-
Therapeutic Advances in Respiratory... 2023Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease. (Review)
Review
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease.
OBJECTIVES
This systematic review aimed to evaluate the disease burden of COPD in the Chinese population and to determine the factors influencing the economic burden of the disease.
DESIGN
This is a systematic review study.
DATA SOURCES AND METHODS
We searched PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure, WANGFANG Data, and VIP databases for studies regarding the disease burden of COPD in mainland China published before 31 December 2022. The Agency for Healthcare Research and Quality's recommendation rating tool assessed the cross-sectional studies' risk of bias.
RESULTS
A total of 45 studies were included. The disability-adjusted life years (DALYs) for COPD have generally decreased in the Chinese population over the past 30 years. The total number of DALYs due to COPD in China decreased from 26.12 million person-years to 19.92 million person-years, with an annual decline rate of 0.9%. Subjects aged 40 years and older make up the majority of those with COPD in the Chinese population, and the condition is more prevalent among males than females, in rural areas than urban places, and in the West than the East. The median direct medical cost of COPD ranges from 150 to 2014 USD per capita per year. Among 23 influencing factors, age, hospitalization days, hospital type, gender, and career were the most significant variables that had an impact on the economic burden of COPD patients.
CONCLUSION
The overall burden of COPD in China has been decreasing over the past 30 years. But there is a lack of standardized indicators for the economic burden of COPD patients in China, and it is recommended to establish a unified standard.
REGISTRATION
The systematic review protocol was prospectively registered with PROSPERO (No. CRD42023393429).
Topics: Adult; Female; Humans; Male; Middle Aged; China; Cost of Illness; Cross-Sectional Studies; Pulmonary Disease, Chronic Obstructive
PubMed: 38146618
DOI: 10.1177/17534666231218899 -
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 -
Annals of Plastic Surgery Jan 2024Neuromas substantially decrease a patient's quality of life and obstruct the use of prosthetics. This systematic review and meta-analysis aimed to determine the global... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Neuromas substantially decrease a patient's quality of life and obstruct the use of prosthetics. This systematic review and meta-analysis aimed to determine the global incidence of neuroma formation in upper extremity amputees.
METHODS
A literature search was performed using 3 databases: Web of Science, MEDLINE, and Cochrane. Inclusion criteria for the systematic review were those studies investigating only upper extremity amputees and reported postamputation neuroma. A random-effects, inverse-variance analysis was conducted to determine the pooled proportion of neuromas within the upper extremity amputation population. Critical appraisal using the JBI Checklist for Studies Reporting Prevalence Data of each individual article were performed for the systematic review.
RESULTS
Eleven studies met the inclusion criteria collating a total of 1931 patients across 8 countries. More than three-fourth of patients are young men (77%; age range, 19-54 years) and had an amputation due to trauma. The random-effects analysis found the pooled combined proportion of neuromas to be 13% (95% confidence interval, 8%-18%). The treatment of neuroma is highly variable, with some patients receiving no treatment.
CONCLUSIONS
The pooled proportion of neuroma incidence in the 1931 patients was 13%. With the known global prevalence of upper extremity amputees, this translates to nearly 3 million amputees suffering from a neuroma globally. Increasing training in preventative surgical methods could contribute to lowering this incidence and improving the outcomes of this patient population.
Topics: Male; Humans; Young Adult; Adult; Middle Aged; Amputees; Incidence; Quality of Life; Retrospective Studies; Neuroma; Upper Extremity
PubMed: 38117048
DOI: 10.1097/SAP.0000000000003742 -
PloS One 2023Over 1.3 billion people, or 16% of the world's population, live with some form of disability. Recent studies have reported that people with disabilities (PwD) might not...
BACKGROUND
Over 1.3 billion people, or 16% of the world's population, live with some form of disability. Recent studies have reported that people with disabilities (PwD) might not be receiving state-of-the-art treatment for cancer as their non-disabled peers; our objective was to systematically review this topic.
METHODS
A systematic review was undertaken to compare cancer outcomes and quality of cancer care between adults with and without disabilities (NIHR Prospero register ID number: CRD42022281506). A search of the literature was performed in July 2022 across five databases: EMBASE, Medline, Cochrane Library, Web of Science and CINAHL databases. Peer-reviewed quantitative research articles, published in English from 2000 to 2022, with interventional or observational study designs, comparing cancer outcomes between a sample of adult patients with disabilities and a sample without disabilities were included. Studies focused on cancer screening and not treatment were excluded, as well as editorials, commentaries, opinion papers, reviews, case reports, case series under 10 patients and conference abstracts. Studies were evaluated by one reviewer for risk of bias based on a set of criteria according to the SIGN 50 guidelines. A narrative synthesis was conducted according to the Cochrane SWiM guidelines, with tables summarizing study characteristics and outcomes. This research received no external funding.
RESULTS
Thirty-one studies were included in the systematic review. Compared to people without disabilities, PwD had worse cancer outcomes, in terms of poorer survival and higher overall and cancer-specific mortality. There was also evidence that PwD received poorer quality cancer care, including lower access to state-of-the-art care or curative-intent therapies, treatment delays, undertreatment or excessively invasive treatment, worse access to in-hospital services, less specialist healthcare utilization, less access to pain medications and inadequate end-of-life quality of care.
DISCUSSION
Limitations of this work include the exclusion of qualitative research, no assessment of publication bias, selection performed by only one reviewer, results from high-income countries only, no meta-analysis and a high risk of bias in 15% of included studies. In spite of these limitations, our results show that PwD often experience severe disparities in cancer care with less guideline-consistent care and higher mortality than people without disabilities. These findings raise urgent questions about how to ensure equitable care for PwD; in order to prevent avoidable morbidity and mortality, cancer care programs need to be evaluated and urgently improved, with specific training of clinical staff, more disability inclusive research, better communication and shared decision-making with patients and elimination of physical, social and cultural barriers.
Topics: Adult; Humans; Delivery of Health Care; Hospitalization; Pain; Disabled Persons; Neoplasms; Observational Studies as Topic
PubMed: 38091337
DOI: 10.1371/journal.pone.0285146 -
BMC Public Health Dec 2023Physical activity has numerous health benefits for people with physical disabilities. Nevertheless, activity levels are often below recommended levels. To promote...
Physical activity has numerous health benefits for people with physical disabilities. Nevertheless, activity levels are often below recommended levels. To promote physical activity among children and adolescents who use a wheelchair as their primary source of mobility, this systematic review explores the physical activity patterns of this group. A systematic search of PubMed, Sports Medicine & Education Index, Web of Science, and SPORTDiscus was performed, included articles were synthesized in terms of duration, intensity, and settings in which physical activity occurred, as well as the physical activity measurement methods. Nine articles were included. The mean overall physical activity level across the included studies was 98 minutes per day (range: 78-115 minutes per day). Two articles analysed the duration of physical activity at different intensities (very light physical activity, light physical activity (LPA), moderate to vigorous physical activity (MVPA) and intensities near to maximum). Within the included articles, both subjective and objective measurement methods were used. Due to the small number of articles, combined with small sample sizes, there is not enough evidence to answer the research questions sufficiently. Nevertheless, the review provides an overview of actual research and clearly shows that the physical activity values are insufficiently researched. There is a need for further research on the scope, types and settings of physical activity in the target group.
Topics: Child; Humans; Adolescent; Exercise; Disabled Persons; Wheelchairs; Educational Status
PubMed: 38082282
DOI: 10.1186/s12889-023-17201-6 -
Journal of Deaf Studies and Deaf... Mar 2024There is great variability in the ways in which the speech intelligibility of d/Deaf and hard-of-hearing (DHH) children who use spoken language as part, or all, of their...
There is great variability in the ways in which the speech intelligibility of d/Deaf and hard-of-hearing (DHH) children who use spoken language as part, or all, of their communication system is measured. This systematic review examined the measures and methods that have been used when examining the speech intelligibility of children who are DHH and the characteristics of these measures and methods. A systematic database search was conducted of CENTRAL; CINAHL; Cochrane; ERIC; Joanna Briggs; Linguistics, Language and Behavior Abstracts; Medline; Scopus; and Web of Science databases, as well as supplemental searches. A total of 204 included studies reported the use of many different measures/methods which measured segmental aspects of speech, with the most common being Allen et al.'s (2001, The reliability of a rating scale for measuring speech intelligibility following pediatric cochlear implantation. Otology and Neurotology, 22(5), 631-633. https://doi.org/10.1097/00129492-200109000-00012) Speech Intelligibility Rating scale. Many studies included insufficient details to determine the measure that was used. Future research should utilize methods/measures with known psychometric validity, provide clear descriptions of the methods/measures used, and consider using more than one measure to account for limitations inherent in different methods of measuring the speech intelligibility of children who are DHH, and consider and discuss the rationale for the measure/method chosen.
Topics: Child; Humans; Speech Intelligibility; Deafness; Persons With Hearing Impairments; Reproducibility of Results; Cochlear Implantation; Speech Perception; Cochlear Implants
PubMed: 38079579
DOI: 10.1093/deafed/enad054 -
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 -
European Journal of Pain (London,... Apr 2024Among many treatment approaches for chronic low back pain (CLBP), self-management techniques are becoming increasingly important. The aim of this paper was to (a)... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND OBJECTIVE
Among many treatment approaches for chronic low back pain (CLBP), self-management techniques are becoming increasingly important. The aim of this paper was to (a) provide an overview of existing digital self-help interventions for CLBP and (b) examine the effect of these interventions in reducing pain intensity, pain catastrophizing and pain disability.
DATABASES AND DATA TREATMENT
Following the PRISMA guideline, a systematic literature search was conducted in the MEDLINE, EMBASE, PsychInfo, CINAHL and Cochrane databases. We included randomized controlled trials from the last 10 years that examined the impact of digital self-management interventions on at least one of the three outcomes in adult patients with CLBP (duration ≥3 months). The meta-analysis was based on random-effects models. Standardized tools were used to assess the risk of bias (RoB) for each study and the quality of evidence for each outcome.
RESULTS
We included 12 studies (n = 1545). A small but robust and statistically significant pooled effect was found on pain intensity (g = 0.24; 95% CI [0.09, 0.40], k = 12) and pain disability (g = 0.43; 95% CI [0.27, 0.59], k = 11). The effect on pain catastrophizing was not significant (g = 0.38; 95% CI [-0.31, 1.06], k = 4). The overall effect size including all three outcomes was g = 0.33 (95% CI [0.21, 0.44], k = 27). The RoB of the included studies was mixed. The quality of evidence was moderate or high.
CONCLUSION
In summary, we were able to substantiate recent evidence that digital self-management interventions are effective in the treatment of CLBP. Given the heterogeneity of interventions, further research should aim to investigate which patients benefit most from which approach.
SIGNIFICANCE
This meta-analysis examines the effect of digital self-management techniques in patients with CLBP. The results add to the evidence that digital interventions can help patients reduce their pain intensity and disability. A minority of studies point towards the possibility that digital interventions can reduce pain catastrophizing. Future research should further explore which patients benefit most from these kinds of interventions.
Topics: Adult; Humans; Low Back Pain; Self-Management; Disabled Persons; Chronic Pain
PubMed: 38071425
DOI: 10.1002/ejp.2221 -
Scandinavian Journal of Work,... Mar 2024Young adults living with episodic disabilities face unpredictable disruptions to their employment and health. Our study aimed to examine the impact of employment and...
OBJECTIVE
Young adults living with episodic disabilities face unpredictable disruptions to their employment and health. Our study aimed to examine the impact of employment and income support interventions on the health and well-being of young adults living with episodic disabilities.
METHODS
We conducted a systematic review of peer-reviewed intervention studies published in 2001-2021 in industrialized contexts. Two independent reviewers screened titles, abstracts and full-texts. We undertook a narrative synthesis of eligible articles.
RESULTS
Our search yielded 15 269 published articles, of which only five studies were eligible for evidence synthesis. All articles were appraised as being of medium quality. Four interventions focused on young adults living with mental health conditions. Two were based in clinical settings; three were based in community-based settings. Each employment intervention exhibited improvements in health outcomes. Three studies examined the impact of supported employment interventions that were particularly beneficial to improving work and health outcomes.
CONCLUSION
Involvement in employment interventions could provide benefits for the health of young adults living with episodic disabilities. Our systematic review highlights the need for research to elaborate on the ways in which employment interventions can impact the health and well-being of young adults living with different episodic disabilities.
Topics: Humans; Young Adult; Disabled Persons; Mental Disorders; Employment, Supported
PubMed: 38060325
DOI: 10.5271/sjweh.4133 -
Prosthetics and Orthotics International Jun 2024Prosthetic alignment is a highly subjective process that is still based on clinical judgments. Thus, researchers have aimed their effort to quantify prosthetic alignment...
Prosthetic alignment is a highly subjective process that is still based on clinical judgments. Thus, researchers have aimed their effort to quantify prosthetic alignment by providing an objective method that can assist and guide prosthetists in achieving transtibial (TT) prosthetic alignment. This systematic review aimed to examine the current literature on TT prosthetic alignment to scope the qualitative and quantitative methods designed to guide prosthetists throughout the TT prosthetic alignment process as well as evaluate the reported instruments and devices that are used to align TT prostheses and their clinical feasibility. A literature search, completed in June 2022, was performed using the following databases: Web of Science (Clarivate), SCOPUS (Elsevier), and Pub Med (Medline) with searching terms focusing on TT, prosthesis, prosthetist, prosthetic alignment, and questionnaires, resulting in 2790 studies being screened. Twenty-four studies have used quantitative methodologies, where sensor technologies were found to be the most frequently proposed technology combined with gait analysis tools and/or subjective assessments. A qualitative method that assists prosthetists throughout the alignment process was not found. In this systematic review, we presented diverse methods for guiding and assisting clinical decision-making regarding TT prosthetic alignment. However, most of these methods considered varied parameters, and there is a need for elaboration toward standardized methods, which would improve the prosthetic alignment clinical outcome.
Topics: Humans; Artificial Limbs; Tibia; Prosthesis Design; Prosthesis Fitting; Clinical Decision-Making; Decision Making; Amputees
PubMed: 38018968
DOI: 10.1097/PXR.0000000000000309