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Evidence-based Dentistry Jun 2024This systematic review was conducted to explore the factors influencing access to oral health services and to identify and examine the strategies to improve the access.
OBJECTIVE
This systematic review was conducted to explore the factors influencing access to oral health services and to identify and examine the strategies to improve the access.
MATERIALS AND METHODS
PubMed, Scopus and Embase databases were searched. Studies except editorials reported in English regardless of the study design were included. Risk of Bias assessment was carried out using Agency for Healthcare Research and Quality, Newcastle Ottawa Scale and The Joanna Briggs Institute tool for cross-sectional, case-control and cohort and qualitative studies, respectively.
RESULTS
In total, 11,372 records were initially identified, eventually leading to 12 relevant publications to be included in the review. Individuals valued oral health but found it difficult to access oral health services. Dental care was mainly accessed during emergencies and participants felt apprehensive in visiting dentists. Caregiver's and dentist's perspective was also reported.
CONCLUSION
There is a need for provision of education, training and increasing awareness on dental hygiene and annual dental checkups to improve access.
Topics: Humans; Health Services Accessibility; Disabled Persons; Dental Care; Dental Care for Disabled; Oral Health
PubMed: 38225370
DOI: 10.1038/s41432-024-00970-3 -
British Journal of Sports Medicine Mar 2024To evaluate the effects of sport or physical recreation on participation, mobility and quality of life for adults living with disabilities. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the effects of sport or physical recreation on participation, mobility and quality of life for adults living with disabilities.
DESIGN
Systematic review with meta-analysis.
DATA SOURCES
Six databases searched from inception to May 2022.
ELIGIBILITY CRITERIA
Randomised controlled trials including adults living with a physical or intellectual disability, comparing sport or physical recreation to non-active control.
RESULTS
Seventy-four trials (n=2954; mean age 55 years) were included. Most (70) trials included people with physical disabilities, none evaluated sport and the most common physical recreation activities tested were traditional Chinese exercise (35%), yoga (27%) and dance (18%). Mean frequency and duration was 65 min/session, two times per week for 13 weeks. Most (86%) interventions were led by people with experience and/or training in the recreation activity, and only 37% reported leader experience and/or training working with people with disabilities. Participation was measured as attendance (mean 81%, 30 intervention groups). Physical recreation improved mobility (standardised mean difference (SMD) 0.38, 95% CI 0.07 to 0.69, n=469) and walking endurance (mean difference (MD) 40.3 m, 95% CI 19.5 to 61.1, n=801) with low certainty evidence and balance (Berg Balance Scale, range 0-56 points; MD 3.4 points, 95% CI 2.3 to 4.4, n=906) and quality of life (physical health; SMD 0.37, 95% CI 0.02 to 0.72, n=468) with very low certainty evidence, but not walking speed (MD 0.03 m/s, 95% CI -0.05 to 0.11, n=486).
CONCLUSION
Physical recreation may confer multiple benefits for people living with disabilities regardless of the activity chosen, thus offering a potentially enjoyable and scalable strategy to increase physical activity.
PROSPERO REGISTRATION NUMBER
CRD42018104379.
Topics: Humans; Exercise; Intellectual Disability; Quality of Life; Walking; Disabled Persons; Sports for Persons with Disabilities; Randomized Controlled Trials as Topic
PubMed: 38129104
DOI: 10.1136/bjsports-2023-107123 -
BMJ Quality & Safety Apr 2024To identify factors acting as barriers or enablers to the process of healthcare consent for people with intellectual disability and to understand how to make this...
OBJECTIVE
To identify factors acting as barriers or enablers to the process of healthcare consent for people with intellectual disability and to understand how to make this process equitable and accessible.
DATA SOURCES
Databases: Embase, MEDLINE, PsychINFO, PubMed, SCOPUS, Web of Science and CINAHL. Additional articles were obtained from an ancestral search and hand-searching three journals.
ELIGIBILITY CRITERIA
Peer-reviewed original research about the consent process for healthcare interventions, published after 1990, involving adult participants with intellectual disability.
SYNTHESIS OF RESULTS
Inductive thematic analysis was used to identify factors affecting informed consent. The findings were reviewed by co-researchers with intellectual disability to ensure they reflected lived experiences, and an easy read summary was created.
RESULTS
Twenty-three studies were included (1999 to 2020), with a mix of qualitative (n=14), quantitative (n=6) and mixed-methods (n=3) studies. Participant numbers ranged from 9 to 604 people (median 21) and included people with intellectual disability, health professionals, carers and support people, and others working with people with intellectual disability. Six themes were identified: (1) health professionals' attitudes and lack of education, (2) inadequate accessible health information, (3) involvement of support people, (4) systemic constraints, (5) person-centred informed consent and (6) effective communication between health professionals and patients. Themes were barriers (themes 1, 2 and 4), enablers (themes 5 and 6) or both (theme 3).
CONCLUSIONS
Multiple reasons contribute to poor consent practices for people with intellectual disability in current health systems. Recommendations include addressing health professionals' attitudes and lack of education in informed consent with clinician training, the co-production of accessible information resources and further inclusive research into informed consent for people with intellectual disability.
PROSPERO REGISTRATION
CRD42021290548.
Topics: Humans; Intellectual Disability; Informed Consent; Attitude of Health Personnel
PubMed: 38071590
DOI: 10.1136/bmjqs-2023-016113 -
Current Pediatric Reviews Jan 2024To perform a systematic review and meta-analysis compiling data on the prevalence of bruxism in children and adolescents with cerebral palsy.
AIMS
To perform a systematic review and meta-analysis compiling data on the prevalence of bruxism in children and adolescents with cerebral palsy.
METHODS AND RESULTS
Searches were carried out in PubMed/Medline, Web of Science, and Scopus databases to identify the articles published by February 2023. Two independent reviewers, and in duplicate, employed a two-stage process to select publications. The same two reviewers performed the data extraction. Studies were included when the following eligibility criteria were met: performed in children and/or adolescents with cerebral palsy and reporting bruxism. Potentially eligible studies were read in full and excluded that: not presented numerical data on the prevalence of bruxism; not reported how the bruxism was assessed; not reported data about the cerebral palsy; and not an observational study. The risk assessment of bias was assessed by the Newcastle- Ottawa Scale. After reading the titles and abstracts of the 358 identified articles, eight articles from 1966 to 2020 were included. The main reason for not including the studies was not to report data about bruxism (59.3%), and 44.5% were excluded for not reporting data from patients with cerebral palsy. The studies were carried out in schools, university hospitals, or centers for patients with special needs (Brazil, the United States, and Egypt). The pooled prevalence of bruxism in children and adolescents with cerebral palsy was 46% (95%CI: 0.38-0.55) after removing one study.
CONCLUSION
The pooled prevalence of bruxism in children with cerebral palsy can be considered high since almost half of the studied population is affected by this condition. PROSPERO #CRD42021225781.
PubMed: 38243943
DOI: 10.2174/0115733963252499231120092148 -
Occupational and Environmental Medicine Sep 2023Burnout is a work-related mental health problem that often causes long-term sickness absence. Return-to-work (RTW) interventions for burned-out sick-listed employees aim...
Burnout is a work-related mental health problem that often causes long-term sickness absence. Return-to-work (RTW) interventions for burned-out sick-listed employees aim to prevent long-term work disability. This systematic review addresses two questions: (1) Which interventions for burned-out sick-listed employees have been studied?; (2) What is the effect of these interventions on RTW?We performed a systematic literature review and searched PubMed, Cochrane Central Register of Controlled Trials, Embase, CINAHL and Web of Science from 1 January 2000 to 31 December 2022. We searched for articles of interventions for burned-out sick-listed employees. We conducted the review in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Outcome was RTW.We identified 2160 articles after removal of all duplicates. Eight studies met inclusion criteria. RTW outcomes were number of sick-leave days, sick-leave rates, median period of RTW and worked hours per week. Five studies described person-directed interventions, one described a workplace-directed intervention, one described a combination of both intervention types and one study described all three types of intervention. Only the workplace-directed intervention showed a significant improvement in RTW compared with the comparator group: at 18-month follow-up, 89% of the intervention group had returned to work compared with 73% of the comparator group.Only a limited number of studies have explored interventions specifically focused on burned-out sick-listed employees and the effect on RTW. Due to heterogeneity and moderate to high risk of bias of these studies, no firm conclusions can be drawn on the described interventions and their effect on RTW.The study was registered with the International prospective register of systematic reviews (PROSPERO, registration number: CRD42018089155).
Topics: Humans; Return to Work; Employment; Workplace; Burnout, Professional; Sick Leave
PubMed: 37500536
DOI: 10.1136/oemed-2023-108867 -
Disability and Health Journal Jul 2024People with disability living in supported accommodation experience ongoing health disparities. Physical activity and dietary quality are factors that may minimise the... (Review)
Review
Biopsychosocial determinants of physical activity and healthy eating for people with disability living in supported accommodation: A systematic review of qualitative research.
BACKGROUND
People with disability living in supported accommodation experience ongoing health disparities. Physical activity and dietary quality are factors that may minimise the risk of chronic disease, however this population may experience a range of biopsychosocial barriers to physical activity and healthy eating.
OBJECTIVE
The aim of this review was to synthesise the biopsychosocial determinants of physical activity and healthy eating for people with disability living in supported accommodation, as reported by existing qualitative research.
METHODS
A systematic review of qualitative evidence was conducted according to the JBI's methodological guidance. In September 2023, five academic databases were searched for relevant literature published since database inception. A secondary analysis of the results of included studies was guided by the International Framework for Functioning, Disability, and Health (ICF), using the ICF Linking Rules.
RESULTS
A total of 31 articles were included. The analysis identified 154 determinants of physical activity and 112 determinants of healthy eating. Determinants were most prominently representative of environmental factors that captured the health promoting role and attitudes of staff, alongside the influence of the organisational context.
CONCLUSION
This review provided evidence for the complex interactions between body functions and structures, activities and participation, personal factors, and the environment that influence physical activity and healthy eating within supported accommodation. Although there is a limited body of evidence to guide practice, the findings highlight the multifactorial nature of interventions that can be utilised by direct care professionals and adapted to the individual needs and interests of people with disability.
Topics: Humans; Disabled Persons; Exercise; Diet, Healthy; Qualitative Research; Health Promotion
PubMed: 38548523
DOI: 10.1016/j.dhjo.2024.101618 -
JPEN. Journal of Parenteral and Enteral... May 2024The efficacy of creatine replacement through supplementation for the optimization of physical function in the population at risk of functional disability is unclear. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The efficacy of creatine replacement through supplementation for the optimization of physical function in the population at risk of functional disability is unclear.
METHODS
We conducted a systematic literature search of MEDLINE, EMBASE, the Cochrane Library, and CINAHL from inception to November 2022. Studies included were randomized controlled trials (RCTs) comparing creatine supplementation with placebos in older adults and adults with chronic disease. The primary outcome was physical function measured by the sit-to-stand test after pooling data using random-effects modeling. We also performed a Bayesian meta-analysis to describe the treatment effect in probability terms. Secondary outcomes included other measures of physical function, muscle function, and body composition. The risk of bias was assessed using the Cochrane risk-of-bias tool.
RESULTS
We identified 33 RCTs, comprising 1076 participants. From six trials reporting the primary outcome, the pooled standardized mean difference (SMD) was 0.51 (95% confidence interval [CI]: 0.01-1.00; I = 62%; P = 0.04); using weakly informative priors, the posterior probability that creatine supplementation improves physical function was 66.7%. Upper-body muscle strength (SMD: 0.25; 95% CI: 0.06-0.44; I = 0%; P = 0.01), handgrip strength (SMD 0.23; 95% CI: 0.01-0.45; I = 0%; P = 0.04), and lean tissue mass (MD 1.08 kg; 95% CI: 0.77-1.38; I = 26%; P < 0.01) improved with creatine supplementation. The quality of evidence for all outcomes was low or very low because of a high risk of bias.
CONCLUSION
Creatine supplementation improves sit-to-stand performance, muscle function, and lean tissue mass. It is crucial to conduct high-quality prospective RCTs to confirm these hypotheses (PROSPERO number, CRD42023354929).
Topics: Humans; Creatine; Dietary Supplements; Muscle Strength; Randomized Controlled Trials as Topic; Aged; Physical Functional Performance; Disabled Persons; Middle Aged; Female; Male; Chronic Disease; Body Composition; Adult
PubMed: 38417175
DOI: 10.1002/jpen.2607 -
Nutrients Oct 2023The current systematic review (PROSPERO registration no. CRD42022334707) of observational (OS) and interventional studies (IS) aimed at evaluating the state of... (Review)
Review
Practical Application and Methodological Considerations on the Basics of Sports Nutrition in Basketball: A Comprehensive Systematic Review of Observational and Interventional Studies.
The current systematic review (PROSPERO registration no. CRD42022334707) of observational (OS) and interventional studies (IS) aimed at evaluating the state of scientific knowledge on the basics of sports nutrition, framing discipline-specific dietary recommendations, and indicating potential directions for future studies in various age, experience level, and able-bodied abilities groups of basketball players (BP). A systematic search of PubMed, SPORTDiscus, and Web of Science ended on 20 December 2022. Records were excluded if reporting studies on animals, sport disciplines other than basketball, or supplementation protocols other than those related to macronutrients and hydration manipulations. Risk of bias (RoB) was evaluated using Cochrane RoB_2 tools, 'JBI checklist for prevalence studies', and 'Quality assessment tool for before-after (pre-post) studies with no control group'. The relevant data was synthesized in tables and a narrative review was performed. Seventy-two records were included (2581 participants): 63 were on able-bodied BP (2433 participants) and 9 on para-athlete players (148 participants); 45 records were OS and 27 IS. The review disclosed widespread poor nutritional habits and knowledge and shortages in applying adequate nutritional and hydration practices in BP. Moreover, the systematic review revealed the lack of a sufficient number of investigations delivering reliable proof for framing discipline-specific and evidence-based recommendations on the basics of sports nutrition in basketball.
Topics: Humans; Basketball; Sports Nutritional Sciences; Para-Athletes; Diet; Forecasting
PubMed: 37892559
DOI: 10.3390/nu15204484 -
American Journal of Speech-language... Jul 2023This article provides a systematic review and analysis of group and single-case studies addressing augmentative and alternative communication (AAC) intervention with...
PURPOSE
This article provides a systematic review and analysis of group and single-case studies addressing augmentative and alternative communication (AAC) intervention with school-aged persons having autism spectrum disorder (ASD) and/or intellectual/developmental disabilities resulting in complex communication needs (CCNs). Specifically, we examined participant characteristics in group-design studies reporting AAC intervention outcomes and how these compared to those reported in single-case experimental designs (SCEDs). In addition, we compared the status of intervention features reported in group and SCED studies with respect to instructional strategies utilized.
PARTICIPANTS
Participants included school-aged individuals with CCNs who also experienced ASD or ASD with an intellectual delay who utilized aided or unaided AAC.
METHOD
A systematic review using descriptive statistics and effect sizes was implemented.
RESULTS
Findings revealed that participant features such as race, ethnicity, and home language continue to be underreported in both SCED and group-design studies. Participants in SCED investigations more frequently used multiple communication modes when compared to participants in group studies. The status of pivotal skills such as imitation was sparsely reported in both types of studies. With respect to instructional features, group-design studies were more apt to utilize clinical rather than educational or home settings when compared with SCED studies. In addition, SCED studies were more apt to utilize instructional methods that closely adhered to instructional features more typically characterized as being associated with behavioral approaches.
CONCLUSION
The authors discuss future research needs, practice implications, and a more detailed specification of treatment intensity parameters for future research.
Topics: Humans; Child; Autism Spectrum Disorder; Communication Disorders; Communication Aids for Disabled; Communication; Intellectual Disability
PubMed: 37235744
DOI: 10.1044/2023_AJSLP-22-00314 -
PloS One 2023Back pain in athletes varies with sport, age, and sex, which can impair athletic performance, thereby contributing to retirement. Studies on back pain in this population...
Back pain in athletes varies with sport, age, and sex, which can impair athletic performance, thereby contributing to retirement. Studies on back pain in this population use questionnaires to assess components, such as pain intensity and location and factors associated with pain, among others. This study aimed to review validated questionnaires that have assessed back pain in athletes. This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) by searching the databases Embase, MEDLINE, SPORTDiscus, CINAHL, and Scopus. The articles were selected regardless of language and date of publication. Titles and abstracts were independently selected by two reviewers; disagreements were resolved by a third reviewer. All the steps were conducted using the software Rayyan. The methodological quality of the questionnaire validation articles was assessed using a critical appraisal tool checklist proposed by Brink and Louw. The search returned 4748 articles, of which 60 were selected for this review, including 5 questionnaire validation studies. These articles were published between 2004 and 2022, which were performed in more than 20 countries, particularly Germany (14) and Sweden (5). Thirteen different instruments were identified, of which 46.1% were developed in Europe. The most commonly used questionnaires were the Oswestry Disability Index and Nordic Standardized Questionnaire. In addition, five questionnaire validation studies were selected for methodological quality assessment, with only two studies demonstrating high methodological quality. The following three instruments were identified for assessing back pain specifically in athletes: Micheli Functional Scale, Persian Functional Rating Index, and Athlete Disability Index. This review confirmed that all three instruments were specifically designed to assess this condition.
Topics: Humans; Athletes; Athletic Performance; Low Back Pain; Disabled Persons; Europe
PubMed: 37922315
DOI: 10.1371/journal.pone.0293333