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Work (Reading, Mass.) Jun 2024There is increasing evidence that employment, or the lack thereof, affects an individual's health. Consequently, employment provides people with physical disabilities...
BACKGROUND
There is increasing evidence that employment, or the lack thereof, affects an individual's health. Consequently, employment provides people with physical disabilities (PWPD) with financial independence, enhances their well-being and self-worth, and facilitates a sense of purpose. People with physical disabilities often retain job skills and motivation to return to work after acquiring a disability. Their vocational rehabilitation and job accommodation needs likely differ from people with disabilities resulting from developmental, sensory, cognitive, and mental health conditions. To better target the needs of PWPD and improve vocational rehabilitation services, it is crucial to identify the modifiable factors that influence their employment outcomes.
OBJECTIVE
This research aimed to examine systematically the client-, employer-, and context-related facilitators and barriers to employment experienced by PWPD.
METHODS
We recruited to this cross-sectional study, PWPD from the Midwestern United States who returned to work after injury or illness. An online survey collected data on demographic characteristics and educational history; disability and functional status; supports, facilitators and barriers to employment; and job information and accommodations.
RESULTS
347 working-age PWPD completed the survey; at the time of survey completion, 270 were working and 77 were not. People with physical disabilities who reported social support and encouragement at work were more likely to be working than respondents who did not. Negative attitudes of supervisors and colleagues, inaccessible work environments, and inflexible work schedules were barriers to employment. Important reasons for working included financial needs, a sense of purpose, and self-worth.
CONCLUSIONS
Results provide insights into the importance of social supports in the work environment. Novel approaches are needed to develop supportive relationships with supervisors and coworkers.
PubMed: 38905070
DOI: 10.3233/WOR-220721 -
BMJ Open Jun 2024To identify the needs of people with long COVID (LC) in the UK.
OBJECTIVES
To identify the needs of people with long COVID (LC) in the UK.
DESIGN
Qualitative study using the Framework Analysis to analyse focus group discussions.
PARTICIPANTS
25 adults with LC aged 19-76 years including 17 men and 8 women. Average disease duration was 80.1 weeks.
SETTING
Eight focus groups were conducted in April 2023 online and in-person at the University of Leeds (UoL), UK. Recruitment routes included advertisement via Leeds Community Healthcare services, the English National Opera Breathe Programme and within the UoL.
RESULTS
Three key themes/needs were identified. (Theme 1) Support systems including community groups, disability benefits, clinical services and employment support should be accessible and tailored to the needs of people with LC. (Theme 2) Research should investigate the physiology of symptoms, new clinical tests and treatment interventions to improve clinical understanding of the condition and symptom management. (Theme 3) Societal awareness should be promoted via local and national initiatives to educate the public about the condition and reduce stigma.
CONCLUSIONS
Participants experienced varied and individual challenges to daily life due to LC. There is a need for government acknowledgement of LC as a disability to ensure people with LC have access to disability support and legal protection. Policy development should be patient-driven and acknowledge the individual needs of people with LC in order to improve their quality of life.
Topics: Humans; Female; Male; Middle Aged; Aged; Adult; United Kingdom; Qualitative Research; COVID-19; Focus Groups; Needs Assessment; SARS-CoV-2; Young Adult; Post-Acute COVID-19 Syndrome; Health Services Needs and Demand
PubMed: 38904135
DOI: 10.1136/bmjopen-2023-082728 -
Medical Education Online Dec 2024In the United States, sexual, reproductive, and perinatal health inequities are well documented and known to be caused by a history of systemic oppression along many...
In the United States, sexual, reproductive, and perinatal health inequities are well documented and known to be caused by a history of systemic oppression along many axes, including but not limited to race, ethnicity, gender, socioeconomic position, sexual orientation, and disability. Medical schools are responsible for educating students on systems of oppression and their impact on health. Reproductive justice advocates, including lay persons, medical students, and teaching faculty, have urged for integrating the reproductive justice framework into medical education and clinical practice. In response to medical student advocacy, we developed introductory didactic sessions on social and reproductive justice for preclinical medical students. These were created in a team-based learning format and include pre-course primer materials on reproductive justice. During the sessions, students engaged with hypothetical clinical vignettes in small groups to identify oppressive structures that may have contributed to the health outcomes described and potential avenues for contextually relevant and level-appropriate advocacy. The sessions took place in November 2019 (in-person) and 2020 (virtually) and were well attended by students. We highlight our experience, student feedback, and next steps, including further integration of reproductive health equity into medical school curricula in concert with department-wide education for faculty, residents, nursing, and allied health professionals. This introduction to social and reproductive justice can be adapted and scaled across different medical school curricula, enhancing the training of a new generation of physicians to become critically aware of how oppressive structures create health inequities and able to mitigate their impact through their roles as clinicians, researchers, and advocates.
Topics: Humans; Health Equity; Reproductive Health; Curriculum; Students, Medical; Education, Medical, Undergraduate; Social Justice; United States
PubMed: 38903002
DOI: 10.1080/10872981.2024.2364984 -
BMC Health Services Research Jun 2024Along with the social and economic challenges posed by an aging society, creating work conditions that allow persons to stay healthy and work into old age has become a...
Risk factors and service gaps affecting a sustainable work: a qualitative multi-stakeholder analysis in the context of persons with acquired brain injury living in Switzerland.
INTRODUCTION
Along with the social and economic challenges posed by an aging society, creating work conditions that allow persons to stay healthy and work into old age has become a major task of Western societies. Retaining employment after returning to work is particularly difficult for individuals with a disability, as evidenced by the high rate of premature labor market dropout. Individuals with acquired brain injury (ABI) exemplify this challenge, as it often impairs cognitive, technical, and interpersonal abilities that are crucial in today's labor market. To effectively support these individuals, vocational integration practitioners require comprehensive knowledge of risk factors for premature labor market dropout and effective strategies for sustainable work.
OBJECTIVE
This study aimed to identify perceived risk factors and related service gaps regarding sustainable work for people with ABI, as reported by affected individuals, employers, vocational integration professionals, and health professionals.
METHODS
Secondary data analysis. Data that was originally collected through seven focus groups and two interviews with persons with ABI, 15 interviews with employers, and 13 interviews with vocational integration and health professionals in the context of the project 'Sustainable employment' was re-analysed thematically.
RESULTS
Two major themes of risk factors were identified: (1) person-related factors (including the subthemes: post-ABI impairments; lack of understanding of post-ABI impairments; poor health management) and (2) environment-related factors (including the subthemes: challenges related to the service structure; insufficient knowledge and education about ABI; challenges at the workplace; difficulties in private life). While stakeholders noted the variety of the currently available services, they particularly pointed to the missing long-term monitoring and counseling services for persons with ABI following the initial return-to-work, reflecting a major challenge for sustainable work. An overarching gap related to the fragmentation of the service structure and the lack of case coordination along the working life.
CONCLUSIONS
Multiple stakeholders emphasized the importance of empowering individuals, ensuring easy access to professional support, and providing a suitable work environment to address key risk factors and facilitate sustainable work for individuals with ABI. Continuous coaching, long-term monitoring and counseling following return-to-work, were identified as potential strategies to achieve these goals.
Topics: Humans; Female; Switzerland; Risk Factors; Male; Adult; Middle Aged; Qualitative Research; Brain Injuries; Focus Groups; Return to Work; Rehabilitation, Vocational; Employment; Stakeholder Participation; Interviews as Topic
PubMed: 38902701
DOI: 10.1186/s12913-024-11128-3 -
Revue de L'infirmiere 2024As part of their training, volunteer nursing students from the Gers healthcare training institute were invited to take part in a sports exchange with a handibasket team.... (Review)
Review
As part of their training, volunteer nursing students from the Gers healthcare training institute were invited to take part in a sports exchange with a handibasket team. The main aim of the project was to change their perceptions of disability. Here, four of the students share their experiences and the benefits of the experience.
Topics: Humans; Students, Nursing; Disabled Persons
PubMed: 38901912
DOI: 10.1016/j.revinf.2024.05.014 -
Epidemiology and Health Jun 2024This cohort profile describes one of the largest linked datasets in the world concerning the health of people with intellectual disability. The cohort comprises a...
This cohort profile describes one of the largest linked datasets in the world concerning the health of people with intellectual disability. The cohort comprises a retrospective group of 100,089 individuals with intellectual disability who received disability and/or health services in New South Wales, Australia. Of these participants, 34% were female, with a median age at cohort entry of 3 years (interquartile range, 0 to 19 years). A separate comparator cohort included 455,677 individuals, matched by 5-year age group, sex, and residential postcode at a 5:1 ratio. Initial results indicate that between 2001 and 2018, people with intellectual disability experienced more than double the rate of hospitalisations (538 versus 235 per 1000 person-years), as well as markedly higher rates of emergency department presentations (707 versus 379 per 1000 person-years) and use of ambulatory mental health services (1012 versus 157 per 1000 person-years), relative to the comparator cohort. The largest disparities in hospital admissions were for mental disorders, dialysis, and diseases of the nervous system and sense organs. Furthermore, individuals with intellectual disability had more than double the rate of dispensed medications found in the comparator cohort. Of these medications, 46.6% were for the treatment of nervous system conditions, as opposed to 24.7% for the comparator cohort. The mean age at death was 52 years (standard deviation [SD], 19 years) for people with intellectual disability and 64 years (SD, 22 years) for the comparator participants.
PubMed: 38901827
DOI: 10.4178/epih.e2024054 -
American Journal of Ophthalmology Jun 2024To investigate the prevalence of non-person-first language (PFL) in consecutive general ophthalmology referrals to a single tertiary ophthalmology clinic.
PURPOSE
To investigate the prevalence of non-person-first language (PFL) in consecutive general ophthalmology referrals to a single tertiary ophthalmology clinic.
DESIGN
Retrospective cross-sectional study.
METHODS
Participants included Ophthalmology patients seen for their initial visit to a single tertiary ophthalmology clinic from July 2018 to December 2022. Ten randomly selected referrals from each day were screened for non-PFL as per the American Medical Association and American Psychological Association guidelines. Non-PFL was further categorized into general, diabetes, stigma, obesity, or ageism subcategories. The Chi-square test was used to evaluate associations between non-PFL use and referring provider gender and specialty, length of referral, and patient age and gender.
RESULTS
A total of 2625 referrals were included in the study and 136 (5.2%) used non-PFL, such as referring to a person with diabetes as a "diabetic". Error types included Diabetes (38.2%), Stigma (30.9%), General (23.5%), Disability (8.8%), and Obesity (4.4%). Year of referral was predictive of non-PFL (p=0.0016), with most occurring in 2020 (9.5%). Non-PFL was significantly more likely to occur in long length referrals compared to medium and short length referrals (16.2% vs. 5.1% vs. 3.5%, p<0.001). Referring provider specialty was also predictive of non-PFL (p<0.001) with most received by Family Medicine (8.3%), Optometry (4.4%), Emergency Medicine (0.62%), Ophthalmology (4.2%), Others (2.9%). Patient gender (p=0.5563), patient age (p=0.3466), and referring provider gender (p=0.9057) were not predictive of non-PFL.
CONCLUSIONS
Non-PFL use was most prevalent in 2020, with the most common referral sources being Family Medicine and Optometry. The highest proportions of non-PFL errors made were diabetes and stigma errors. Increased use of PFL in physician-physician communication can decrease intersectional stigma and promote inclusive patient care for ophthalmology patients.
PubMed: 38901721
DOI: 10.1016/j.ajo.2024.05.033 -
A New Pandemic of the XXIst Century: The Growing Crisis of Adolescent Depression in the Digital Age.Medical Science Monitor : International... Jun 2024In a reality dominated by social media and affected by the recent COVID-19 pandemic, the mental health of people in various age groups has undoubtedly suffered,... (Review)
Review
In a reality dominated by social media and affected by the recent COVID-19 pandemic, the mental health of people in various age groups has undoubtedly suffered, especially among young people. Statistics confirm that adolescent depression is a significant health problem and is the most common cause of disability in this age group. Research shows the multifactorial basis of this disease entity, placing particular emphasis on the genetic, environmental, and biological background. A family history of depression can increase the risk of developing depression by 4-fold. A teenager, being part of many systems, such as family, school community, and social media co-user, is exposed to many stressors. Maturing youth have a very demanding educational plan to implement, and depression causes a decline in cognitive functions, which are so important in acquiring knowledge. Among many patients, an additional risk is self-harm and suicide, which are part of the clinical picture of depressive disorders. Suicide accounts for about one-third of mortality among youth. We draw attention to the need to increase educational and psychoeducational impacts on adolescent depression, as it is a huge health problem that has an impact on all areas of a young person's life. The trend of depression among adolescents is constantly increasing. The aim of this article is to review the global causes and consequences of the growing number of cases of depression, self-harm, and suicide among children and adolescents, as well as contemporary approaches to management.
Topics: Adolescent; Humans; COVID-19; Depression; Depressive Disorder; Mental Health; Pandemics; SARS-CoV-2; Self-Injurious Behavior; Social Media; Suicide; Child
PubMed: 38900715
DOI: 10.12659/MSM.944838 -
Revue Medicale Suisse Jun 2024Despite chronic primary pain being recognized as a disease in the 11th revision of the International Classification of Diseases (ICD-11), individuals suffering from it...
Despite chronic primary pain being recognized as a disease in the 11th revision of the International Classification of Diseases (ICD-11), individuals suffering from it are still too frequently met with a certain skepticism. This skepticism can detrimentally affect their healthcare journey, social life, and economic stability. This article outlines part of the legal evolution regarding the recognition of chronic pain as well as the current insurance-related provisions in Switzerland. With a thorough understanding of this system, physicians can reduce frustration and disputes as well as promoting decision-making processes. The article concludes by highlighting the tools that physicians can use to navigate procedures related to disability insurance effectively.
Topics: Humans; Chronic Pain; Switzerland; Insurance, Disability; Disabled Persons; International Classification of Diseases
PubMed: 38898753
DOI: 10.53738/REVMED.2024.20.879.1190 -
Journal of Rehabilitation Medicine Jun 2024To examine the association between physical activity, neck circumference, and cardiovascular disease risk in older wheelchair users.
OBJECTIVE
To examine the association between physical activity, neck circumference, and cardiovascular disease risk in older wheelchair users.
DESIGN
A cross-sectional study.
SUBJECTS/PATIENTS
Sixty-one Korean wheelchair users aged 50 years and older.
METHODS
Physical activity was assessed using a self-administered questionnaire. Neck circumference was measured with a tape ruler. Cardiovascular disease risk was evaluated by calculating the Framingham risk score (FRS) for estimating 10-year cardiovascular disease risk, which was classified as low-moderate (19% or less) or high risk (20% or more).
RESULTS
The FRS for 10-year cardiovascular disease risk was inversely related to physical activity (beta [SE] = -0.213 (0.103), p = 0.043) and positively related to neck circumference (beta [SE] = 1.331 ± 0.419, p = 0.003). Binary logistic regression showed that those with low physical activity (odds ratio [95% confidence interval] = 4.256 (1.188~15.243), p = 0.026) or a large neck circumference (odds ratio [95% confidence interval] = 3.645 (1.172~11.338), p = 0.025) had a higher risk for high cardiovascular disease risk compared with those with high physical activity or normal neck circumference.
CONCLUSION
The current study findings suggest that an intervention targeting physical inactivity and upper-body obesity should be implemented to reduce cardiovascular disease risk in older wheelchair users.
Topics: Humans; Male; Female; Middle Aged; Neck; Cross-Sectional Studies; Wheelchairs; Aged; Cardiovascular Diseases; Motor Activity; Risk Factors; Heart Disease Risk Factors; Exercise; Surveys and Questionnaires; Disabled Persons
PubMed: 38898678
DOI: 10.2340/jrm.v56.35279