminary evidence that spinal cord GM area is a neuroanatomical substrate associated with STEPS. STEPS could serve as a proxy to alert clinicians and researchers to possible changes in structural nervous system pathology.

Sign language (SL) recognition for individuals with hearing disabilities involves leveraging machine learning (ML) and computer vision (CV) approaches for interpreting and understanding SL gestures. By employing cameras and deep learning (DL) approaches, namely convolutional neural networks (CNN) and recurrent neural networks (RNN), these models analyze facial expressions, hand movements, and body gestures connected with SL. The major challenges in SL recognition comprise the diversity of signs, differences in signing styles, and the need to recognize the context in which signs are utilized. Therefore, this manuscript develops an SL detection by Improved Coyote Optimization Algorithm with DL (SLR-ICOADL) technique for hearing disabled persons. The goal of the SLR-ICOADL technique is to accomplish an accurate detection model that enables communication for persons using SL as a primary case of expression. At the initial stage, the SLR-ICOADL technique applies a bilateral filtering (BF) approach for noise elimination. Following this, the SLR-ICOADL technique uses the Inception-ResNetv2 for feature extraction. Meanwhile, the ICOA is utilized to select the optimal hyperparameter values of the DL model. At last, the extreme learning machine (ELM) classification model can be utilized for the recognition of various kinds of signs. To exhibit the better performance of the SLR-ICOADL approach, a detailed set of experiments are performed. The experimental outcome emphasizes that the SLR-ICOADL technique gains promising performance in the SL detection process.

Objectives This study investigated the characteristics of coronavirus disease 2019 (COVID-19) among individuals with disabilities on a nationwide scale in the Republic of Korea, as limited research has examined this population. Methods Between January 1 and November 30, 2021, a total of 5,687 confirmed COVID-19 cases among individuals with disabilities were reported through the Korea Disease Control and Prevention Agency’s COVID-19 web reporting system. Follow-up continued until December 24, and demographic, epidemiological, and clinical characteristics were analyzed. Results Individuals with disabilities represented approximately 1.5% of confirmed cases, with a mean age of 58.1 years. Most resided in or near metropolitan areas (86.6%) and were male (60.6%). Frequent sources of infection included home (33.4%) and contact with confirmed cases (40.7%). Many individuals (75.9%) had underlying conditions, and 7.7% of cases were severe. People with disabilities showed significantly elevated risk of severe infection (adjusted odds ratio [aOR], 1.63; 95% confidence interval [CI], 1.47–1.81) and mortality (aOR, 1.65; 95% CI, 1.43–1.91). Vaccination against COVID-19 was associated with significantly lower risk of severe infection (aORs for the first, second, and third doses: 0.60 [95% CI, 0.42–0.85], 0.28 [95% CI, 0.22–0.35], and 0.16 [95% CI, 0.05–0.51], respectively) and death (adjusted hazard ratios for the first and second doses: 0.57 [95% CI, 0.35–0.93] and 0.30 [95% CI, 0.23–0.40], respectively). Conclusion Individuals with disabilities showed higher risk of severe infection and mortality from COVID-19. Consequently, it is critical to strengthen COVID-19 vaccination initiatives and provide socioeconomic assistance for this vulnerable population.

Aim. To study the rates of repeated disability due to brain malignancies in the female population in Moscow for 2017–2021 and develop measures to prevent morbidity and reduce disability from these causes. Materials and methods. The study was continuous; the information database of the Single Automated Vertically Integrated Information and Analytics System for Social Security Medical Assessments of the Main Office of Medical and Social Assessment was used based on the results of a re-examination of female patients with brain malignancies (BM) at the Bureau of Medical and Social Expertise for 2017–2021. Results. The study of repeated disability of the female population due to brain malignancies in Moscow for 2017–2021 showed an increase in the absolute number and percentage of persons repeatedly recognized as disabled; the predominance of persons of working age (63.8%) with an upward trend; the predominance of disabled people of group II with a tendency to increase in absolute number, proportion and level; the predominance of disabled people of groups II–III among women of working age and groups I–II among persons older than working age. Conclusion. The study of repeated disability of the female population due to brain malignancies in Moscow for 2017–2021 showed an increase in the absolute number and percentage of persons repeatedly recognized as disabled; the predominance of persons of working age (63.8%) with an upward trend; the predominance of disabled people of group II with a tendency to increase in absolute number, proportion and level; the predominance of disabled people of groups II–III among women of working age and groups I–II among persons older than working age. It indicates the need for preventive measures, screening for early detection of brain malignancies, primarily of the working-age population, with the expansion of high-tech approaches to patients, observing routing at all stages of medical rehabilitation with the introduction of modern technologies.