REVIEW | doi:10.20944/preprints201808.0224.v1
Subject: Social Sciences, Psychology Keywords: disability, ageing, health, disablement, wellbeing, functioning, participation, inclusion, oldest olds, genetics, environmental variables, lifestyles, World Health Organization
Online: 13 August 2018 (09:47:22 CEST)
In the last decades there has been a progressive aging of the population, known as “demographic revolution” or “demographic transition”. As a consequence of the worldwide progressive aging of population and of the increasing of general life expectancy, the relationship between aging and disability became a very important one and received a huge interest in research for its consequences on participation, inclusion and quality of life of ageing people and for its consequences on socio-sanitary organizations. The aim of this paper is to analyze this relationship and to discuss consequences on participation, inclusion and quality of life of ageing people, according to recent conceptual models of disability and active ageing. According to previous papers this relationship could be considered in two ways: ageing with disability (which refers to people living with long-term effects of disabling conditions acquired from birth to middle age) and disability with ageing (which refers to people which disabling conditions acquired later or age-related conditions), but newer papers proposed a convergence of these two approaches, taking into account the similarities and the differences between the two ways.
ARTICLE | doi:10.20944/preprints202304.0939.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: oral health care; older people; multimorbidity; polypharmacy; frailty; sarcopenia; disability; care dependency
Online: 26 April 2023 (03:23:46 CEST)
The oral health of older individuals can be negatively impacted by various systemic health factors, leading to rapid oral health deterioration. Older people are at risk of experiencing adverse reactions to medications due to multimorbidity, polypharmacy, and changes in pharmacokinetics and pharmacodynamics. Hyposalivation, a significant side effect of some medications, can be induced by both the type and number of medications used. Frailty, disability, sarcopenia, care dependency, and limited access to professional oral healthcare can also compromise the oral health of older people. To prevent rapid oral health deterioration, a comprehensive approach is required that involves effective communication between oral healthcare providers, other healthcare providers, and informal carers. Regardless of their health status, it is crucial to prioritize the well-being of older people. Oral healthcare providers have a responsibility to advocate for the importance of maintaining adequate oral health and to raise awareness of the serious consequences of weakened oral health. By doing so, we can prevent weakened oral health from becoming a geriatric syndrome.
ARTICLE | doi:10.20944/preprints202103.0188.v1
Subject: Medicine And Pharmacology, Immunology And Allergy Keywords: disability; quality of life; cerebral palsy; surveillance
Online: 5 March 2021 (11:51:51 CET)
Secondary and tertiary prevention strategies targeting people with disabilities to improve their health and wellbeing is important. In Sweden, >95% of all children with cerebral palsy (CP) participate in a follow-up program, where one of the goals is the prevention of hip dislocations. We reviewed the incidence of hip dislocations from 2010 to 2019 and the number of children who underwent different types of hip surgeries. The number of hip dislocations was reduced from 8.8% before introduction of the program to 0.3-0.4% up to 2015, followed by a gradual increase to 0.8% in 2019. The proportion of children who underwent adductor-psoas lengthening as their primary preventive surgery decreased from 50% in 2017 to 37% in 2019 with a corresponding increase of children undergoing femoral osteotomy, indicating more children underwent surgery at a later stage. Reasons for the increased number of children with hip dislocation may be that more children have moved to Sweden in recent years without corresponding compensation in health care resources and increased waiting times for surgery due to, among other things, a shortage of nurses. The results highlight the importance of constantly monitoring follow-up programs.
ARTICLE | doi:10.20944/preprints201809.0585.v1
Subject: Social Sciences, Sociology Keywords: disability; poverty; health; social exclusion; social inequality
Online: 29 September 2018 (06:05:36 CEST)
In this paper, we analyze data from the 2012 Encuesta de Integración Social y Salud (Social Integration and Health Survey) of the Instituto Nacional de Estadística (Spanish National Institute of Statistics) to obtain profiles created by combining disability, poverty and social exclusion. We hypothesize that the probability that people will experience social exclusion increases if they have a disability, chronic illness or limitation in conducting everyday activities, and that this probability is greater for women than for men. To conduct our analysis, we constructed a social exclusion model based on a series of social determinants that acts as a dependent variable. In this context, social exclusion is understood to go beyond the concept of financial poverty. We performed bivariate analyses, in which we calculated the Odds Ratios (OR) for certain variables considered to be predictors of social exclusion. We also performed a means comparison test and an ANOVA test to observe differences between individuals with recognized disability and those without. Finally, we conducted logistic regression analysis to determine which vulnerability profiles are most likely to experience a situation of social exclusion. We also discuss the limitations of our study, and suggest areas in, which the relationships between health, social exclusion and disability can be further investigated.
ARTICLE | doi:10.20944/preprints202008.0553.v1
Subject: Social Sciences, Education Keywords: disability statistics; kappa; intraclass correlation coefficient; young adolescents; functional difficulties; special education; survey; health behaviour
Online: 25 August 2020 (11:48:46 CEST)
Determining disability prevalence is an important area for population statistics, especially among young adolescents. The Washington Group on Disability Statistics is one source of reporting disabilities through functional difficulties. However, young adolescents self-reporting this measure is in its infancy. The purpose of this study was to carry out an intra-rater test-retest reliability study on a modified set of items for self-reporting functional difficulties. Young adolescents (n=74; boys=64%; age m=13.7, SD=1.8) completed a self-reported version of the child functioning module in a supervised classroom. The second administration took place two weeks later. Intraclass correlation coefficient (ICC) and Kappa (k) statistics were used to test reliability of the items, and interpretation through Landis & Koch, and Cohen, respectively. The majority of items had substantial or moderate agreement, although there was only fair agreement for self-care (ICC=0.59), concentration (ICC=0.50), and routine (ICC=0.54). Kappa statistics of behaviour were interpreted to be large (k=0.65), and seeing (k=0.49), walking (k=0.49), and speaking (k=0.49) difficulties were moderate. The majority of the items in the self-reported version of the child functioning module can be used in a scale format, although some caution may be required on items of self-care and concentration when used as a dichotomous variable.
ARTICLE | doi:10.20944/preprints202205.0038.v1
Subject: Public Health And Healthcare, Other Keywords: COVID-19; spinal cord injury; disability; stroke; well-being; social isolation
Online: 5 May 2022 (12:35:32 CEST)
Coronavirus disease 2019 restrictions impacted Canadians' daily living, especially those at higher risk of compromised health conditions. This study aimed to describe the physical, psychological, and social well-being of adults with disabilities, and older adults from May to June 2020. An online survey was used to administer standardized measures of mobility, anxiety and depression, boredom, resilience, technology readiness, social support, social networks, and participation. Seventy-two participants were recruited, with a mean age (SD) of 61.2 (13.8). 69.4% of participants had a disability, and 51.4% were older adults. 27.8% and 16.7% of participants exceeded the anxiety and depression cut-off scores, respectively. Boredom and restriction in participation were experienced by 76.4% and 80.1% of participants, respectively. Participants' mean (SD) resilience and life space scores were 72.4 (14.0) and 51.9 (24.0), respectively. Individuals with disabilities have comparatively higher mean anxiety (5.5 to 3.3), depression (4.8 to 2.9), and boredom (92.2 to 72.3) scores than those without. Individuals with a disability had lower resilience (69.9 to 78.0) and felt more life space restrictions (45.4 to 67.6). Our findings revealed issues with anxiety, boredom, participation, and life space activity. This information may provide supporting evidence when creating policies to mitigate existent health and social inequities.
ARTICLE | doi:10.20944/preprints202105.0141.v2
Subject: Medicine And Pharmacology, Orthopedics And Sports Medicine Keywords: low back pain; women; exercise; physical activity; health education; Oswestry Disability Index; Back Pain Functional Scale; ergonomics
Online: 10 May 2021 (14:07:50 CEST)
Back pain is a common symptom that affects all age groups across the globe, when left untreated may eventually lead to disability. A convenient sample selection method was used in this study due to the global Covid-19 pandemic lockdown which was effective in Turkey during the investigation period. Thus, virtual data collection and health education including some health risks were employed. A total population of two hundred adult women was involved in the study but one hundred and twenty-one responses were collected. Findings show that, for socio-demographic characteristics, the pain was found highest in women between the ages of 41-50 and obese/overweight individuals. Although, there was no significant difference recorded in the marital status category. Moreover, statistical mean differences were detected between the scales for ODI (4.18) and BPFS (6.09). Also, p<0.05, paired sample t-test was 0.001 ODI and 0.001 BPFS after the training exercise. This suggests that exercise training is inversely correlated with pain severity which implies that training has a significant influence on pain intensity. Thus, it could be concluded that there is a relationship between the training exercise and ODI/BPFS.
BRIEF REPORT | doi:10.20944/preprints202007.0633.v1
Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: Children; adolescents; post-road traffic accidents; EQ-5D-5L; disability burden; health-related quality of life
Online: 26 July 2020 (03:11:18 CEST)
The objective of the study was to report the health-related quality of life (HRQOL) following road traffic accidents (RTAs) among children. A community-based survey using EuroQol five-dimension questionnaire (EQ-5D-5L) in Hindi was used to collected data from community. The survey included 2620 households from urban and rural areas of Ujjain, India. From these households 229 children aged 5–18 years with a history of RTA in the last 1 year were identified, with 27%, 63%, and 10% children reporting mild, moderate, and severe injury based on length of hospitalization. Motorcycles, bicycles, and pedestrians constituted most RTAs. Helmet use was low (12%). EQ-5D-5L revealed that the most severe and extreme problem was pain and discomfort, whereas the least severe problem was usual activity and self-care. The most common (65%) injuries were either abrasion or fracture and dislocation. EQ-5D-5L severity index was maximum (mean 72) for lower extremity injuries. The results of the present study highlight the ability and requirement for quality of life measurement using EQ-5D-5L among children post-RTA.
ARTICLE | doi:10.20944/preprints202109.0037.v1
Subject: Medicine And Pharmacology, Psychiatry And Mental Health Keywords: COVID-19; disability; risk factors; communication; medical rehabilitation; psychosomatic patients; general public; infection; physical health; psychological health
Online: 2 September 2021 (12:08:42 CEST)
Background: During the COVID-19 pandemic, hygiene behaviors such as keeping distance, avoid-ing masses, wearing face masks and adhering to hand hygiene recommendations became impera-tive. The current study aims to determine factors interrelating with hygiene behaviors. Methods: 4,049 individuals (1,305 male, 2,709 female, aged 18-80 years) were recruited from rehabilitation clinics or freely on the internet and surveyed via online questionnaire between May 2020 and August 2021. Socio-demographics, hygiene behaviors, emotions (fear), life-satisfaction, risk factors and disability as well as communication were assessed. Results: Prevalence for hygiene behaviors was: keeping the distance 84.9%, avoiding mass gatherings 84.6%, wearing face masks 96.5% and hand hygiene 80.7%. Hygiene behaviors were significantly related to fear with linear and quad-ratic associations. Conclusion: Individuals with disabilities, risk factors and psychological symp-toms are more compliant. Especially hand hygiene should be targeted to achieve higher compli-ance rates. A medium level of fear is more functional than too elevated fear. Behavioral interven-tions and targeted communication aiming at improving different behaviors in orchestration can help individuals to remain healthy and maintain a high life-satisfaction. Thereby, communication in the healthcare setting is imperative and all involved individuals should become more aware of this to ensure high hygiene standards and patient safety.
REVIEW | doi:10.20944/preprints202102.0389.v1
Subject: Business, Economics And Management, Accounting And Taxation Keywords: Family; Disability; Relationships
Online: 17 February 2021 (12:44:53 CET)
The existence and family living with a sibling with a disability implies a dynamic and a structure with meaning to children and their circumstances. However, a sibling that accompanies, helps, or takes part in family life, usually is lower analysis compared with children with disabilities. The goal of this work is to analyze the behavior of children before siblings with disabilities. Following two children’s opinions in this context. It is intended to make some analysis about the children's behavior towards their sibling, and finally, seek reflection on the structure of family relationships.
ARTICLE | doi:10.20944/preprints202201.0176.v2
Subject: Social Sciences, Sociology Keywords: Disaster; Disability; Disaster Management; NCCD; UNCRPD; Disability & Disaster; Disaster Medicine
Online: 25 May 2022 (11:19:53 CEST)
Disabled children on the one hand have a wide range of impairments that translate into functional limitations but at the same time they possess various talents and capacities. These are manifested into the dynamics of society and the environment that they interact with. This article discusses disaster management with disabled children as a focus group. Disaster, disability and its management is discussed in the context of international practices in general and suited to India in particular. The research follows a review of the recommendations of the United States National Commission on Children and Disaster. In addition to this Disaster Medicine as one approach to Disaster Management concerning disabled children has been explored. The research concludes that the understanding of particular issues of Children with disabilities as one stakeholder, their capacity to engage and a shift in mindset and power relations in which they can contribute to disability inclusive disaster management are fundamental to disability-inclusive DRR.
ARTICLE | doi:10.20944/preprints202003.0383.v1
Subject: Computer Science And Mathematics, Computer Science Keywords: ontology; disability; Semantic Web
Online: 30 March 2020 (07:21:42 CEST)
At least 15% of the population in the world has some type of disability. Unfortunately, this population has the problem of facing various accessibility barriers, to which technological barriers are also added. One of the most relevant obstacles is the one that arises as a result of the development of the technology itself when using the Information and Communication Technologies (ICT). Therefore, the objective of this article is to review the main uses of the Semantic Web tools and to group them together in order to be able to propose the design and construction of more personalized and flexible systems, which allows to help people with disabilities to perform some type of activity using ICT, in this way, knowledge can be modeled in different domains related to people who have some type of disability, using ontologies, and some ontological models can be reused for various types of disability depending on the case study. The usefulness of this study is to reveal that with the models presented, it is possible to construct a Meta ontology that includes some or all areas of disability.
ARTICLE | doi:10.20944/preprints201905.0209.v1
Subject: Social Sciences, Education Keywords: disability, inclusion, medical education
Online: 16 May 2019 (10:41:19 CEST)
ABSTRACT:This paper presents arguments for why it is important to include disability in the undergraduate medical curriculum. I, the first author am currently involved with my doctoral thesis proposal titled "Proposing clinician competency guidelines for the inclusion of disability in the undergraduate medical curriculum of South Africa. An exploratory study.” As part of my research, I conducted a literature search and developed arguments to strengthen the reasons why the research I propose in my thesis is necessary. It is important that I position myself in this research. I am a South African, Caucasian, female medical doctor, with an interest in physical rehabilitation medicine and I am a person with a physical disability. Although this research study will be conducted in South Africa, I am hopeful that the findings will be transferable to medical schools across the world.
ARTICLE | doi:10.20944/preprints201812.0282.v1
Subject: Social Sciences, Cognitive Science Keywords: Twice-Exceptional, Interventions, Gifted, Disability
Online: 24 December 2018 (14:49:46 CET)
What began nearly a century ago with the contributions of Hollingworth and Asperger, among others, has developed into a field dedicated to the study of gifted individuals with a disability. These twice-exceptional (2e) people and their unique set of needs differ from those of their once-exceptional counterparts on either end of the spectrum and often remain unaddressed or are discovered very late in life resulting in longterm consequences. For those discovered, effective treatment options to improve their quality of life remain uncertain. The goal of the present paper was to determine whether effective interventions exist to improve domain-specific (i.e., social, emotional, or academic) outcomes for people exhibiting both signs of giftedness and disability. A query was performed using evidence databases TRIP and PDQ in addition to University at Buffalo Libraries holdings for "twice-exceptional," "Giftedness," "Disability," and "intervention." The hits were reduced to the four most relevant, freely available studies in English that were selected for critique. Despite the selected studies being found to share methodological similarities that were their strengths and conducive to comparison, they also had threats to validity that served as potential weakness. Not only can directly effective interventions improve specific domains for 2e individuals, but the effects of domain-specific interventions may carry over into another domain resulting in indirect effects.
ARTICLE | doi:10.20944/preprints202305.2214.v1
Subject: Social Sciences, Education Keywords: Mathematics; Self-efficacy; Learning disability; Dyscalculia
Online: 31 May 2023 (09:50:56 CEST)
In the study, it was aimed to develop a valid and reliable scale in order to determine the self-efficacy perceptions of classroom teachers in the field of mathematics learning difficulties. In the development process of the scale, the basic resources and the scale development studies in the literature were examined. First, a pool of substances was created. Content validity was ensured by taking the opinions of 21 expert participants in the 24 question areas determined in the item pool. Content validity index was used in content validity. In this analysis, two questions were removed from the scale. Preliminary application was made with 44 participating teachers who are experts in their fields and exploratory factor analysis was started. For exploratory factor analysis, 359 people consisting of classroom teachers in Sakarya province were studied. In the explanatory factor analysis, 5 items were removed from the scale by looking at the factor load. The factor loadings for the 17 items in the scale vary between 0.508 and 0.976. Among the comparative fit indices obtained as a result of confirmatory factor analysis, RMSEA=0.067 and Cmin/DF=1.568 were calculated. The Cronbach alpha reliability coefficient of the measurements is 0.970. The data obtained were analyzed with statistical methods using SPSS 25, AMOS 24 and Microsoft Excel programs. The validity and reliability criteria of the scale developed within the scope of the study were met.
ARTICLE | doi:10.20944/preprints202012.0729.v1
Subject: Social Sciences, Cognitive Science Keywords: disability; ARW2; ARST; tilt angle; trajectory
Online: 29 December 2020 (14:26:10 CET)
The purpose of this study is to compare and analyze the kinematic characteristics of the upper limb segments during the archery shooting of Paralympic Wheelchair Class archers (ARW2 - second wheelchair class – paraplegia or comparable disability) and Paralympic Standing Class archers (ARST - standing archery class – loss of 25 points in the upper limbs or lower limbs), where archers are classified according to their disability grade among elite disabled archers. The participants of this study were selected as seven elite athletes with disabilities, 4 ARW2, and 3 ARST. The analysis variables were 1) the time required for each phase, 2) the angle of inclination of the body center, 3) the change of trajectory of body center, and 4) the change of movement locus of bow center by phase when performing six shots in total. The ARW2 group showed a longer time than the ARST group, and the angle of the body did not show a significant difference between the two groups. Although there was no significant difference in the mean score between the two groups, it was judged that kinematic performance according to each group was, in that there was a measurable variation in kinematic variables.
Subject: Medicine And Pharmacology, Orthopedics And Sports Medicine Keywords: Disability, function, knee osteoarthritis, physical therapy.
Online: 22 March 2019 (10:10:19 CET)
BACKGROUND: Knee osteoarthritis (OA) commonly causes increase in the patients’ disability and reduce their function because it causes pain, limitation in knee range of motion and decrease in muscle power.AIM: This study investigated the effect of three different physical therapy programs on knee range of motion , pain level, muscle strength and functional condition in patients with knee OA. DESIGN: Randomized comparative study.SETTING: Outpatient Rehabilitation clinic of Tongji Hospital (Wuhan, China).POPULATION: Seventy-two patients of Knee OA (aged 40-70) enrolled and randomly allocated into three groups. Group A (n=24) received physical agents and isometric quadriceps exercises, group B (n=24) received same physical agents as group A in addition to open kinetic chain exercises and group C (n=24) received physical agents as group A in addition to closed kinetic chain exercises.METHODS: knee range of motion (by electro goniometer), knee pain level (by VAS), quadriceps muscle strength (by isokinetic dynamometer) and functional condition (by WOMAC) were assessed before and after 5 weeks of treatment.RESULTS: In between group analysis, there were significant differences (P<0.05) between the three groups for all outcome measure. In within-group analysis, group C was the only group that showed significant differences (P<0.05) in all the outcomes. Group A and B showed significant differences (P<0.05) in quadriceps muscle strength and knee pain and no significant differences (P>0.05) in knee ROM and functional condition.CONCLUSIONS: After the study, our solid conclusion is that in physical therapy programs or protocols, closed kinematic chain exercise is very effective, it improves knee ROM, and help in reducing knee pain, muscle strength, function and disability for patients with knee osteoarthritis.CLINICAL REHABILITATION IMPACT: Comparison between different physical therapy programs provides the rehabilitation team with the best treatment intervention that is more effective in treating the problems associated with knee osteoarthritis.
ARTICLE | doi:10.20944/preprints201808.0199.v1
Subject: Social Sciences, Psychology Keywords: disability, exercise, health promotion, framework, theory
Online: 9 August 2018 (21:01:43 CEST)
Lack of physical activity participation for adults with a disability remain a large public health concern. For those with existing, or newly acquired disability, increased sedentary behavior stemming from physical impairments often results in the development of secondary chronic health conditions (e.g., obesity or osteoarthritis) which leads to participation restrictions within major life roles. Without intervention these secondary conditions further increase physical impairment which, in turn, sets these populations up for continuous negative health trajectories over their remaining lifespan. Physical activity can attenuate the development of secondary health conditions and optimize health outcomes within these populations. However, those with disability often do not possess the necessary physical capacity to maintain physically active lifestyles. Therefore, exercise programs specifically designed to increase physical functioning have been identified as a necessary intermediate step to reduce physical limitations prior to adoption of physically active lifestyles. Adoption of exercise program participation remains a difficult task for both the general population and those with disability alike. Based on current rates of physical inactivity, it is clear that traditional health behavior change models do not adequately address the complexity of this issue. This paper highlights some of the limitations within the current health behavior change models as they relate to exercise behavior. Additionally, a novel conceptual framework is presented for the intent of its incorporation within research and health promotion interventions targeting exercise behavior within disability populations.
ARTICLE | doi:10.20944/preprints202201.0158.v1
Subject: Medicine And Pharmacology, Orthopedics And Sports Medicine Keywords: low back pain; physical therapy; disability; hydrotherapy
Online: 12 January 2022 (08:23:24 CET)
Low back pain is a common problem in the active population, and the second reason for visiting a physician. In patients with lumbar disc protrusion, the nucleus pulposus bulges against the disc and the latter protrudes into the spinal column, but the annulus fibrosus remains intact. The purpose of this study was to prove that starting an early complex rehabilitation treatment results into pain and disability reduction, and increased muscle strength and mobility in patients with lumbar disc protrusions. We performed a prospective cohort study, enrolling 60 patients (25 men and 35 women) aged between 26 to 76 years, diagnosed with lumbar disc protrusion. Patients in the experimental group registered significant improvements in all studied variables (pain, mobility, muscle strength, disability) after 6 months of treatment. The results of our study suggest that, in the lumbar disc disease, a combined rehabilitation program may be more effective in terms of pain and disability reduction, if it starts early after diagnosis. The current study proves the importance of combining electrotherapy with hydrotherapy and physical therapy. Patients who received this treatment combination showed an extremely significant improvement in pain relief, and reduction of functional disability after 6 months of treatment.
ARTICLE | doi:10.20944/preprints202103.0115.v1
Subject: Social Sciences, Gender And Sexuality Studies Keywords: Disability; Caste; Intersectionality; Maternal healthcare; Utilization; Nepal
Online: 2 March 2021 (22:07:38 CET)
Background: Disability and caste are two different forms of oppression, however Dalits and people with disabilities commonly face similar types of marginalities. Dalit women with disabilities may experience double discrimination because of the intersectionality of disability and caste. This study examines whether the disability and caste identity of women together affects and compounds the utilization of maternal healthcare services. Methods: A cross-sectional survey was conducted using a semi-structured questionnaire among a total of 354 Dalit and non-Dalit women, with and without a disability aged between 15 – 49 years. Maternal healthcare service utilization was assessed by Ante-Natal Care (ANC), health facility (HF) delivery, and Post-Natal Care (PNC) during the last pregnancy. Logistic regression was performed to detect the predictors of service utilization and identify whether disability and caste were associated with service utilization. First, disability and caste were fitted separately in models. Secondly, the intersectionality of disability and caste was tested by the inclusion of disability*caste interaction term. Finally, the confounding effect of socio-demographic factors was investigated. Results: Out of surveyed women, 73% had 4+ ANC visits, 65% had HF delivery and 29% had a PNC visit during their last pregnancy. Women with a disability had lower odds of HF delivery (OR 0.50, CI 0.30 – 0.84) and PNC (OR 0.47, CI 0.25 – 0.88) than women without a disability. Adjustment for women’s age and household wealth explained associations in HF delivery by women with disabilities. There was no association between caste and service utilization. Disability overrode caste and there was no other evidence of effect modification by women’s caste status in the utilization. However, a weak interaction effect in the utilization of ANC services was found in the caste group by their education (OR 0.19, 95% CI 0.05 – 0.74). Conclusions: Disabled women – whether Dalit or non-Dalit - had lower rates of utilizing all maternal healthcare services than non-disabled women. However, Dalit women with disabilities were more likely to receive PNC than non-Dalit women with disabilities. Increasing equity in maternal healthcare service utilization requires that traditional approaches to service development and program intervention to be re-examined and more nuanced interventions considered to ensure improved access and outcome among all vulnerable groups.
Subject: Social Sciences, Psychology Keywords: screening; dementia; intellectual disability; early-onset; neuropsychology
Online: 15 October 2020 (12:01:34 CEST)
Background and Aims: Screening and assessment of cognitive changes in adults with Intellectual Disabilities, mainly Down Syndrome (DS), is crucial to offer appropriate services to their needs. We present a systematic review of the existing instruments assessing dementia, aiming to support researchers and clinicians’ best practice. Methods: Searches were carried out in the databases Web of Science; PubMed; PsycINFO in March 2019 and updated in May 2020. Studies were selected and examined if they: (1) focused on assessing age-related cognitive changes in person with ID; (2) included adults and/or older adults; (3) included scales and batteries for cognitive assessment. Results: Forty-eight cross-sectional studies and twenty-six longitudinal studies were selected representing a total sample of 5,851 participants (4,089 DS and 1,801 with other ID). In those studies, we found 38 scales, questionnaires, and inventories, and 14 batteries for assessing cognitive and behavioural changes in adults with DS and other ID. Conclusion: The most used instrument completed by an informant or carer was the Dementia Questionnaire for Learning Disabilities (DLD), and its previous versions. We discuss the strengths and limitations of the instruments and outline recommendations for future use.
ARTICLE | doi:10.20944/preprints201809.0249.v2
Subject: Medicine And Pharmacology, Orthopedics And Sports Medicine Keywords: sedentary behaviours; screen time; children; HBSC; disability
Online: 19 October 2018 (06:18:52 CEST)
Reducing sedentary behaviours can help prevent non-communicable diseases, particularly among young adolescents with long term illnesses or disabilities (LTID). Much of young people’s voluntary sedentary time is related to screen-time behaviours (STBs) such as TV viewing, playing computer games, and using the computer for other activities. Although public health data on adolescents’ STB is growing, information about adolescents with LTID is currently lacking in a European context. The purpose of this study is to compare time on STBs between adolescents with and without LTID in European Countries through the HBSC 2013/14 study. Young adolescents (n = 61,329; boys 47.8%) from 15 European countries reported the time spent on TV viewing, playing computer games, and using the computer for other purposes on weekdays and the weekend. STBs were dichotomised based on international recommendations of less than 2 h per day, and Chi-square tests of independence were performed to investigate differences. STB time was combined to produce a sum score as dependent variable in multiple analysis of covariance with age and family affluence as covariates. There were statistically significant differences in computer gaming among boys and other computer use among girls for both weekdays and weekends, whereby adolescents with LTID reported higher use. In addition, both boys and girls with LTID spent more time on STBs than their same sex peers without LTID (Boys, F = 28.17, p < 0.001; Girls, F = 9.60, p = 0.002). The results of this study indicate a need for preventive strategies to address high levels of STB among young adolescents with LTID and reduce the risk of poor health outcomes associated with higher levels of sedentary behaviour.
REVIEW | doi:10.20944/preprints202305.1845.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: Low back pain; hip; strengthening; treatment; pain; disability.
Online: 26 May 2023 (04:22:58 CEST)
Low back pain (LBP) is a health problem that affects 70-80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of the study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from PubMed, PEDro, and Scopus databases published up to September 2022. Based on Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASpe and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as “good”. In conclusion, the addition of hip muscle strengthening exercises iterating LBP effectively improving pain and disability.
ARTICLE | doi:10.20944/preprints202304.1132.v1
Subject: Social Sciences, Other Keywords: disability; children, extra costs; standard of living; Philippines
Online: 28 April 2023 (07:18:27 CEST)
The assessment of disability related costs among children remains a largely under-researched subject with related questions rarely included in surveys. This paper addresses this issue through a unique mixed methods study conducted in the Philippines combining a nationally representative survey and in-depth interviews with families and health professionals. To quantify the extra costs associated with disability the research used the standard of living approach, whereby expenditure levels of families with children with and without disabilities are compared in relation to different measures of living standards. The results find consistent evidence of high extra costs among households that have children with disabilities and point to health expenses as the leading source. Using an asset index as the indicator of living standards, a child with disability is estimated to require between 40 and 80% extra expenditure to reach the same living standard of other children. However, the size of extra costs is substantially higher when the measure of standard of living relies on a broader set of deprivations. In such cases, higher estimates of extra costs are likely to be the result of the lack of an inclusive environment. Critically, this points to the need not only to provide financial support, but also inclusive services, especially in health and education.
ARTICLE | doi:10.20944/preprints202011.0170.v1
Subject: Social Sciences, Psychology Keywords: Chronic musculoskeletal pain; Adolescents; functional disability; multidisciplinary rehabilitation.
Online: 3 November 2020 (15:41:07 CET)
(1) Background: Chronic musculoskeletal pain (CMP) in adolescents can negatively affect physical, psychological and social functioning, resulting in functional disability. This study aims to evaluate the effectiveness of an outpatient rehabilitation program based on graded exposure in vivo (EP) compared with care as usual (CAU) in a RCT. The aim of the interventions (EP and CAU) is to improve functional ability in adolescents with CMP, CAU is interdisciplinary outpatient rehabilitation care, based on graded activity. (2) Methods: A pragmatic multicenter randomized clinical trial with a 12-month follow-up was used. Adolescents (12-21 years) with musculoskeletal pain were invited to participate. Primary outcome was functional disability (Functional Disability Inventory). Most important secondary measures: perceived harmfulness, pain catastrophizing and intensity. Data analysis was performed by intention-to-treat linear mixed model analysis. (3) Results: Sixty adolescents were randomized to EP or CAU and data of 53 adolescents (93% female) could be analyzed (25 EP, 28 CAU). Mean age was 16.0 years (SD=1.87). Adolescents in EP showed a clinically relevant and statistically significant decrease in functional disability (estimated mean difference at least -8.81,p-values≤0.01) compared with CAU at all time points. Significant differences in favor of EP were found for perceived harmfulness at all time points (p-values≤0.002), for pain catastrophizing (PCS) at 2 months follow-up (p-value=0.039) and for pain intensity at 4 and 10 months follow-up (p-values≤0.028). (4) Conclusion: The effectiveness of the trial is in favor of the EP and leads to a significant and clinically relevant decrease in functional disability compared to usual care.
REVIEW | doi:10.20944/preprints201807.0601.v1
Subject: Medicine And Pharmacology, Orthopedics And Sports Medicine Keywords: aging; disability; healthy aging; osteoarthritis; pain, rehabilitation, successful aging
Online: 30 July 2018 (22:20:03 CEST)
Background: Aging is commonly accepted as a time period of declining heath. Aims: This review aimed to examine the research base concerning the use of term ‘successful aging’, a process and outcome deemed desirable, but challenging to attain. A second was to provide related information to demonstrate how health professionals as well as individuals can aim for a ‘successful aging’ process and outcome, despite the presence of disabling osteoarthritis. Methods: Information specifically focusing on ‘successful aging’ and the concept of improving opportunities for advancing ‘successful aging’ despite osteoarthritis was sought. Results: Among the many articles on ‘successful aging’, several authors highlight the need to include, a broader array of older adults into the conceptual framework. Moreover, conditions such as osteoarthritis should not necessarily preclude the individual from attaining a personally valued successful aging outcome. Conclusion: Pursuing more inclusive research and research designs, and not neglecting to include people with chronic osteoarthritis can potentially heighten the life quality of all aging individuals, while reducing pain and depression, among other adverse aging and disability correlates among those with osteoarthritis
ARTICLE | doi:10.20944/preprints201712.0064.v1
Subject: Social Sciences, Psychology Keywords: sex differences; suicide attempt; late life; depression; physical disability
Online: 11 December 2017 (13:04:01 CET)
Relatively little research attention has been paid to sex issues in late life suicidal behaviour. The aim was to compare clinical characteristics of women and men aged 70+ who were hospitalized after a suicide attempt. We hypothesized higher depression and anxiety scores in women, and we expected to find that men would more often attribute the attempt to health problems and compromised autonomy. Participants (56 women and 47 men, mean age 80) were interviewed by a psychologist. In addition to psychiatric and somatic health assessments, participants responded to an open-ended question concerning attributions of the attempt. There were no sex differences in depression and anxiety, but women were more likely to report that they found their situation hopeless (67.9% vs. 43.8%, p = 0.02). At least one serious physical disability was noted in 60.7% of the women and 53.2% of the men (p = 0.55). Proportions attributing their attempt to somatic illness did not differ (women, 14.5% vs. men 17.4%, p = 0.79), and similar proportions attributed the attempt to reduced autonomy (women, 21.8% vs. men, 26.1 %, p = 0.64). The unexpected lack of sex differences might be influenced by cultural context in which sex norms play a part.
REVIEW | doi:10.20944/preprints202202.0342.v1
Subject: Medicine And Pharmacology, Neuroscience And Neurology Keywords: biomarker; diagnostic; prognostic; blood; cerebrospinal fluid; multiple sclerosis; disability pregression
Online: 26 February 2022 (03:33:31 CET)
Introduction: multiple sclerosis (MS) is the most common immune-mediated chronic neurodegenerative disease of the central nervous system (CNS), affecting young people. Due to the permanent disability, cognitive impairment, and the enormous detrimental impact MS can exert on the patients’ health-related quality of life. It is of great importance to recognise it in time and commence adequate treatment at an early stage. The currently used disease-modifying therapies (DMT) aim to reduce disease activity and thus halt disability development, which in current clinical practice are monitored by clinical and imaging parameters but not by biomarkers found in blood and/or the cerebrospinal fluid (CSF). Both clinical and radiological measures routinely used to monitor disease activity lack information on the fundamental pathophysiological features and mechanisms of MS. Furthermore, they lag behind the disease process itself. By the time a clinical relapse becomes evident or a new lesion appears on the MRI scan, potentially irreversible damage has already occurred in the CNS. In recent years several biomarkers that previously have been linked to other neurological and immunological diseases have received increased attention in MS. Additionally, other novel, potential biomarkers with prognostic and diagnostic properties have been detected in the CSF and blood of MS patients. Areas covered: in this review, we summarise the most up to date knowledge and research conducted on the already known and most promising new biomarker candidates found in the CSF and blood of MS patients. Author commentary: the current diagnostic criteria of MS rely on three pillars; MRI imaging, clinical events and the presence of oligoclonal bands in the CSF (which was reinstated into the diagnostic criteria by the most recent revision). Even though the most recent McDonald criteria made the diagnosis of MS faster than the prior iteration, it is still not an infallible diagnostic toolset, especially at the very early stage of clinically isolated syndrome. Together with the gold standard MRI and clinical measures, ancillary blood and CSF biomarkers may not just improve diagnostic accuracy and speed but very well may become agents to monitor therapeutic efficacy and make even more personalised treatment in MS a reality in the near future. The major disadvantage of these biomarkers in the past has been the need to obtain CSF to measure them. However, the recent advances in extremely sensitive immunoassays made their measurement possible from peripheral blood even when present only in minuscule concentrations. This should mark the beginning of a new biomarker research and utilisation era in MS.
Subject: Business, Economics And Management, Accounting And Taxation Keywords: disability; COVID-19; pandemic; social care; lockdown; social distancing; information
Online: 27 January 2021 (13:44:10 CET)
This paper reports on in-depth qualitative interviews conducted with 69 disabled people in England and Scotland, and with 28 key informants from infrastructure organisations in the voluntary and statutory sectors, about the impact of COVID-19, and measures taken to control it. Participants were recruited through voluntary organisations. As with everyone, the Pandemic has had a huge impact: we discuss the dislocations it has caused in everyday life; the failures of social care; the use of new technologies; and participants’ view on leadership and communication. We conclude with suggestions for urgent short term and medium term responses, so that the United Kingdom and other countries can respond better to this and other pandemics, and build a more inclusive world.
ARTICLE | doi:10.20944/preprints202009.0092.v1
Subject: Social Sciences, Psychology Keywords: intellectual disability; children; South Africa; access to services; poverty; inequality
Online: 4 September 2020 (08:15:25 CEST)
1) Background: Intellectual disability is more common in low- and middle-income countries than in high-income countries. Stigma and discrimination have contributed to barriers to people with intellectual disability accessing healthcare. As part of a larger study on caregiving of children with intellectual disability in urban Cape Town, South Africa, we interviewed a sub-group of families who had never used the intellectual disability services available to them, or who had stopped using them; 2) Methods: We employed a qualitative research design and conducted semi-structured interviews to explore the views and perspectives of parents and caregivers of children with intellectual disability who are not using specialised hospital services. We developed an interview guide to help explore caregivers’ and parents’ views; 3) Results: Results revealed that caregivers and parents of children with intellectual disability did not use the service due to financial difficulties, fragile care networks and opportunity costs, community stigma and lack of safety, lack of faith in services and powerlessness at effecting changes, and self-stigmatisation; 4) Conclusion: Current findings highlight a need for increased intervention at community level and collaboration with community-based projects to facilitate access to services, and engagement with broader issues of social exclusion.
ARTICLE | doi:10.20944/preprints202203.0311.v1
Subject: Medicine And Pharmacology, Orthopedics And Sports Medicine Keywords: robot-assisted gait training; rehabilitation; stroke; cardiorespiratory fitness; robotics; disability; locomotion
Online: 23 March 2022 (08:40:16 CET)
Robot-assisted gait training (RAGT) is a promising treatment for stroke rehabilitation. Although the coordination between the upper and lower limbs is important for locomotor training, commercially available robotics for gait training mainly focus on the restoration of lower limb function. We aimed to evaluate the feasibility and usability of complex upper and lower limb RAGT in stroke patients using the GTR-A®, end effector-type robotic device. Patients with subacute stroke (N=9) received 30-minute RAGT thrice a week for two weeks (six sessions). Functionally, the hand grip strength (HGS), Functional Ambulatory Categories, modified Barthel Index, muscle strength test sum score, Berg Balance Scale, Timed Up and Go test, and Short Physical Performance Battery were used. The heart rate and a structured questionnaire were used to evaluate cardiorespiratory fitness and the usability of RAGT. Among the nine patients, all functional parameters between the baseline and post-training were significantly improved after RAGT, except for HGS and the muscle strength test. The questionnaire’s mean scores for each domain were as follows: safety 4.40±0.35, effects 4.23±0.31, efficiency 4.22±0.77, and satisfaction 4.41±0.25. The GTR-A® is a feasible and safe robotic device for patients with gait impairment after stroke. It showed functional improvement with endurance training effects.
ARTICLE | doi:10.20944/preprints202112.0026.v2
Subject: Medicine And Pharmacology, Neuroscience And Neurology Keywords: Leukocyte telomere length; Mitochondrial DNA; Relapsing- Remittent Multiple Sclerosis; Disability; Aging
Online: 7 December 2021 (12:35:12 CET)
Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease that affects the nervous system. Peripheral blood leukocyte telomere length (LTL) and mitochondrial DNA copy number (mtDNA-CN) are potential biomarkers of disability and neurological damage. The present work evaluated LTL and mtDNA-CN in 75 relapsing-remittent MS (RRMS) patients 50 of whom had an Expanded Disability Status Scale (EDSS) 0 to 3 (mild-moderate disability), and 25 had an EDSS of 3.5 to 7 (severe disability). Absolute LTL and absolute mtDNA-CN were measured via real-time polymerase chain reaction (qPCR). The LTL and mtDNA-CN were significantly lower in RRMS severe disability than in RRMS mild-moderate disability (3.924 ± 0.124 vs 2.854 ± 0.092, p<00001; 75.14 ± 1.77 vs 68.06 ± 1.608, p<0.00001, respectively). The LTL and mtDNA-CN showed a linear correlation in RRMS with mild-moderate disability (r=0.2986, p=0.0351). In addition, in a binary logistic regression model the LTL can predict severe disability (AUC=0.697, p=0.0031, cutoff ≤ 3.0875 Kb, sensitivity= 73.1%, specificity=62.5%), the prediction is improved by including age to the model (AUC=0.765, <0.0001, sensitivity=78.26%, specificity=81.25%). Aging is closely linked to the development of disability in RRMS and can be evaluated through LTL and mtDNA-CN absolute quantification.
REVIEW | doi:10.20944/preprints201704.0074.v1
Subject: Social Sciences, Education Keywords: mathematics education; special education; problem solving; critical mathematics education; disability studies
Online: 13 April 2017 (10:11:23 CEST)
Students with disabilities are often framed as “the problem” and have limited opportunities to engage in standards based mathematics, leading to persistent underachievement. In this paper, we investigate a research divide between mathematics educational research for students with and without disabilities, a divide with significant differences in the theoretical orientations and research methodologies used to understand learners. Based on an analysis of 149 mathematics educational research articles published between 2013 and 2015, we found significant differences between articles focused on learners with and without disabilities. For those with disabilities, mathematical problem solving was understood primarily from behavioral and information processing theoretical perspectives, while for those without disabilities, problem solving was understood primarily through constructivist and sociocultural perspectives. While 86% of research on problem-solving including students with disabilities was quantitative, only 35% of research on students without disabilities was quantitative. Fifty percent of problem-solving research on students without disabilities was qualitative, compared to only 6% of research on students with disabilities. Problem solving, then, is studied in very different ways for learners with and without disabilities. Students without disabilities are studied through close analysis of learning, often individual. Students with disabilities are most often studied quantitatively, in groups, with little analysis of individual thinking. By offering only a limited range of methods and theoretical orientations, this research divide reifies deficit constructions of students with disabilities.
ARTICLE | doi:10.20944/preprints202306.0317.v1
Subject: Social Sciences, Psychology Keywords: exhaustion; disability; illness; disorder; adopted child; adoptive parent; single mom; single dad
Online: 5 June 2023 (12:07:39 CEST)
Although early work on parental burnout in the 1980s did not link parental burnout to specific parenting situations, the idea that parents affected by specific vulnerability factors were particularly at risk of burnout quickly emerged. Based on the etiological model of parental burnout (i.e., the balance between risks and resources), the objective of this study was to determine if there were specific vulnerability factors that significantly increase the risk of parental burnout. 2,563 parents participated in the study. We compared parents with a child with special needs (n = 25), parents who had adopted a child (n = 130), and single parents (n = 109), to strictly matched control groups of parents. Parents with a child with special needs displayed higher burnout and lower balance between risk and resources than the control group; parents with an adopted child had similar levels of both parental burnout and balance; and single parents had higher parental burnout but similar balance. Parents who combined specific several vulnerability factors were at greater risk of burnout. Single parenthood and adoption do not in themselves trigger a process leading de facto to other risk factors, but having a child with special needs does.
ARTICLE | doi:10.20944/preprints202208.0184.v1
Subject: Medicine And Pharmacology, Orthopedics And Sports Medicine Keywords: Exergames; Kinect; neuromuscular disesase; physical disability; rehabilitation; serious games; Virtual reality rehabilitation
Online: 10 August 2022 (03:24:24 CEST)
This paper presents a modular approach to generic exergame design that combines custom physical exercises in a meaningful and motivating story. This aims to provide a tool that can be individually tailored and adapted to people with different needs, making it applicable to different diseases and states of disease. The game is based on motion capturing and integrates four example exercises that can be configured via our therapeutic web platform "Blexer-med". To prove the feasibility for a wide range of different users, evaluation tests were performed on 14 patients with various types and degrees of neuromuscular disorders, classified into three groups based on strength and autonomy. Users were free to choose their schedule and frequency. Game scores and three surveys (before, during, and after the intervention) showed similar experiences for all groups, with the most vulnerable having the most fun and satisfaction. The players were motivated by the story and by achieving high scores. The average usage time was 2.5 times per week, 20 minutes per session. Pure exercise time was about half the game time. The concept has proven feasible and forms a reasonable basis for further developments. The full 3D exercise needs further fine-tuning to enhance fun and motivation.
ARTICLE | doi:10.20944/preprints202211.0273.v1
Subject: Medicine And Pharmacology, Clinical Medicine Keywords: intellectual disability; KAT6A syndrome; Lysine acetyltransferase 6 A; pantothenate; L-carnitine; histone acetylation
Online: 15 November 2022 (04:14:12 CET)
Autism Spectrum disorder (ASD) and intellectual disability (ID) are the most frequent develop-mental disorders with a prevalence between 3% and 5% of the population. In addition, both ASD and ID can be found in the same patient. Mutations in several genes involved in the epigenetic regulation of gene expression have been linked to different ID associated with ASD features including alterations of the ly-sine-acetyltransferase 6A (KAT6A) gene in KAT6A syndrome. KAT6A enzyme participates in a wide range of critical cellular functions such as chromatin remodeling, gene expression, protein synthesis, cell metabolism, and replication. In this manuscript, we examined the pathophysiolog-ical alterations in fibroblasts derived from three patients harboring KAT6A mutations. We ad-dressed survival in stress medium, histone acetylation, protein expression patterns and tran-scriptome analysis as well as cell bioenergetics. In addition, we evaluated the therapeutic effec-tiveness of epigenetic modulators and mitochondrial boosting agents such as pantothenate and L-carnitine in correcting the mutant phenotype. Pantothenate and L-carnitine treatment increased histone acetylation and corrected protein and transcriptomic expression patterns in mutant KAT6A cells. Furthermore, cell bioenergetics of mutant cells was significantly improved. Our results suggest that pantothenate and L-carnitine can significantly correct the mutant phe-notype in cellular models of KAT6A syndrome.
ARTICLE | doi:10.20944/preprints202111.0013.v1
Subject: Biology And Life Sciences, Biochemistry And Molecular Biology Keywords: Nonsense-mediated mRNA Decay; UPF3B-knockout; RNA-Sequencing; Intellectual disability; Neuro-developmental disorders
Online: 1 November 2021 (12:17:15 CET)
UPF3B is a constituent of the classical nonsense-mediated mRNA decay (NMD) pathway that degrades both the aberrant transcripts and a set of physiological transcripts. In higher eukaryotes, UPF3B have significant biochemical functions in diverse cellular processes including NMD and translation. UPF3B plays a crucial role in neuronal development and differentiation. Next-generation sequencing technologies identified several loss-of-function mutations in the UPF3B gene that results in neuro-developmental disorders in humans. To uncover the mechanistic role of UPF3B in neuronal functions, we have generated the UPF3B-knockout mammalian cell line model system using CRISPR-Cas9 gene editing method. RNA-Sequencing Analysis of cellular transcriptome from UPF3B-KO cells identified specific genes involved in cell growth and neuronal functions. Altered expression of genes related to the axon guidance pathway delineated the UPF3B function to regulate the neuron-specific genes. Functional enrichment analysis identified the genes involved in the disorders related to mental health and intellectual disability. Our study has the potential to identify the direct players of intellectual disability and will have broader implications.
ARTICLE | doi:10.20944/preprints202001.0162.v1
Subject: Business, Economics And Management, Econometrics And Statistics Keywords: cardiovascular disease (CVD); Disability-Adjusted Life Years (DALYs); cost of admission; risk factors
Online: 16 January 2020 (09:05:32 CET)
Cardiovascular disease (CVD) is considered to be one of the leading health issues in Thailand. CVD not only contributes to an increase in the number of hospital admissions year on year but also impacts on the rising health care expenditure for the treatment and long-term care of CVD patients. Therefore, this study is aimed at examining the impacts of risk reduction strategies on the number of CVD hospital admissions, Disability-Adjusted Life Years (DALYs) and the costs of hospitalisation. To estimate such impacts a CVD cost-offset model wasapplied using a Microsoft Excel spreadsheet. The number of the mid-year population was classified by age, gender and the CVD risk factor profiles from the recent Thai National Health Examination Survey (NHES) IV. This survey was chosen as the baseline population. The CVD risk factor profiles included age, gender, systolic blood pressure, total cholesterol, and smoking status. The Asia-Pacific Collaborative Cohort Study (APCCS) equation was applied to predict the probability of developing CVD over the next eight-year period. Estimates on the following were obtained from the model: (1.) the CVD events both fatal and non-fatal; (2.) the difference between the projected number of deaths and the actual number of deaths in that population; (3.) the number of patients who are expected to live with CVD; (4.) the DALYs from the estimated number of fatal and non-fatal events; (5.) the cost of hospital admissions. Four CVD risk strategy scenarios were investigated as follows: (1.) the do nothing scenario; (2.) the optimistic scenario; (3.) achieve the UN millennium development goal; and (4.) the worst-case scenario. The findings showed that over the next eight years there are likely to be 3,297,428 recorded cases of CVD; 5,870,049 cases of DALYs; and, approximately ฿57,000 million, ($1.9 billion), is projected as the total cost of hospital admissions. However, if the current health policy can reduce the levels of risk factors as defined in the optimistic scenario or such policy meets the specifications of the UN millennium development goal,there would be a significant reduction in the number of hospital admissions. These are estimated to be a reduction of 522,179 male and 515,416 female cases. With these results it is expected that health care costs would save approximately ฿9,000 million, ($298.3 million), for CVD and 900,000 million of DALYs over the next eight years. However, if there is an upward trend in the risk factors as predicted in the worst-case scenario, then there will be an increase of 428,220 CVD cases; consequently, DALYs cases may rise by 766,029 while the hospitalisation costs may increase by approximately ฿7,000 million, ($232.1 million). Based on our findings, reducing the levels of CVD risk factors in the population will drastically reduce: (1.) the number of CVD cases; (2.) DALYs cases; and (3.) health care costs. Therefore it is recommended that the health policy should enhance the primary prevention programs which would be targeted at reducing the CVD risk factors in the population.
ARTICLE | doi:10.20944/preprints201901.0060.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: rehabilitation; global health; disability; global burden of disease; health services needs and demand
Online: 8 January 2019 (10:52:39 CET)
Background: To inform global health policies and resources planning, this paper analyzes evolving trends in physical rehabilitation needs, using data on Years Lived with Disability (YLDs) from the Global Burden of Disease Study (GBD) 2017. Methods: Secondary analysis of how YLDs from conditions amenable to physical rehabilitation have evolved from 1990 to 2017, for the world and across countries of varying income levels. Linear regression analyses were used. Results: A 66.2% growth was found in estimated YLD Counts amenable to physical rehabilitation: a significant and linear growth of more than 5.1 billion YLDs per year (99%CI: 4.8–5.4; r2 = 0.99). Low-income countries more than doubled (111.5% growth) their YLD Counts amenable to physical rehabilitation since 1990. YLD Rates per 100,000 people and the percentage of YLDs amenable to physical rehabilitation also grew significantly over time, across locations (all p > 0.05). Finally, only in high-income countries Age-standardized YLD Rates significantly decreased (p < 0.01; r² = 0.86). Conclusions: Physical rehabilitation needs have been growing significantly in absolute, per-capita and in percentage of total YLDs, globally and across countries of varying income level. In absolute terms, growths were higher in lower income countries, wherein rehabilitation is under-resourced.
ARTICLE | doi:10.20944/preprints201811.0422.v1
Subject: Biology And Life Sciences, Biochemistry And Molecular Biology Keywords: snyder-robinson syndrome; spermine synthase; X-linked intellectual disability; polyamine transport; spermidine; spermine; transglutaminase
Online: 19 November 2018 (06:49:46 CET)
Loss-of-function mutations of the spermine synthase gene (SMS) result in Snyder-Robinson Syndrome (SRS), a recessive X-linked syndrome characterized by intellectual disability, osteoporosis, hypotonia, speech abnormalities, kyphoscoliosis, and seizures. As SMS catalyzes the biosynthesis of the polyamine spermine from its precursor spermidine, SMS deficiency causes a lack of spermine with an accumulation of spermidine. As polyamines, spermine and spermidine play essential cellular roles that require tight homeostatic control to ensure normal cell growth, differentiation, and survival. Using patient-derived lymphoblast cell lines, we sought to comprehensively investigate the effects of SMS deficiency on polyamine homeostatic mechanisms including polyamine biosynthetic and catabolic enzymes, derivatives of the natural polyamines, and polyamine transport activity. In addition to decreased spermine and increased spermidine in SRS cells, ornithine decarboxylase activity and its product putrescine were significantly decreased. Treatment of SRS cells with exogenous spermine revealed that polyamine transport was active, as the cells accumulated spermine, decreased their spermidine level, and established a spermidine-to-spermine ratio within the range of wild type cells. SRS cells also demonstrated elevated levels of tissue transglutaminase, a change associated with certain neurodegenerative diseases. These studies form a basis for further investigations into the leading biochemical changes and properties of SMS-mutant cells that potentially represent therapeutic targets for the treatment of Snyder-Robinson Syndrome.
ARTICLE | doi:10.20944/preprints202305.0997.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: SARS-CoV-2; COVID-19; temporary disability; cumulative incidence; healthcare workers; National Network of Epidemiological Surveillance; Spain
Online: 15 May 2023 (07:49:18 CEST)
Healthcare workers (HCW) have been the professional category most exposed to SARS-CoV-2. The pandemic’s impact on HCW was analyzed in terms of COVID-19-related temporary disability (TD) between February 15 2020 and May 1 2021. TDs in HCW for COVID-19 infection or quarantine were described. TD quarantine/infection ratios and TDs per 100,000 affiliated HCW were compared with the cumulative incidence (CI) of COVID-19 cases notified to the National Network of Epidemiological Surveillance. TDs rates by economic activity and occupation were computed. A total of 429,127 TDs were recorded, 36,6% for infection. Three-quarters (76%) were women. The median TD quarantine/infection ratio was 2.5 (Interquartile range [IQR] 1.5-3.9). TDs rates in HCW were always above the CI except for the last two months of the fourth wave. Hospital activities accounted for 84% of TDs and showed the highest TD rate for infection (8,279/100,000). The highest TDs rates were registered among Nursing assistants, Nursing professionals and Physicians: 7,426, 6,925 and 5,508/100,000, respectively. The results demonstrate the high impact of COVID-19 on HCW in Spain and it’s inequalities. They also confirm that TDs represent a complementary source of information for epidemiological and public health surveillance and could provide an early warning of new emerging infections.
ARTICLE | doi:10.20944/preprints201801.0114.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: rehabilitation; indicators; health systems; right to health; monitoring; health services for persons with disability; human rights; accountability
Online: 12 January 2018 (08:10:28 CET)
Background: Access to rehabilitation is crucial for the realization of the right to health and a proper concern of global health. Yet, reliable information to guide rehabilitation service planning is unavailable in many countries in part due to the lack of appropriate indicators. To ensure universal health coverage and meet the central imperative of “leaving no one behind” countries must be able to assess key aspects of rehabilitation policy and provision and monitor how they have discharged their human rights responsibilities towards those most disadvantaged, including people with disability. This article describes the process of developing an expert guided indicator framework to assess governments’ efforts and progress in strengthening rehabilitation in line with the Convention on the Rights of Persons with Disabilities. Methods: A systems methodology - concept mapping - was used to capture, aggregate and confirm the knowledge of diverse stakeholders on measures thought to be useful for monitoring the implementation of the Convention with respect to health related rehabilitation. 56 individuals generated a list of 107 indicators through online brainstorming which were subsequently sorted by 37 experts from the original panel into non overlapping categories. 41 participants rated the indicators for importance and feasibility. Multivariate statistical techniques where used to explore patterns and themes in the data and create the indicators’ organizing framework which was verified and interpreted by participants. Results: A concept map of 11 clusters of indicators emerged from the analysis grouped into three broader themes: Governance and Leadership (3 clusters); Service Delivery, Financing and Oversight (6 clusters); and Human Resources (2 clusters). The RESYST was comprehensive and well aligned with the Convention. On average, there was a moderately positive correlation between importance and feasibility of the indicators (r=.58) with experts prioritizing the indicators contained in the clusters of the Governance and Leadership domain. Two of the most important indicators arose from the Service Delivery, Financing and Oversight domain and reflect the need to monitor unmet needs and barriers in access to rehabilitation. In total, 59 indicators achieved above average score for importance and comprised the two–tiered priority set of indicators. Conclusion: Concept mapping was successful in generating a shared model that enables a system’s view of the most critical legal, policy and programmatic factors that must be addressed when assessing country efforts to reform, upscale and improve rehabilitation services. The RESYST provides a data driven basis for the development of standardized data collection tools to facilitate comparative analysis of rehabilitation systems.
REVIEW | doi:10.20944/preprints201903.0033.v1
Subject: Computer Science And Mathematics, Artificial Intelligence And Machine Learning Keywords: augmentative and alternative communication; assistive technologies; sensing modalities; signal processing; voice communication; machine learning; mobile health; speech disability
Online: 4 March 2019 (10:14:44 CET)
High-tech augmentative and alternative communication (AAC) methods are on a constant rise; however, the interaction between the user and the assistive technology is still challenged for an optimal user experience centered around the desired activity. This review presents a range of signal sensing and acquisition methods utilized in conjunction with the existing high-tech AAC platforms for speech disabled individuals, including imaging methods, touch-enabled systems, mechanical and electro-mechanical access, breath-activated methods, and brain computer interfaces (BCI). The listed AAC sensing modalities are compared in terms of ease of access, affordability, complexity, portability, and typical conversational speeds. A revelation of the associated AAC signal processing, encoding, and retrieval highlights the roles of machine learning (ML) and deep learning (DL) in the development of intelligent AAC solutions. The demands and the affordability of most systems were found to hinder the scale of usage of high-tech AAC. Further research is indeed needed for the development of intelligent AAC applications reducing the associated costs and enhancing the portability of the solutions for a real user’s environment. The consolidation of natural language processing with current solutions also needs to be further explored for the amelioration of the conversational speeds. The recommendations for prospective advances in coming high-tech AAC are addressed in terms of developments to support mobile health communicative applications.
REVIEW | doi:10.20944/preprints202106.0184.v1
Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: SMA; spinal muscular atrophy type 1; SMN1; nutritional management; enteral nutrition; pediatric gastroenterology; dysphagia; neurological disability; endocrine disorders; precocious pubarche
Online: 7 June 2021 (13:14:37 CEST)
The management of patients with spinal muscular atrophy type 1 (SMA1) is constantly evolving. In just a few decades the medical approach has switched from an exclusively palliative therapy to a targeted therapy, transforming the natural history of the disease, improving survival time and quality of life, and creating new challenges and goals. Many nutritional problems, gastrointesti-nal disorders and metabolic and endocrine alterations are commonly identified in patients af-fected by SMA1 during childhood and adolescence. For this reason, a proper pediatric multidis-ciplinary approach is then required in the clinical care of these patients, with a specific focus on the prevention of most common complications. The purpose of this narrative review is to provide the clinician with a practical and usable tool about SMA1 patients care, through a comprehensive insight into the nutritional, gastroenterological, metabolic and endocrine management of SMA1. Considering the possible horizons opened thanks to new therapeutic frontiers, a nutritional and endo-metabolic surveillance is a crucial element to be considered for a proper clinical care of these patients.
ARTICLE | doi:10.20944/preprints202012.0634.v1
Subject: Social Sciences, Anthropology Keywords: Assistive Technology; Assistive devices; Students with disabilities; Decolonial Approach; South African Higher Education; Disability Staff members; learning; Enable and Constrain
Online: 24 December 2020 (14:46:01 CET)
This paper used the decolonial theory to analyse provision of Assistive Technology and assistive devices at an institution of higher education in South African. It was an empirical study, in which data were collected through interviews with students with disabilities and the Disability Rights Centre staff members. The paper sought to understand the invisible hidden implications of provision of Assistive Technology and assistive devices. The finding was that it is students with disabilities who were provided with Assistive Technology and assistive devices at the institution. The institution provided them through the Centre, to support their learning. However, this way of provision was found to be stigmatising and segregative. Furthermore, while the provision on one hand enabled students with disabilities’ learning, on the other, it constrained it. The argument of the paper is that when provision of Assistive Technology and assistive devices is for a particular group of students it defeats the whole purpose for it is intended, and could hinder rather than promote learning. It is hoped that the paper will contribute to contemporary debate on provision of Assistive Technology and support services for people with disabilities in low resource settings, from a South African context specifically, and in higher education broadly.
ARTICLE | doi:10.20944/preprints202009.0237.v2
Subject: Social Sciences, Behavior Sciences Keywords: Game-based therapy; robot-mediated therapy; neuromotor disability; cerebral palsy; subjective assessment; patient-centered assessment; caregiver burden; ankle range of motion; ankle strengthening; home exercise program
Online: 12 October 2020 (10:09:19 CEST)
Technological advances in game-mediated robotics provide an opportunity to engage children with cerebral palsy (CP) and other neuromotor disabilities in more frequent and intensive therapy by making personalized, programmed interventions available 24/7 in children’s homes. Though shown to be clinically effective and feasible to produce, little is known of the subjective factors impacting acceptance of what we term assistive/rehabilitative (A/R) gamebots by their target populations. This research describes the conceptualization phase of an effort to develop a valid and reliable instrument to guide the design of A/R gamebots. We conducted in-depth interviews with 8 children with CP and their families who had trialed an exemplar A/R gamebot, PedBotHome, for 28 days in their homes. The goal was to understand how existing theories and instruments were either appropriate or inappropriate for measuring the subjective experience of A/R gamebots. Key findings were the importance of differentiating the use case of therapy from that of assistance in rehabilitative technology assessment, the need to incorporate the differing perspectives of children with CP and those of their parents into A/R gamebot evaluation, and the potential conflict between the goals of preserving the quality of the experience of game play for the child while also optimizing the intensity and duration of therapy provided during play.
REVIEW | doi:10.20944/preprints202009.0399.v1
Subject: Biology And Life Sciences, Biology And Biotechnology Keywords: inositide; phosphoinositide; 5-phosphatase; INPP5K; SKIP; phosphatidylinositol 3,4,5-trisphosphate; phosphatidylinositol 4,5-bisphosphate; congenital muscular dystrophy; cataract; intellectual disability; insulin signaling; insulin resistance; endoplasmic reticulum; endoplasmic reticulum stress; unfolded protein response
Online: 17 September 2020 (11:19:10 CEST)
INPP5K (Inositol Polyphosphate 5-Phosphatase K, or SKIP (for Skeletal muscle and Kidney enriched Inositol Phosphatase) is a member of the phosphoinositide 5-phosphatases family. Its protein structure is comprised of a N-terminal catalytic domain which hydrolyses both PtdIns(4,5)P2 and PtdIns(3,4,5)P3, followed by a SKICH domain at the C-terminus which is responsible for protein-protein interactions and subcellular localization of INPP5K. Strikingly, INPP5K is mostly concentrated in the endoplasmic reticulum, although it is also detected at the plasma membrane, in the cytosol and the nucleus. Recently, mutations in INPP5K have been detected in patients with a rare form of autosomal recessive congenital muscular dystrophy with cataract, short stature and intellectual disability. INPP5K functions extend from control of insulin signaling, endoplasmic reticulum stress response and structural integrity, myoblast differentiation, cytoskeleton organization, cell adhesion and migration, renal osmoregulation, to cancer. The goal of this review is thus to summarize and comment recent and less recent data in the literature on INPP5K, in particular on the structure, expression, intracellular localization, interactions and functions of this specific member of the 5-phosphatases family.
ARTICLE | doi:10.20944/preprints201612.0063.v1
Subject: Business, Economics And Management, Finance Keywords: retirement village; optimal control; optimal stopping, HARA, American put option; long-term care needs, costs and products for the elderly; disability/health state transitions; life-cycle modelling related to the retirement phase
Online: 12 December 2016 (11:18:16 CET)
We consider the financial planning problem of a retiree wishing to enter a retirement village at a future uncertain date. The date of entry is determined by the retiree's utility and bequest maximisation problem within the context of uncertain future health states. In addition, the retiree must choose optimal consumption, investment, bequest and purchase of insurance products prior to her full annuitisation on entry to the retirement village. A hyperbolic absolute risk-aversion (HARA) utility function is used to allow necessary consumption for basic living and medical costs. The retirement village will typically require an initial deposit upon entry. This threshold wealth requirement leads to exercising the replication of an American put option at the uncertain stopping time. From our numerical results, active insurance and annuity markets are shown to be a critical aspect in retirement planning.