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European Review For Medical and... Jan 2021Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and Ulcerative Colitis (UC), are chronic, relapsing intestinal disorders that may severely compromise...
OBJECTIVE
Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and Ulcerative Colitis (UC), are chronic, relapsing intestinal disorders that may severely compromise patients' labour force participation. In this context, the present review aims to provide an overview on possible IBD pathological, socio-demographic, and treatment-related factors predictive for work disability with the purpose to provide guidance for a successful clinical and occupational management.
MATERIALS AND METHODS
A systematic review of PubMed, Scopus, and ISI Web of Science databases was performed to retrieve all the studies addressing IBD-related predictors for work disability.
RESULTS
Several factors have been suggested to predict work disability in the 15 revised investigations, although with not homogeneous results. Having CD was reported as a significantly better predictor for permanent work disability compared to UC, maybe in relation to the generally more serious disease course. Activity and severity of IBD, also indicated by the need for surgical treatment and comorbidities, was related to a significantly greater risk for work disability, although the exact role of other variables, i.e., specific symptoms, disease pattern and inflammatory parameters are still unclear. Among demographic factors, a significant predictive role has been suggested for female gender.
CONCLUSIONS
Further research seems necessary to confirm the role of IBD related factors on work disability, and on other parameters of work impairment, i.e., absenteeism, presenteeism, activity and productivity loss. Additionally, work disability should be evaluated in relation to specific occupational risk factors. Overall, this may require a multidisciplinary approach aimed to achieve an adequate IBD clinical evaluation and management, an improvement of patients' psychosocial and professional well-being, while appropriately assessing and managing risks in the workplace.
Topics: Disabled Persons; Humans; Inflammatory Bowel Diseases; Risk Factors
PubMed: 33506905
DOI: 10.26355/eurrev_202101_24382 -
Journal of General Internal Medicine Oct 2021Back pain is the most common cause of disability worldwide. While disability generally is associated with greater mortality, the association between back pain and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Back pain is the most common cause of disability worldwide. While disability generally is associated with greater mortality, the association between back pain and mortality is unclear. Our objective was to examine whether back pain is associated with increased mortality risk and whether this association varies by age, sex, and back pain severity.
METHODS
A systematic search of published literature was conducted using PubMed, Web of Science, and Embase databases from inception through March 2019. We included English-language prospective cohort studies evaluating the association of back pain with all-cause mortality with follow-up periods >5 years. Three reviewers independently screened studies, abstracted data, and appraised risk of bias using the Quality in Prognosis Studies (QUIPS) tool. A random-effects meta-analysis estimated combined odds ratios (OR) and 95% confidence intervals (CI), using the most adjusted model from each study. Potential effect modification by a priori hypothesized factors (age, sex, and back pain severity) was evaluated with meta-regression and stratified estimates.
RESULTS
We identified eleven studies with 81,337 participants. Follow-up periods ranged from 5 to 23 years. The presence of any back pain, compared to none, was not associated with an increase in mortality (OR, 1.06; 95% CI, 0.97 to 1.16). However, back pain was associated with mortality in studies of women (OR, 1.22; 95% CI, 1.02 to 1.46) and among adults with more severe back pain (OR, 1.26; 95% CI, 1.14 to 1.40).
CONCLUSION
Back pain was associated with a modest increase in all-cause mortality among women and those with more severe back pain.
Topics: Adult; Back Pain; Cohort Studies; Disabled Persons; Female; Humans; Prognosis; Prospective Studies
PubMed: 33876379
DOI: 10.1007/s11606-021-06732-6 -
International Journal of Environmental... Jan 2022Disability is an important problem in aging societies globally. However, the research findings of the prevalence of disability have been inconsistent. This study aims to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Disability is an important problem in aging societies globally. However, the research findings of the prevalence of disability have been inconsistent. This study aims to estimate the prevalence of disability and its influencing factors among the Chinese older population from 1979 to 31 July 2021.
METHODS
A systematic review and meta-analysis were conducted using both international (PubMed, Web of Science, CBMdisc, PsycINFO, the Cochrane Library, and EMBASE) and Chinese (CNKI, CQVIP, and WanFang) databases. Meta-analysis was performed using a random-effects model to account for heterogeneity. Subgroup analyses were also done.
RESULTS
The pooled prevalence of disability across all 97 studies was 26.2% (95% CI: 23.7-28.6%). The estimates varied according to the types of activities of daily living (ADL), gender, age, and region. Studies based on the identification of cases by using the complete ADL scale showed a higher prevalence than those using the basic ADL scale. The prevalence was slightly higher among female older individuals than among male older individuals. The highest rates were seen in older individuals aged 80 years or older. Elders in central China, southwest China, and northwest China were more likely to be BADL-disabled.
CONCLUSION
Prevalence of disability among the Chinese older population is high, around 26%. Using standardized diagnostic systems to correctly estimate the prevalence of disability would be helpful for public health professionals in China.
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Asian People; China; Disabled Persons; Female; Humans; Male; Prevalence
PubMed: 35162679
DOI: 10.3390/ijerph19031656 -
Iranian Journal of Public Health Sep 2022Multiple Sclerosis (MS) patients experience a variety of disease caused disabilities that makes them more vulnerable to the effects of disasters. This study aimed to... (Review)
Review
BACKGROUND
Multiple Sclerosis (MS) patients experience a variety of disease caused disabilities that makes them more vulnerable to the effects of disasters. This study aimed to review all existed studies about disasters and related disaster management planning about MS patients.
METHODS
The PubMed, Google Scholar, Scopus, and Web of Science, ProQuest, science direct , and grey literature databases were searched up to the mid of 2021. All obtained titles were assessed by the inclusion criteria. Abstracts of the relevant titles were reviewed and eligible articles/documents were included for full text review and data abstraction.
RESULTS
From 24616 Articles/documents, finally 15 documents (13 articles, and 2 books) were selected. In 8 articles (53%) specifically, focused on MS patients and, in the rest focused on them as a member of people with disabilities. Most studies (10, 71.4%), emphasized on the disaster induced stress effect on MS patients. In two books/book sections, the disaster preparedness plan for all types of disabilities was presented in general, and MS patients were mentioned as a member of the group of patients with disabilities.
CONCLUSION
Despite the importance of planning in response to disasters to address specific problems of MS patients, there is a lack of proper planning. This is very important and there is an urgent need to develop appropriate planning protocols for addressing the special conditions of MS patients in response to disasters.
PubMed: 36743361
DOI: 10.18502/ijph.v51i9.10549 -
International Journal of Environmental... Aug 2022This paper presents an ontological review of the global research on access to geriatric disability care and a roadmap for future research to address the problem in... (Review)
Review
This paper presents an ontological review of the global research on access to geriatric disability care and a roadmap for future research to address the problem in India. First, the dominant research focus is on resources (human, financial, and spatial) that affect access to disability care; there is little focus on informational and technological resources. Second, functional disabilities are the dominant focus of the research, followed by cognitive, mental, and locomotor disabilities; there is little focus on speech, hearing, and visual disabilities. Third, barriers, inhibitors, and catalysts of physical access are the dominant focus, with relatively less focus on virtual access; there is very little emphasis on the drivers to access. Fourth, the primary, although not dominant, focus is on access for urban and rural populations; there is very little focus on access for underserved and indigenous populations. Future research must address these gaps systematically to improve access. This paper adds: (a) a systemic framework for the study of an important, complex, emerging problem; (b) a systematic review of the global research on the problem; and (c) a research roadmap to address the emerging problem in India.
Topics: Aged; Disabled Persons; Health Services Accessibility; Humans; India; Rural Population
PubMed: 36011654
DOI: 10.3390/ijerph191610018 -
BMC Public Health Jun 2021The aim of this review is to identify and summarize factors that are associated with public attitudes towards people with various disabilities systematically.
OBJECTIVE
The aim of this review is to identify and summarize factors that are associated with public attitudes towards people with various disabilities systematically.
METHODS
An electronic search of three databases was performed (Medline, EMBASE and Cochrane) covering the period from 1950 to present. A comprehensive search strategy was developed and the lists of citations were screened for potential eligible studies. Only quantitative studies using valid measurements were included, and the methodological quality of included studies was appraised based on three criteria (sample, measurement, analysis) by two independent reviewers.
RESULTS
The initial electronic search yielded 995 articles after duplicates removed, and 27 studies met the eligibility criteria were included in the study. Three categories of the factors were found to be associated with the public attitudes, which are related to the attitude provider, disabled people, and society respectively. Specifically, the more people know about disabilities, the more likely they were to have positive attitude; and the frequency and quality of the contact with the disabled are also proved to be influential to the attitudes. Meanwhile, the type of disability is also closely correlated to the public's attitude towards the disabilities.
CONCLUSION
People's knowledge of the disability and their contact with individuals with disabilities are the main influential factors in public attitudes towards persons with disabilities.
Topics: Attitude; Delivery of Health Care; Disabled Persons; Humans; Public Opinion
PubMed: 34082734
DOI: 10.1186/s12889-021-11139-3 -
The Lancet. Infectious Diseases Jul 2022The incidence of invasive disease caused by group A streptococcus (GAS) has increased in multiple countries in the past 15 years. However, despite these reports, to the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The incidence of invasive disease caused by group A streptococcus (GAS) has increased in multiple countries in the past 15 years. However, despite these reports, to the best of our knowledge, no systematic reviews and combined estimates of the incidence of invasive GAS have been done in key high-risk groups. To address this, we estimated the incidence of invasive GAS disease, including death and disability outcomes, among two high-risk groups-namely, pregnant women and children younger than 5 years.
METHODS
We did a systematic review and meta-analyses on invasive GAS outcomes, including incidence, case fatality risks, and neurodevelopmental impairment risk, among pregnant women, neonates (younger than 28 days), infants (younger than 1 year), and children (younger than 5 years) worldwide and by income region. We searched several databases for articles published from Jan 1, 2000, to June 3, 2020, for publications that reported invasive GAS outcomes, and we sought unpublished data from an investigator group of collaborators. We included studies with data on invasive GAS cases, defined as laboratory isolation of Streptococcus pyogenes from any normally sterile site, or isolation of S pyogenes from a non-sterile site in a patient with necrotising fasciitis or streptococcal toxic shock syndrome. For inclusion in pooled incidence estimates, studies had to report a population denominator, and for inclusion in pooled estimates of case fatality risk, studies had to report aggregate data on the outcome of interest and the total number of cases included as a denominator. We excluded studies focusing on groups at very high risk (eg, only preterm infants). We assessed heterogeneity with I.
FINDINGS
Of the 950 published articles and 29 unpublished datasets identified, 20 studies (seven unpublished; 3829 cases of invasive GAS) from 12 countries provided sufficient data to be included in pooled estimates of outcomes. We did not identify studies reporting invasive GAS incidence among pregnant women in low-income and middle-income countries (LMICs) nor any reporting neurodevelopmental impairment after invasive GAS in LMICs. In nine studies from high-income countries (HICs) that reported invasive GAS in pregnancy and the post-partum period, invasive GAS incidence was 0·12 per 1000 livebirths (95% CI 0·11 to 0·14; I=100%). Invasive GAS incidence was 0·04 per 1000 livebirths (0·03 to 0·05; I=100%; 11 studies) for neonates, 0·13 per 1000 livebirths (0·10 to 0·16; I=100%; ten studies) for infants, and 0·09 per 1000 person-years (95% CI 0·07 to 0·10; I=100%; nine studies) for children worldwide; 0·12 per 1000 livebirths (95% CI 0·00 to 0·24; I=100%; three studies) in neonates, 0·33 per 1000 livebirths (-0·22 to 0·88; I=100%; two studies) in infants, and 0·22 per 1000 person-years (0·13 to 0·31; I=100%; two studies) in children in LMICs; and 0·02 per 1000 livebirths (0·00 to 0·03; I=100%; eight studies) in neonates, 0·08 per 1000 livebirths (0·05 to 0·11; I=100%; eight studies) in infants, and 0·05 per 1000 person-years (0·03 to 0·06; I=100%; seven studies) in children for HICs. Case fatality risks were high, particularly among neonates in LMICs (61% [95% CI 33 to 89]; I=54%; two studies).
INTERPRETATION
We found a substantial burden of invasive GAS among young children. In LMICs, little data were available for neonates and children and no data were available for pregnant women. Incidences of invasive GAS are likely to be underestimates, particularly in LMICs, due to low GAS surveillance. It is essential to improve available data to inform development of prevention and management strategies for invasive GAS.
FUNDING
Wellcome Trust.
Topics: Child; Child, Preschool; Female; Humans; Incidence; Infant; Infant, Newborn; Infant, Premature; Pregnancy; Pregnant Women; Streptococcal Infections; Streptococcus pyogenes
PubMed: 35390294
DOI: 10.1016/S1473-3099(21)00672-1 -
The Cochrane Database of Systematic... Jan 2022The ideal objective of treating a person with epilepsy is to induce remission (free of seizures for some time) using antiepileptic drugs (AEDs) and withdraw the AEDs... (Review)
Review
BACKGROUND
The ideal objective of treating a person with epilepsy is to induce remission (free of seizures for some time) using antiepileptic drugs (AEDs) and withdraw the AEDs without causing seizure recurrence. Prolonged usage of AEDs may have long-term adverse effects. Hence, when a person with epilepsy is in remission, it is logical to attempt to discontinue the medication. The timing of withdrawal and the mode of withdrawal arise while contemplating withdrawal of AEDs. This review examines the evidence for the rate of withdrawal of AEDs (whether rapid or slow tapering) and its effect on seizure recurrence. This is an updated version of the Cochrane Review previously published in 2020.
OBJECTIVES
To quantify risk of seizure recurrence after rapid (tapering period of three months or less) or slow (tapering period of more than three months) discontinuation of antiepileptic drugs in adults and children with epilepsy who are in remission, and to assess which variables modify the risk of seizure recurrence.
SEARCH METHODS
For the latest update, on 8 November 2021, we searched: Cochrane Register of Studies (CRS Web), MEDLINE (Ovid), and SCOPUS. There were no language restrictions. CRS Web includes randomized or quasi-randomized, controlled trials from PubMed, Embase, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform (ICTRP), CENTRAL, and the Specialized Registers of Cochrane Review Groups including Epilepsy.
SELECTION CRITERIA
Randomized controlled trials that evaluated withdrawal of AEDs in a rapid or slow tapering after varying periods of seizure control in people with epilepsy.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed the trials for inclusion and extracted the data. The outcomes assessed included seizure freedom after one, two, or five years of AED withdrawal; time to recurrence of seizure following withdrawal; occurrence of status epilepticus; mortality; morbidity due to seizure, such as injuries, fractures, and aspiration pneumonia; and quality of life (assessed by validated scale).
MAIN RESULTS
There are two included studies in this review. One study randomized 57 children with epilepsy with seizure freedom for at least two years to taper down the AED over one or six months. The study was not blinded and there were no details of randomization. Over the period of 54 months of follow-up, 20/30 participants in the one-month group remained seizure-free compared to 15/27 participants in the six-month group (no evidence of a difference). There was no information on time of seizure recurrence for each group to allow a comparison. The other study involved 149 children. There was a non-significant trend towards a lower risk of seizure recurrence after one year of AED withdrawal in participants allocated to slow tapering (risk ratio (RR) 0.76, 95% confidence interval (CI) 0.58 to 1.01; P = 0.06; very low-certainty evidence). At the end of two years, 30 participants were seizure free in the rapid-tapering group and 29 participants in the slow-tapering group (RR 0.87, 95% CI 0.58 to 1.29; P = 0.48; very low-certainty evidence). At the end of five years, 10 participants were seizure free in the rapid-tapering group and six participants in the slow-tapering group (RR 1.40, 95% CI 0.54 to 3.65; P = 0.49; very low-certainty evidence). There were no data for the other outcomes. Due to the methodological heterogeneity and the difference in the duration of tapering, we did not perform a quantitative synthesis of these studies. Currently, one Italian trial is ongoing that is investigating if a slow or a rapid withdrawal schedule of AEDs influences return of seizures (relapse) in adults with focal or generalized epilepsy who have been seizure free for at least two years (no preliminary results available).
AUTHORS' CONCLUSIONS
In view of methodological deficiencies, and small sample size of the two included studies, we cannot draw any reliable conclusions regarding the optimal rate of tapering of AEDs. Using GRADE, we assessed the certainty of the evidence as very low for outcomes for which data were available. We judged both studies to be at an overall high risk of bias. Further studies are needed in adults and children to investigate the optimal rate of withdrawal of AEDs and to study the effects of variables such as seizure types, aetiology, intellectual disability, electroencephalography abnormalities, presence of neurological deficits, and other comorbidities on the rate of tapering.
Topics: Adult; Anticonvulsants; Child; Epilepsy; Epilepsy, Generalized; Humans; Quality of Life; Seizures
PubMed: 35005782
DOI: 10.1002/14651858.CD005003.pub4 -
PloS One 2023Social interventions are essential in supporting the health and well-being of people with disability, but there is a critical need to prioritise resources for those that...
Social interventions are essential in supporting the health and well-being of people with disability, but there is a critical need to prioritise resources for those that provide the best value for money. Economic evaluation is a widely used tool to assist priority setting when resources are scarce. However, the scope and consistency of economic evaluation evidence for disability social services are unclear, making it hard to compare across interventions to guide funding decisions. This systematic review aims to summarise the current evidence in the economic evaluation of social services for people with disability and to critically compare the methodologies used in conducting the economic evaluations with a focus on the outcomes and costs. We searched seven databases for relevant studies published from January 2005 to October 2021. Data were extracted on study characteristics such as costs, outcomes, perspectives, time horizons and intervention types. Overall, economic evaluation evidence of social services for people with disability was scarce. Twenty-four economic evaluations were included, with the majority conducting a cost-effectiveness analysis (n = 16). Most interventions focused on employment (n = 10), followed by community support and independent living (n = 6). Around 40% of the studies addressed people with mental illnesses (n = 10). The evidence was mixed on whether the interventions were cost-effective but the methods used were highly variable, which made comparisons across studies very difficult. More economic evidence on the value of interventions is needed as well as a more standardised and transparent approach for future research.
Topics: Humans; Cost-Benefit Analysis; Mental Disorders; Social Work; Cost-Effectiveness Analysis; Disabled Persons
PubMed: 36662789
DOI: 10.1371/journal.pone.0278930 -
Sensors (Basel, Switzerland) Dec 2021Social interactions significantly impact the quality of life for people with special needs (e.g., older adults with dementia and children with autism). They may suffer... (Review)
Review
Social interactions significantly impact the quality of life for people with special needs (e.g., older adults with dementia and children with autism). They may suffer loneliness and social isolation more often than people without disabilities. There is a growing demand for technologies to satisfy the social needs of such user groups. However, evaluating these systems can be challenging due to the extra difficulty of gathering data from people with special needs (e.g., communication barriers involving older adults with dementia and children with autism). Thus, in this systematic review, we focus on studying data gathering methods for evaluating socially assistive systems (SAS). Six academic databases (i.e., Scopus, Web of Science, ACM, Science Direct, PubMed, and IEEE Xplore) were searched, covering articles published from January 2000 to July 2021. A total of 65 articles met the inclusion criteria for this systematic review. The results showed that existing SASs most often targeted people with visual impairments, older adults, and children with autism. For instance, a common type of SASs aimed to help blind people perceive social signals (e.g., facial expressions). SASs were most commonly assessed with interviews, questionnaires, and observation data. Around half of the interview studies only involved target users, while the other half also included secondary users or stakeholders. Questionnaires were mostly used with older adults and people with visual impairments to measure their social interaction, emotional state, and system usability. A great majority of observational studies were carried out with users in special age groups, especially older adults and children with autism. We thereby contribute an overview of how different data gathering methods were used with various target users of SASs. Relevant insights are extracted to inform future development and research.
Topics: Aged; Child; Disabled Persons; Emotions; Humans; Loneliness; Quality of Life; Social Isolation
PubMed: 35009623
DOI: 10.3390/s22010082