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AIDS Care 2014More than one billion people worldwide are estimated to be living with a disability. A significant proportion of them lives in Sub-Saharan Africa where they are reported... (Meta-Analysis)
Meta-Analysis Review
More than one billion people worldwide are estimated to be living with a disability. A significant proportion of them lives in Sub-Saharan Africa where they are reported to be at increased risk of HIV. However, quantitative evidence on this remains scarce. A systematic review and a meta-analysis of the risk of HIV infection among people with disabilities living in Sub-Saharan Africa were undertaken. We searched all published or unpublished studies and national surveys reporting HIV prevalence among adults with disabilities living in Sub-Saharan Africa between 2000 and 2013. The risk ratio (RR) of HIV infection in people with disabilities versus people without disabilities was estimated through a random-effects meta-analysis. Of the 12,252 references screened, 13 studies were selected. HIV prevalence varied widely across studies from 1.1% to 29%. Pooled RRs of HIV infection in people with disabilities compared to the general population were 1.31 (1.02-1.69) overall; 1.16 (0.71-1.87) among people with mental illness or intellectual disabilities and 1.07 (0.58-1.95) among people with hearing disabilities. This meta-analysis provides evidence that people with disabilities do not have a lower risk of HIV when compared to the general population, and that women with disabilities are especially affected. A clear increasing gradient in the risk of HIV according to gender and disability status was also observed. The important heterogeneity across studies and their varying quality warrant a closer look at the intersection between disability and HIV. Additional studies with more systematic approaches and with higher-quality methodologies are required to further address this knowledge gap.
Topics: Adult; Africa South of the Sahara; Disabled Persons; Female; HIV Infections; HIV Seropositivity; Humans; Male; Prevalence; Risk Assessment; Risk Factors; Sex Distribution
PubMed: 25033274
DOI: 10.1080/09540121.2014.936820 -
Pain Jun 2015Disability is an important outcome from a clinical and public health perspective. However, it is unclear how disability develops in people with low back pain or neck... (Meta-Analysis)
Meta-Analysis Review
Disability is an important outcome from a clinical and public health perspective. However, it is unclear how disability develops in people with low back pain or neck pain. More specifically, the mechanisms by which pain leads to disability are not well understood. Mediation analysis is a way of investigating these mechanisms by examining the extent to which an intermediate variable explains the effect of an exposure on an outcome. This systematic review and meta-analysis aimed to identify and examine the extent to which putative mediators explain the effect of pain on disability in people with low back pain or neck pain. Five electronic databases were searched. We found 12 studies (N = 2961) that examined how pain leads to disability with mediation analysis. Standardized regression coefficients (β) of the indirect and total paths were pooled. We found evidence to show that self-efficacy (β = 0.23, 95% confidence interval [CI] = 0.10 to 0.34), psychological distress (β = 0.10, 95% CI = 0.01 to 0.18), and fear (β = 0.08, 95% CI = 0.01 to 0.14) mediated the relationship between pain and disability, but catastrophizing did not (β = 0.07, 95% CI = -0.06 to 0.19). The methodological quality of these studies was low, and we highlight potential areas for development. Nonetheless, the results suggest that there are significant mediating effects of self-efficacy, psychological distress, and fear, which underpins the direct targeting of these constructs in treatment.
Topics: Back Pain; Databases, Factual; Disabled Persons; Disease Progression; Humans; Neck Pain
PubMed: 25760473
DOI: 10.1097/j.pain.0000000000000146 -
PloS One 2014'Learning disabilities' (LD) refer to a wide group of neurological disorders caused by deficits in the central nervous system which influence the individual's ability to... (Review)
Review
BACKGROUND
'Learning disabilities' (LD) refer to a wide group of neurological disorders caused by deficits in the central nervous system which influence the individual's ability to maintain-, process or convey information to others in an efficient way. A worldwide discussion about the definitions of LD continues while a conceptual framework for studying the diverse life outcomes of adults with LD is still missing.
OBJECTIVE
The aim was to review the literature on the activity and participation of adults with LD based on the International Classification of Functioning, Disability and Health (ICF) concepts.
METHODS
"PsychInfo", "Eric" and "PubMed" were searched for relevant literature according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). After a three-stage process, 62 articles relevant for domains of activity and participation of adults with LD were included in the review.
RESULTS
Thirty-two articles focused on the domain of major life areas of education, work and employment and twelve articles focused on the domain of learning and applying knowledge. Limitations in activity and participation of the population with LD in these domains are recognized and discussed. Eighteen additional articles demonstrated that adults with LD confront difficulties in various life domains (e.g., communication, interpersonal interactions, mobility, and domestic life), however literature concerning these domains is scarce.
CONCLUSIONS
The ICF can be useful for further exploration of activity and participation characteristics of adults with LD in various life domains. Such exploration is required in order to gain a wider perspective of their functional characteristics and daily needs.
Topics: Activities of Daily Living; Adult; Central Nervous System; Disability Evaluation; Disabled Persons; Humans; Interpersonal Relations; Learning Disabilities
PubMed: 25184315
DOI: 10.1371/journal.pone.0106657 -
Journal of Applied Research in... Jan 2022People with intellectual disabilities have a high risk of developing mental ill-health. Treatment is often neglected and diagnosis is misattributed to a person's... (Review)
Review
BACKGROUND
People with intellectual disabilities have a high risk of developing mental ill-health. Treatment is often neglected and diagnosis is misattributed to a person's disability. Standard psychosocial interventions can improve a person's well-being. This review aimed to understand what interventions are being delivered, any benefits, and future recommendations.
METHODS
Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed, and the review registered with PROSPERO-CRD42020160254. Databases searched included: MEDLINE, Embase, and PsycINFO. A framework synthesis approach was used to present the findings.
RESULTS
There are limited psychosocial interventions offered for this population. When groups are delivered having a creative element, multiple activities over a short period of time, with breaks and group rules outcomes can be improved.
CONCLUSIONS
Adaptations and reasonable adjustments should be used specifically to a person's ability. A mixed-method design allows people to share their experiences alongside quantitative data that provides clinical information.
Topics: Disabled Persons; Humans; Intellectual Disability; Mental Health; Psychosocial Intervention
PubMed: 34337837
DOI: 10.1111/jar.12919 -
Journal of Occupational Rehabilitation Sep 2010Depression is associated with negative work outcomes such as reduced work participation (WP) (e.g., sick leave duration, work status) and work functioning (WF) (e.g.,... (Review)
Review
BACKGROUND
Depression is associated with negative work outcomes such as reduced work participation (WP) (e.g., sick leave duration, work status) and work functioning (WF) (e.g., loss of productivity, work limitations). For the development of evidence-based interventions to improve these work outcomes, factors predicting WP and WF have to be identified.
METHODS
This paper presents a systematic literature review of studies identifying factors associated with WP and WF of currently depressed workers.
RESULTS
A total of 30 studies were found that addressed factors associated with WP (N = 19) or WF (N = 11). For both outcomes, studies reported most often on the relationship with disorder-related factors, whereas personal factors and work-related factors were less frequently addressed. For WP, the following relationships were supported: strong evidence was found for the association between a long duration of the depressive episode and work disability. Moderate evidence was found for the associations between more severe types of depressive disorder, presence of co-morbid mental or physical disorders, older age, a history of previous sick leave, and work disability. For WF, severe depressive symptoms were associated with work limitations, and clinical improvement was related to work productivity (moderate evidence). Due to the cross-sectional nature of about half of the studies, only few true prospective associations could be identified.
CONCLUSION
Our study identifies gaps in knowledge regarding factors predictive of WP and WF in depressed workers and can be used for the design of future research and evidence-based interventions. We recommend undertaking more longitudinal studies to identify modifiable factors predictive of WP and WF, especially work-related and personal factors.
Topics: Depression; Disabled Persons; Efficiency; Employment; Humans; Occupational Health; Sick Leave
PubMed: 20091105
DOI: 10.1007/s10926-009-9224-x -
Lancet (London, England) Apr 2012About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities.
METHODS
In this systematic review and meta-analysis, we searched 12 electronic databases to identify primary research studies published between Jan 1, 1990, and Aug 17, 2010, reporting prevalence estimates of violence against adults (aged mainly ≥18 years) with disabilities, or their risk of violence compared with non-disabled adults. We included only studies reporting violence occurring within the 12 months before the study. We assessed studies with six core quality criteria, and pooled data for analysis.
FINDINGS
Of 10,663 references initially identified, 26 were eligible for inclusion, with data for 21,557 individuals with disabilities. 21 studies provided data suitable for meta-analysis of prevalence of violence, and ten for meta-analysis of risks of violence. Pooled prevalence of any (physical, sexual, or intimate partner) recent violence was 24·3% (95% CI 18·3-31·0) in people with mental illnesses, 6·1% (2·5-11·1) in those with intellectual impairments, and 3·2% (2·5-4·1) in those with non-specific impairments. We identified substantial heterogeneity in most prevalence estimates (I(2) >75%). We noted large uncertainty around pooled risk estimates. Pooled crude odds ratios for the risk of violence in disabled compared with non-disabled individuals were 1·50 (95% CI 1·09-2·05) for all studies combined, 1·31 (0·93-1·84) for people with non-specific impairments, 1·60 (1·05-2·45) for people with intellectual impairments, and 3·86 (0·91-16·43) for those with mental illnesses.
INTERPRETATION
Adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable. However, available studies have methodological weaknesses and gaps exist in the types of disability and violence they address. Robust studies are absent for most regions of the world, particularly low-income and middle-income countries.
FUNDING
WHO Department of Violence and Injury Prevention and Disability.
Topics: Disabled Persons; Humans; Mental Disorders; Prevalence; Risk; Violence
PubMed: 22377290
DOI: 10.1016/S0140-6736(11)61851-5 -
Cadernos de Saude Publica 2009This systematic review aimed to assess the effect of gender on the incidence of functional disability in the elderly. The search for publications in the MEDLINE, EMBASE,... (Review)
Review
This systematic review aimed to assess the effect of gender on the incidence of functional disability in the elderly. The search for publications in the MEDLINE, EMBASE, and ProQuest electronic databases from January 1990 to March 2008 identified 879 publications, from which 21 cohort studies were selected that evaluated gender as an independent variable and incidence of functional disability in elderly as the outcome. Review of the studies found that after adjusting for socioeconomic, health, and social relations indicators, incidence of functional disability was similar between genders. The main risk factors for functional disability in the elderly, regardless of gender, were: lack of schooling, living in rental housing, chronic diseases, arthritis, diabetes, visual impairment, body mass index above 25, poor self-perceived health, cognitive impairment, depression, slow gait, sedentary lifestyle, tiredness while performing daily activities, and limited diversity in social relations.
Topics: Activities of Daily Living; Aged; Cohort Studies; Disabled Persons; Frail Elderly; Geriatric Assessment; Humans; Incidence; Risk Factors; Sex Factors; Socioeconomic Factors
PubMed: 20027393
DOI: 10.1590/s0102-311x2009001500011 -
International Journal of Geriatric... Mar 2015The objective of this study is to investigate the effectiveness of cognitive behavioral therapies (CBTs) in improving depressive symptoms, disability, and cognition in... (Review)
Review
OBJECTIVES
The objective of this study is to investigate the effectiveness of cognitive behavioral therapies (CBTs) in improving depressive symptoms, disability, and cognition in older adults with depression and cognitive deficits.
DESIGN
It was performed a systematic search for articles published between 1994 and February 2014 in the MEDLINE/Pubmed, PsycINFO, and SCIELO. The studies should have provided information about benefits after CBTs to older adults with depression and cognitive deficits.
RESULTS
Cognitive behavioral therapy focused on problem solving is the main approach studied, having better effectiveness than supportive therapy in randomized clinical trials. Significant improvements in mood and disability were consistent, although evidence of changes in cognitive measures is controversial, less studied, and limited. Nevertheless, improvements in executive functions, processing speed, and changes in patients' perspectives of problem solving skills, such as generating alternatives and decision-making, were described. Also, it would be necessary that future studies more often evaluate cognitive status of depressed elders, as well as cognitive changes after psychotherapy. It should be emphasized that there is a lack of studies in this field, and more approaches in CBTs need to be investigated to this population.
CONCLUSION
Older adults with depression and cognitive deficits can benefit from CBTs. Improvements in mood and disability are more consistent than changes in cognition, which are little studied after CBTs. It is necessary more studies in the field, as well as, to investigate more approaches in CBTs to older adults with depression and cognitive deficits.
Topics: Aged; Cognition Disorders; Cognitive Behavioral Therapy; Depressive Disorder; Disabled Persons; Executive Function; Humans; Problem Solving
PubMed: 25521935
DOI: 10.1002/gps.4239 -
The Australian Journal of Rural Health Aug 2023Australia's National Disability Insurance Scheme (NDIS) was launched in 2013 to provide financial support packages for people with disability to purchase supports and... (Review)
Review
The experiences of people with disability and their families/carers navigating the NDIS planning process in regional, rural and remote regions of Australia: Scoping review.
BACKGROUND
Australia's National Disability Insurance Scheme (NDIS) was launched in 2013 to provide financial support packages for people with disability to purchase supports and services to enhance independence. People with disability are required to develop a plan with the National Disability Insurance Agency (NDIA), the government department responsible for managing the NDIS. This scoping review aims to ascertain the level of research into people's experience of the NDIS planning process in these geographic areas.
METHODOLOGY
Research publication databases were searched using a specific search string to identify research about people with disability and their families/carer's experiences of the NDIS planning process in regional, rural and remote regions of Australia. The Mixed Methods Appraisal Tool (MMAT) was adopted to appraise the quality of the research publications. Research publications focused on Aboriginal and Torres Strait Islander people were additionally appraised using the Aboriginal and Torres Strait Islander Quality Appraisal Tool developed by the Centre for Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange. A thematic synthesis of the publications' contents was undertaken to ascertain people with disabilities and carers experience of the NDIS planning process.
RESULTS
Ten (N = 10) research papers were found that met the inclusion criteria. Two papers were policy reviews and reported on the improvements of the NDIS planning process since its conception. The analysis found the research archive focused on five themes: (1) healthcare workforce and NDIA staff; (2) NDIS package holders and carers lack of awareness of the NDIS; (3) cultural/socio-economic barriers; (4) travel funding; and (5) emotional burden of the NDIS planning process.
CONCLUSION
There are limited papers available that explore people's experiences of the NDIS planning process in regional, rural and remote regions of Australia. This systematic review illuminates the difficulties, barriers and concerns of people with disability and their carers about the planning process.
Topics: Humans; Caregivers; Australia; Disabled Persons; Insurance, Disability; Indigenous Peoples; Health Services, Indigenous
PubMed: 37367630
DOI: 10.1111/ajr.13011 -
Journal of Developmental and Behavioral... 2017Perform a systematic review of the available literature regarding the effectiveness of exercise interventions on children with any type of social, emotional, or... (Review)
Review
OBJECTIVE
Perform a systematic review of the available literature regarding the effectiveness of exercise interventions on children with any type of social, emotional, or behavioral disability (SEBD), with attention to a range of physiological, behavioral, and mood outcomes.
METHODS
Six databases were searched using a systematic methodology. References of included studies, as well as relevant reviews, were also examined. The review was limited to studies published since 2000 reporting a quantitative analysis of the effects of a physical activity (PA) intervention on at least 1 behavioral, psychological, or cognitive outcome in children aged 21 and under, diagnosed with a SEBD. Only studies with a control group were included.
RESULTS
We identified 24 eligible studies. Studies varied in design, participant characteristics, and intervention characteristics (single-bout vs repeated exposure, duration, intensity level, mode of exercise). Of the 20 behavioral outcome assessments, there was 1 negative finding, 12 null findings, 5 positive findings, and 2 mixed findings. For the 25 executive functioning outcome assessments, there were 5 null findings, 18 positive findings, and 2 mixed findings. For the remaining outcome domains, 1 of 2 studies looking at academic performance, 3 of 6 studies looking at objective neurological measures, and 1 of 3 studies looking at affect outcomes found positive results. All other results were null or mixed.
CONCLUSION
Although additional research is warranted to further understand the mechanisms by which PA affects behavioral and cognitive outcome measures in children with SEBDs, PA offers a safe and alternative form of treatment for this population.
Topics: Adolescent; Adult; Child; Child, Preschool; Disabled Children; Exercise Therapy; Humans; Persons with Mental Disabilities; Young Adult
PubMed: 28671892
DOI: 10.1097/DBP.0000000000000452