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Journal of Occupational Rehabilitation Mar 2023Young people with disabilities are persistently under-employed and experience concerning rates of discrimination and ableism in looking for work and within the... (Review)
Review
PURPOSE
Young people with disabilities are persistently under-employed and experience concerning rates of discrimination and ableism in looking for work and within the workplace. Focusing on youth is salient because rates of ableism are often higher among younger ages compared to older. The objective of this systematic review was to explore the experiences and impact of workplace discrimination and ableism among youth and young adults with disabilities.
METHODS
Systematic searches of seven databases from 2000 to 2021 were conducted. Four reviewers independently applied the inclusion criteria, extracted the data and rated the study quality.
RESULTS
Of the 39 studies meeting our inclusion criteria, they represented 516,281 participants across eight countries over a 20-year period. The findings highlight the rates of workplace ableism, factors affecting workplace ableism (i.e., type of disability, gender, education level, lack of employers' knowledge about disability), ableism in job searching and anticipated ableism. The review also noted the impact of workplace ableism, which included pay discrimination, lack of job supports and social exclusion, job turnover and unemployment, and discrimination allegations and charges.
CONCLUSIONS
Our findings reveal the stark prevalence of workplace ableism among youth and young adults with disabilities. There is an urgent need for further in-depth research to understand youth's lived experiences of ableism and the development of solutions to address it so they can be included in a meaningful and respectful way in the workplace.
Topics: Humans; Adolescent; Young Adult; Rehabilitation, Vocational; Workplace; Employment; Disabled Persons; Social Discrimination
PubMed: 35976480
DOI: 10.1007/s10926-022-10049-4 -
Public Health Sep 2020Smoking has negative consequences on occupational health. The current meta-analysis was conducted with the aim to pool the studies about smoking and increased disability... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Smoking has negative consequences on occupational health. The current meta-analysis was conducted with the aim to pool the studies about smoking and increased disability pension.
STUDY DESIGN
Systematic review and meta-analysis.
METHODS
Articles were found in the scientific literature using keywords, and searching was limited to prospective cohort studies that had been published before August 2018. Based on the inclusion and exclusion criteria, 23 prospective cohort studies were selected. The analyses were carried out on the basis of the random-effects method. Subgroup analysis was also carried out. Finally, the bias of publication was examined using Begg's test, the Egger test, the trim-and-fill method, and the funnel plot.
RESULTS
Twenty-three studies were included. The results showed a positive association between smoking and disability pension, with a risk ratio (RR) of 1.41 and 95% confidence interval (95% CI) of 1.30-1.53 (P < 0.001). In men, the RR was equal to 1.48 and 95% CI was equal to 1.30-1.68 (P < 0.001). In women, the RR was equal to 1.23 and 95% CI was equal to 1.09-1.37 (P = 0.001). In current smokers, the RR was equal to 1.41 and 95% CI was equal to 1.26-1.57 (P < 0.001). In former smokers, the RR was equal to 1.16 and 95% CI was equal to 1.05-1.29 (P = 0.003). Qualitative evaluation showed that the studies had a low level of selection bias, data collection bias, and withdrawal and dropout bias.
CONCLUSIONS
Smoking is a risk factor for increasing disability pension, and men are at higher risk of disability pension. In addition, both current and former smokers are in high risk of disability pension. Overall, it can be concluded that smoking is a risk factor for occupational health.
Topics: Disabled Persons; Humans; Pensions; Prospective Studies; Risk Factors; Smoking
PubMed: 32882482
DOI: 10.1016/j.puhe.2020.04.013 -
Disability and Health Journal Oct 2021Opioid use experiences among people with disability (PWD) as a group has not been clearly articulated in the current literature, despite links between pain and measures... (Review)
Review
BACKGROUND
Opioid use experiences among people with disability (PWD) as a group has not been clearly articulated in the current literature, despite links between pain and measures of disability.
OBJECTIVE
To conduct a systematic search and scoping study examining the characteristics of current literature focused on opioid use among PWD.
METHODS
Four databases were queried (i.e., Medline, PsycINFO, Embase, and CINAHL) for peer-reviewed, empirical, English-language, journal articles focused on long-term opioid use among PWD. Collected data points included: disability details (specific condition, onset of disability), opioid details (category of opioid use, and specified substance), study details, and design.
RESULTS
A total of 196 articles were included, with 83.7% published since 2000 largely from the US. The majority of articles (70.4%) focused on the use of opioids as medical treatment, with fewer articles focusing on recreational opioid use or substance use disorders. The majority of included sources (73%) focused on opioid use in acquired conditions; neuropathic pain (21.9%) and attention deficit hyperactivity disorder (20.4%) were the most commonly studied. Differences were observed in the distribution of disability conditions across category of opioid use and study design classification; 73.5% were considered observational in design.
CONCLUSIONS
The varied representation of disability conditions, and differences across opioid use category and study design classification point to a complicated relationship between opioid use and disability. The present research portfolio would benefit from research matching informational needs of a specific disability area or opioid use category to provide the evidence necessary to advance current knowledge and promote inclusion in national agendas.
Topics: Analgesics, Opioid; Disabled Persons; Humans; Opioid-Related Disorders; Pain; Research Design
PubMed: 33888430
DOI: 10.1016/j.dhjo.2021.101106 -
Social Science & Medicine (1982) Jul 2022In many settler-colonial countries, Indigenous people do not access disability services at rates commensurate with disability prevalence. Existing research suggests that... (Review)
Review
In many settler-colonial countries, Indigenous people do not access disability services at rates commensurate with disability prevalence. Existing research suggests that services often do not reflect Indigenous values and social practices, impacting on accessibility. Furthermore, disability services have historically been implicated in processes of colonisation. There is an urgent need to decolonise disability services. Understanding Indigenous knowledge and experience of disability is a necessary step towards achieving this. We systematically reviewed the disability conceptualisations, practices and experiences of First Nations peoples of Australia. Twelve studies met inclusion criteria. There was a consensus among these studies that Western constructs of disability do not resonate with many First Nations people across Australia. The studies reported that many First Nations people conceptualise most disabilities as unremarkable conditions that reflect the normal range of human diversity, although some conditions may be associated with social stigma. Inclusive attitudes and practices of caregiving in First Nations families facilitate the participation of First Nations people with disabilities in family and community life. However, ableism and racism in broader society combine to exclude many First Nations peoples with disabilities from public spaces and from labour markets. Disability services regularly fail to reflect First Nations values and social practices, and can lead to further disempowerment and marginalisation due to diagnostic processes; displacement from country and communities; gendered discrimination; and poor relationships with service providers. We argue that intersectional experiences of colonialism, racism, ableism and sexism, particularly in disability services, can lead to the marginalisation of First Nations participants and families. The decolonisation of disability services requires services to embrace diverse First Nations values and practices associated with human capability, social participation and caregiving. Decolonising disability services also necessitates First Nations control of the governance of disability services and reform across service, organisational, systemic and conceptual levels.
Topics: Colonialism; Concept Formation; Disabled Persons; Humans; Indigenous Peoples; Population Groups
PubMed: 35617764
DOI: 10.1016/j.socscimed.2022.115047 -
Neuroscience Letters Sep 2021People with disabilities face many travel barriers. Autonomous vehicles and services may be one solution. The purpose of this project was to conduct a systematic review...
People with disabilities face many travel barriers. Autonomous vehicles and services may be one solution. The purpose of this project was to conduct a systematic review of the grey and scientific literature on autonomous vehicles for people with disabilities. Scientific evidence (n = 35) was limited to four observational studies with a very low level of evidence, qualitative studies, reviews, design and model reports, and policy proposals. Literature on older adults was most prevalent. Grey literature (n = 37) spanned a variety of media and sources and focuses on a variety of disability and impairment types. Results highlight opportunities and barriers to accessible and usable AVs and services, outline research gaps to set a future research agenda, and identify implications for policy and knowledge translation. People with disabilities are a diverse group, and accessible and usable design solutions will therefore need to be tailored to each group's needs, circumstances, and preferences. Future research in diverse disability groups should include more participatory action design and engineering studies and higher quality, prospective experimental studies to evaluate outcomes of accessible and usable AV technology. Studies will need to address not only all vehicle features but also the entire travel journey.
Topics: Automobiles; Autonomous Vehicles; Disabled Persons; Humans; Travel
PubMed: 34237416
DOI: 10.1016/j.neulet.2021.136103 -
Brazilian Journal of Physical Therapy 2023There is no systematic review assessing the effectiveness of interferential current (IC) in patients with low back pain. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There is no systematic review assessing the effectiveness of interferential current (IC) in patients with low back pain.
OBJECTIVE
To investigate the effectiveness of IC in patients with chronic non-specific low back pain.
METHODS
The databases PUBMED, EMBASE, PEDro, Cochrane Library, CINAHL, and SCIELO were searched. Randomized controlled trials reporting pain intensity and disability in patients with chronic non-specific low back pain, in which IC was applied were included. Methodological quality was assessed using the PEDro scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of evidence.
RESULTS
Thirteen RCTs were considered eligible for this systematic review (pooled n = 1367). Main results showed moderate-quality evidence and moderate effect sizes that IC probably reduces pain intensity and disability compared to placebo immediately post-treatment (Pain: MD = -1.57 points; 95% CI -2.17, -0.98; Disability: MD = -1.51 points; 95% CI -2.57, -0.46), but not at intermediate-term follow-up. Low-quality evidence with small effect size showed that IC may reduce pain intensity (SMD = -0.32; 95% CI -0.61, -0.03, p = 0.03) compared to TENS immediately post-treatment, but not for disability. There is very low-quality evidence that IC combined with other interventions (massage or exercises) may not further reduce pain intensity and disability compared to the other interventions provided in isolation immediately post-treatment.
CONCLUSION
Moderate-quality evidence shows that IC is probably better than placebo for reducing pain intensity and disability immediately post-treatment in patients with chronic non-specific low back pain.
Topics: Humans; Low Back Pain; Exercise Therapy; Pain Measurement; Disabled Persons; Chronic Pain
PubMed: 37801776
DOI: 10.1016/j.bjpt.2023.100549 -
Disability and Rehabilitation Oct 2022The aim of this systematic review was to identify models of community disability, rehabilitation and lifestyle service delivery in non-metropolitan areas of Australia,...
PURPOSE
The aim of this systematic review was to identify models of community disability, rehabilitation and lifestyle service delivery in non-metropolitan areas of Australia, and to describe these models through an Integrated People-Centred Health Services (IPCHS) lens.
MATERIALS AND METHODS
We identified peer-reviewed studies published between 2000 and June 2021 that met the following criteria: described or evaluated a community service delivery model, intervention or program in regional, rural or remote Australia; provided for people with a disability or a potentially disabling health condition. A scoring rubric was developed covering the five IPCHS strategies.
RESULTS
Nineteen studies were included in the review. We identified a range of service delivery models providing support to people with a range of disabilities or conditions. We report evidence of the use of the IPCHS strategies in ways relevant to the local context.
DISCUSSION
Several strengths emerged, with many services tailored to individual need, and significant community engagement. Innovative rural service delivery approaches were also identified. Key areas requiring action included improved coordination or integration within and across professions and sectors. There was limited evidence of co-production of solutions or participatory governance. While people-centred approaches show promise to improve community-based services, large-scale fundamental change is required.IMPLICATIONS FOR REHABILITATIONCommunity-based disability and rehabilitation services in rural and remote Australia performed well at delivering tailored care and engaging in community consultation.These services must urgently implement strategies to enhance community ownership of solutions and participatory governance.Services must place a greater focus on explicit strategies to integrate and coordinate across services and professions, and to create an enabling environment, to deliver people-centred care.The World Health Organisation Integrated People-Centred Health Services framework provides an important roadmap to improving service delivery in rural and remote Australian communities.
Topics: Australia; Delivery of Health Care; Disabled Persons; Humans; Life Style; Rural Health Services; Rural Population
PubMed: 34433373
DOI: 10.1080/09638288.2021.1962992 -
Aging Clinical and Experimental Research Jul 2023With the aging of the population, frailty has attracted much attention, and the social dimension of frailty, namely social frailty, has also attracted attention. Studies... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
With the aging of the population, frailty has attracted much attention, and the social dimension of frailty, namely social frailty, has also attracted attention. Studies have shown that social frailty can bring some adverse effects to the elderly, such as physical and cognitive function.
AIMS
To explore the risk of adverse health outcomes in older adults with social frailty compared with older adults with non-social frailty.
METHODS
Five databases were systematically searched from inception to February 28, 2023. Screening, data extraction and quality assessment were conducted independently by two researchers. The included studies were longitudinal studies of adverse outcomes in community-dwelling socially frail older adults, and the quality of each study was assessed using the Newcastle‒Ottawa Scale.
RESULTS
A total of 15 studies were included based on the inclusion criteria, of which 4 were subjected to meta-analysis. The mean age of the included population ranged from 66.3 to 86.5 years. According to existing research, social frailty was predictive of some adverse outcomes, such as incident disability, depressive symptoms, and reduced neuropsychological function. The meta-analysis showed that social frailty had a significant predictive effect on mortality among older adults [HR = 2.27, (95% CI = 1.03-5.00)].
CONCLUSION
In community-dwelling older adults, social frailty was a predictor of mortality, incident disability, depressive symptoms and other adverse outcomes. Social frailty had a negative impact on older adults, so it was necessary to strengthen the screening of social frailty to reduce the incidence of adverse outcomes.
Topics: Humans; Aged; Aged, 80 and over; Frailty; Frail Elderly; Independent Living; Cognition; Disabled Persons
PubMed: 37219756
DOI: 10.1007/s40520-023-02421-y -
Brazilian Journal of Physical Therapy 2023Low-back pain (LBP) may be directly or indirectly related to impairments from the hip joint. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Low-back pain (LBP) may be directly or indirectly related to impairments from the hip joint.
OBJECTIVE
To evaluate the effectiveness of hip interventions on pain and disability in patients with LBP in the short-, medium-, and long-term.
METHODS
PubMed, Cochrane Library, PEDro, Web of Science, and SCOPUS databases were searched in November 2022. Randomized controlled trials involving hip-targeted interventions compared to specific low back interventions in patients with LBP were selected. The outcomes were pain intensity and disability. The quality of the studies was assessed with the risk of bias tool. GRADE was used to rate the certainty of evidence. Meta-analyses were conducted using random effects models.
RESULTS
A total of 2581 studies were screened. Eight were included in the meta-analysis involving 508 patients with LBP. The results provided very low certainty that both hip strengthening and hip stretching improved pain (MD = -0.66; 95% CI -0.86, -0.48; I:0%) (MD = -0.55; 95% CI -1.02, -0.08) and disability (SMD = -0.81; 95% CI -1.53, -0.10; I: 80%) (SMD = -1.03; 95% CI -1.82, -0.25) in the short-term, respectively. No benefits were found in the medium- or long-term. The risk of bias, heterogeneity, and imprecision of the results downgraded the level of evidence.
CONCLUSIONS
Very low certainty evidence suggest a positive effect of hip strengthening in isolation or combined with specific low back exercise and hip stretching combined with specific low back exercise for decreasing pain intensity and disability in the short-term, in patients with LBP.
SYSTEMATIC REVIEW REGISTRATION NUMBER
PROSPERO CRD42022303173.
Topics: Humans; Chronic Pain; Low Back Pain; Exercise Therapy; Pain Measurement; Disabled Persons
PubMed: 37037144
DOI: 10.1016/j.bjpt.2023.100502 -
Rehabilitation Psychology May 2023People with disabilities (PWD) experience barriers to accessibility and employment, harming their quality of life. Strategies aimed at reducing disparity for PWD have... (Meta-Analysis)
Meta-Analysis
PURPOSE
People with disabilities (PWD) experience barriers to accessibility and employment, harming their quality of life. Strategies aimed at reducing disparity for PWD have not changed key statistics such as unemployment rates. Previous research has focused on explicit attitudes, generally found to be positive, prompting investigation into factors such as implicit bias. This systematic review and meta-analysis investigated implicit bias toward PWD and associated factors.
METHOD
Forty-six peer-reviewed studies published between January 2000 and April 2020 utilizing the Implicit Association Test were included. Of these, 12 studies met the inclusion criteria for meta-analysis.
RESULTS
A significant moderate pooled effect (mean difference = 0.503, 95% CI [0.497-0.509], < .001) was found, suggesting moderate negative implicit attitudes toward general disability. Negative implicit attitudes were also found toward physical, and intellectual disability. PWD were implicitly stereotyped as incompetent, cold, and "child-like." Findings were inconsistent for factors associated with bias including age, race, sex, and individual differences. Contact with PWD may be associated with implicit bias; however, measures were inconsistent.
CONCLUSION
This review has found moderate negative implicit biases toward PWD, however, factors associated with this bias remain unclear. Further research should investigate implicit bias toward specific disability groups and strategies to shift such biases. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Bias, Implicit; Quality of Life; Disabled Persons; Bias
PubMed: 37079819
DOI: 10.1037/rep0000493