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1.
BMC Med Educ ; 22(1): 345, 2022 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-35524331

RESUMEN

BACKGROUND: Deaf and hard of hearing (DHH) people are an underserved population and underrepresented among healthcare professionals. A major barrier to success for DHH healthcare professionals is obtaining effective accommodations during education and employment. Our objective: describe DHH individuals' experiences with accommodations in healthcare education. METHODS: We used an online survey and multipronged snowball sampling to recruit participants who identify as DHH and who had applied to a U.S. health professional school (regardless of acceptance status). One hundred forty-eight individuals representing multiple professions responded; 51 had completed their training. Over 80% had been accepted to, were currently enrolled, or had completed health professions schools or residency programs, and/or were employed. The survey included questions addressing experiences applying to health professions programs and employment; satisfaction with accommodations in school and training; having worked with a disability resource professional (DRP); and depression screening. RESULTS: Use and type of accommodation varied widely. While in school, respondents reported spending a mean of 2.1 h weekly managing their accommodations. Only 50% were highly satisfied with the accommodations provided by their programs. Use of disability resource providers (DRPs) for accommodations was highest during school (56%) and less frequent during post-graduate training (20%) and employment (14%). Respondents who transitioned directly from school to employment (versus via additional training) were more satisfied with their accommodations during school and were more likely to find employment (p = 0.02). Seventeen respondents screened positive for risk of depression; a positive screen was statistically associated with lower school accommodation satisfaction. CONCLUSIONS: DHH people study and practice across many health professions. While respondents were mostly successful in entering health professions programs, accommodation experiences and satisfaction varied. Satisfaction with accommodations was related to successful employment and wellness. Low satisfaction was associated with higher likelihood of depression symptoms. To increase representation in the workforce, healthcare professional schools, training programs, and employers should enhance support for the learning and working climates for people with disabilities.


Asunto(s)
Personas con Discapacidad , Personas con Deficiencia Auditiva , Atención a la Salud , Escolaridad , Empleo , Humanos
4.
Adv Gerontol ; 35(1): 44-52, 2022.
Artículo en Ruso | MEDLINE | ID: mdl-35522108

RESUMEN

The increase in the number of older people (elderly and senile) among the population around the world is associated with a significant impact on the increase in the incidence of malignant neoplasms (MN). The federal project «Fight against oncological diseases for 2018-2024¼ has been launched in Russia within the framework of the national project «Healthcare¼. The article presents the results of a study of the general disability (primary and repeated) of the adult population due to MN in the Chechen Republic (2010-2020). The main trends in the dynamics of general disability (age differentiation, severity, level) in the Chechen Republic and in the North Caucasus Federal District as a whole are compared. Older people with disabilities prevail in the structure of both primary and repeated disability due to MN in the Chechen Republic. This corresponds to the indicators for the North Caucasus Federal District and correspond to the data for the Russian Federation as a whole. The level of disability in the Chechen Republic is lower compared to the indicators for the North Caucasus Federal District. The proportion of disabled people with severe group II and group I disabilities is higher in the republic compared to extensive indicators for the district. The formed structure of disability and the identified trends in its dynamics are a scientific and practical basis that is advisable to use when developing an integrated approach to the medical and social rehabilitation of disabled people and the prevention of health disorders due to MN, taking into account the identified features of disability of the population in the territorial subject of the Russian Federation.


Asunto(s)
Personas con Discapacidad , Neoplasias , Anciano , Envejecimiento , Humanos , Neoplasias/epidemiología , Federación de Rusia/epidemiología
5.
BMC Med Ethics ; 23(1): 49, 2022 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-35505331

RESUMEN

BACKGROUND: Sexual boundary violations (SBV) in healthcare are harmful and exploitative sexual transgressions in the professional-client relationship. Persons with mental health issues or intellectual disabilities, especially those living in residential settings, are especially vulnerable to SBV because they often receive long-term intimate care. Promoting good sexual health and preventing SBV in these care contexts is a moral and practical challenge for healthcare organizations. METHODS: We carried out a qualitative interview study with 16 Dutch policy advisors, regulators, healthcare professionals and other relevant experts to explore their perspectives on preventing SBV in mental health and disability care organizations. We used inductive thematic analysis to interpret our data. RESULTS: We found three main themes on how healthcare organizations can prevent SBV in mental health and disability care: (1) setting rules and regulations, (2) engaging in dialogue about sexuality, and (3) addressing systemic and organizational dimensions. CONCLUSION: Our findings suggest that preventing SBV in mental health and disability care organizations necessitates setting suitable rules and regulations and facilitating dialogue about positive aspects of sexuality and intimacy, as well as about boundaries, and inappropriate behaviors or feelings. Combining both further requires organizational policies and practices that promote transparency and reflection, and focus on creating a safe environment. Our findings will help prevent SBV and promote sexual health in mental health and disability care organizations.


Asunto(s)
Personas con Discapacidad , Salud Mental , Humanos , Organizaciones , Investigación Cualitativa , Sexualidad/psicología
6.
CBE Life Sci Educ ; 21(2): ar32, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35499822

RESUMEN

Individuals with disabilities are underrepresented in postsecondary science education and in science careers, yet few studies have explored why this may be. A primary predictor of student persistence in science is participating in undergraduate research. However, it is unclear to what extent students with disabilities are participating in research and what the experiences of these students in research are. To address this gap in the literature, in study 1, we conducted a national survey of more than 1200 undergraduate researchers to determine the percent of students with disabilities participating in undergraduate research in the life sciences. We found that 12% of undergraduate researchers we surveyed self-identified as having a disability, which indicates that students with disabilities are likely underrepresented in undergraduate research. In study 2, we conducted semistructured interviews with 20 undergraduate researchers with disabilities. We identified unique challenges experienced by students with disabilities in undergraduate research, as well as some possible solutions to these challenges. Further, we found that students with disabilities perceived that they provide unique contributions to the research community. This work provides a foundation for creating undergraduate research experiences that are more accessible and inclusive for students with disabilities.


Asunto(s)
Disciplinas de las Ciencias Biológicas , Personas con Discapacidad , Humanos , Investigadores , Estudiantes
7.
Aust J Gen Pract ; 51(5): 316-320, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35491466

RESUMEN

BACKGROUND: The National Disability Insurance Scheme emphasises the use of models that move beyond an impairment focus to a holistic and individualised approach to disability. Application of specific biopsychosocial models supports general practitioners (GPs) to advance best practice in disability care within these schemes by meeting the complex care needs of their clients. OBJECTIVE: The aims of this article are to: 1) review current biopsychosocial models that underpin the health and functioning of children living with a disability in order to identify common elements of relevance to the paediatric sector, and 2) provide considerations for applying a biopsychosocial approach to paediatric care in practice. DISCUSSION: A succinct summary of common concepts within biopsychosocial models used in the paediatric setting, and recommendations for how these models can be best applied in practice, are presented in this article. The GP plays a crucial part in initiating and supporting children and adolescents who have complex care needs. Understanding these key concepts is fundamental to this process.


Asunto(s)
Personas con Discapacidad , Médicos Generales , Adolescente , Niño , Humanos
9.
BMC Public Health ; 22(1): 875, 2022 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-35501737

RESUMEN

BACKGROUND: Long-term disability has a great impact on both society and workers with disabilities. Little is known about the barriers which prohibit workers with long-term disabilities from returning to work and which interventions are best suited to counteract these barriers. The main purpose of this study was to obtain consensus among professionals on important return to work (RTW) factors and effective vocational rehabilitation (VR) interventions for long-term (> 2 years), partially disabled workers. Our three research questions were: (1) which factors are associated with RTW for long-term disabled workers?; (2) which factors associated with RTW can be targeted by VR interventions?; and (3) which VR interventions are the most effective to target these factors? METHODS: A modified Delphi Study was conducted using a panel of 22 labour experts, caseworkers, and insurance physicians. The study consisted of several rounds of questionnaires and one online meeting. RESULTS: The multidisciplinary panel reached consensus that 58 out of 67 factors were important for RTW and that 35 of these factors could be targeted using VR interventions. In five rounds, the expert panel reached consensus that 11 out of 22 VR interventions were effective for at least one of the eight most important RTW factors. CONCLUSIONS: Consensus was reached among the expert panel that many factors that are important for the RTW of short-term disabled workers are also important for the RTW of long-term partially disabled workers and that a substantial number of these factors could effectively be targeted using VR interventions. The results of this study will be used to develop a decision aid that supports vocational rehabilitation professionals in profiling clients and in choosing suitable VR interventions.


Asunto(s)
Personas con Discapacidad , Reinserción al Trabajo , Técnica Delfos , Personas con Discapacidad/rehabilitación , Humanos , Rehabilitación Vocacional/métodos , Encuestas y Cuestionarios
10.
Ned Tijdschr Geneeskd ; 1662022 02 16.
Artículo en Holandés | MEDLINE | ID: mdl-35499589

RESUMEN

Cerebral palsy (CP) is the most common cause of motor disability in children. The largest group of children with CP present with spasticity. Dystonia is estimated to be present in approximately 15% of children with CP, referred to as dyskinetic CP. Still, dystonia in CP remains underdiagnosed. Dystonia and spasticity can occur together in a subgroup of children with CP as well. Dystonia is characterized by fluctuating hypertonia and involuntary movement and postures. Dystonia in children with CP can interfere with motor function, caregiving and comfort. It is important to recognize dystonia in children with CP as specific treatment is indicated. In this paper we describe three cases of children with dystonia in CP and we review the pharmacological treatment options for dystonia in CP and the surgical options including intrathecal baclofen pump and deep brain stimulation.


Asunto(s)
Parálisis Cerebral , Personas con Discapacidad , Distonía , Trastornos Distónicos , Trastornos Motores , Parálisis Cerebral/tratamiento farmacológico , Parálisis Cerebral/terapia , Niño , Distonía/diagnóstico , Distonía/etiología , Distonía/terapia , Trastornos Distónicos/diagnóstico , Trastornos Distónicos/etiología , Trastornos Distónicos/terapia , Humanos , Trastornos Motores/complicaciones , Espasticidad Muscular
11.
BMC Geriatr ; 22(1): 390, 2022 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-35505297

RESUMEN

BACKGROUND: There is no general agreement on a standard form of functional classification in older adults and is mainly assessed by Activities of Daily Living (ADL) and/or Instrument Activity of Daily Living. A refined classification based on evaluation the limitations of intrinsic capacity, environment and social interaction, could provide a basis to predict the future disability and identify individuals with increased risk of adverse outcomes. METHODS: A new functional classification among older adults aged 60 and over was conducted by latent class analysis and compared with the traditional classifications, based on the China Health and Retirement Longitudinal Study. To further investigate the scientific validity of this new classification, associations with 7-year mortality and ADLs impairments among categories were tested by using Survival curves and Cox proportional hazard models. This was followed by the confirmatory analysis related to the prospective data. Competing risk analysis was also performed to analysis the sensitivity to further support our conclusions. RESULTS: Five categories were identified among 5,992 older adults which gave the best fitting, yielding a significant Bootstrap Likelihood Ratio Test (p < 0.001) and Lo-Mendell-Rubin adjusted likelihood ratio test (p < 0.001), with an entropy over 0.80. The presence of five categories: "health" (34.0%), "sub-disorder status" (36.6%), "acute diseases" (10.3%), "somatic functional disorder" (7.7%), and "viability disorder" (11.4%), which matched well with the functional independence rates by the international classifications. Among them, those in "sub-disorder status" were considered as an intermediate status between disability and health. The findings also revealed that those who were in "acute disease", "somatic functional disorders", "health" and "sub-disorder status" had a significant lower risk of mortality and ADLs limitations than "viability disorder". And the risks gradually increased towards the less functionally independent end of the classification. However, the distribution of characteristics among five categories were in a synchronous change, indicating a stable classification. CONCLUSIONS: A new classification representing the functional heterogeneity of older adults could effectively stratify the risk of mortality and ADLs limitations. Identifying the clusters of functional decline might be useful in predicting subsequent ageing trends, designing personalized intervention, and delaying the progression of disability and preventing its occurrence.


Asunto(s)
Actividades Cotidianas , Personas con Discapacidad , Anciano , China/epidemiología , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Estudios Prospectivos
12.
Chiropr Man Therap ; 30(1): 22, 2022 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-35505334

RESUMEN

BACKGROUND: To report the national prevalence, years lived with disability (YLDs) and attributable risk factors for all musculoskeletal conditions and separately for low back pain (LBP), as well as compare the disability burden related to musculoskeletal with other health conditions in Australia in 2019. METHODS: Global Burden of Disease (GBD) 2019 study meta-data on all musculoskeletal conditions and LBP specifically were accessed and aggregated. Counts and age-standardised rates, for both sexes and across all ages, for prevalence, YLDs and attributable risk factors are reported. RESULTS: In 2019, musculoskeletal conditions were estimated to be the leading cause of YLDs in Australia (20.1%). There were 7,219,894.5 (95% UI: 6,847,113-7,616,567) prevalent cases of musculoskeletal conditions and 685,363 (95% UI: 487,722-921,471) YLDs due to musculoskeletal conditions. There were 2,676,192 (95% UI: 2,339,327-3,061,066) prevalent cases of LBP and 298,624 (95% UI: 209,364-402,395) YLDs due to LBP. LBP was attributed to 44% of YLDs due to musculoskeletal conditions. In 2019, 22.3% and 39.8% of YLDs due to musculoskeletal conditions and LBP, respectively, were attributed to modifiable GBD risk factors. CONCLUSIONS: The ongoing high burden due to musculoskeletal conditions impacts Australians across the life course, and in particular females and older Australians. Strategies for integrative and organisational interventions in the Australian healthcare system should support high-value care and address key modifiable risk factors for disability such as smoking, occupational ergonomic factors and obesity.


Asunto(s)
Personas con Discapacidad , Dolor de la Región Lumbar , Enfermedades Musculoesqueléticas , Australia/epidemiología , Femenino , Carga Global de Enfermedades , Humanos , Dolor de la Región Lumbar/epidemiología , Masculino , Enfermedades Musculoesqueléticas/epidemiología
13.
BMC Psychiatry ; 22(1): 317, 2022 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-35509005

RESUMEN

BACKGROUND: This study aimed to examine the potential independent association of functional disability with major depression and moderating effects of social support variables including marital status, living arrangement and social participation in such associations. METHODS: Data for the study were drawn from the Longitudinal Ageing Study in India (LASI) wave 1 that was collected during 2017-18 including a sample of 31,464 individuals aged 60 years and above. Descriptive statistics and results from bivariate analysis have been reported. Further, moderated multivariable logistic regression models were used to fulfil the study objective. Major depressive disorder was assessed using the scale of the Short Form Composite International Diagnostic Interview (CIDI-SF). RESULTS: It was found that 8.67% of older participants were depressed in this study. Older adults who had difficulty in basic activities of daily living (BADL) (15.34%), difficulty in instrumental activities of daily living (IADL) (12.06%), unmarried (10.13%), separate living (9.67%) and socially inactive (10.09) were having higher prevalence of major depression compared to their respective counterparts. The adjusted model-1 revealed that older adults who had difficulty in BADL and IADL were 2.53 times [AOR: 2.53, CI: 2.17-2.95] and 2.27 times [AOR: 2.27, CI: 1.97-2.64] more likely to have major depression than those with no difficulty in BADL and IADL respectively. Further, interaction analyses found that currently unmarried status, separate living and being socially inactive have moderation effects in the observed associations and exacerbate the likelihood of major depression among older adults who are functionally impaired. CONCLUSIONS: The findings highlight the importance of integrating social participation in the daily life of older adults and developing initiatives that promote a healthy surrounding such as social connectedness, co-residential living and special care for those who are physically disabled to protect against late-life depression.


Asunto(s)
Trastorno Depresivo Mayor , Personas con Discapacidad , Actividades Cotidianas , Anciano , Envejecimiento , Depresión/epidemiología , Trastorno Depresivo Mayor/epidemiología , Humanos , Vida Independiente , India/epidemiología , Apoyo Social
14.
Occup Ther Int ; 2022: 6657620, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35418814

RESUMEN

Objective: The aim of this study is to investigate the effect of occupation-based community rehabilitation on activity daily of living and health-related quality of life of people with disabilities after stroke at home. Method: In this study of three people with disabilities after stroke living at home, A-B-A single-subject design was used. The occupation-based community rehabilitation was implemented during the intervention phase. It included task oriented and feedback, related information education, home environment modification, and community resource network. After applying the intervention, changes in activities of daily living and health-related quality of life were evaluated by the Modified Barthel Index (MBI), the EuroQol-5 dimension (EQ-5D), and the Assessment of Motor and Process Skills (AMPS). Result: After applying the occupation-based community rehabilitation program, all three participants' daily life activities and quality of life improved. In addition, the occupational performance skills in all participants were maintained. Conclusion: It was confirmed that individual occupational-based community rehabilitation had a positive effect on the activities of daily living and quality of life improvement of the people with disabilities after stroke at home.


Asunto(s)
Personas con Discapacidad , Terapia Ocupacional , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Actividades Cotidianas , Humanos , Terapia Ocupacional/métodos , Ocupaciones , Calidad de Vida , Rehabilitación de Accidente Cerebrovascular/métodos
15.
BMC Geriatr ; 22(1): 308, 2022 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-35397500

RESUMEN

BACKGROUND: This study aims to determine the change of inequality in functional disability of older populations in China over the period from 2008 to 2018 and decompose the contribution of the personal and environmental predictors to the change. METHODS: Data were drawn from two waves (2008 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Functional disability was assessed by the basic activities of daily living (ADL) and the instrumental activities of daily living (IADL). Concentration index (CI) was calculated to measure the socioeconomic inequality in ADL and IADL. A two-level linear regression model was established to identify the individual and care environmental predictors and their contribution to the inequality of ADL and IADL, respectively. The Oaxaca-type decomposition technique was adopted to estimate the contribution of these predictors to changes of the inequality in ADL and IADL over the period from 2008 to 2018. RESULTS: Socioeconomic inequality in functional disability of older adults increased over the period from 2008 to 2018, with the CI for ADL changing from - 0.0085 to - 0.0137 and the CI for IADL changing from - 0.0164 to - 0.0276, respectively. Self-rated economic status was the single most powerful predictor of changes in the inequality, although the growing and dominant rating of older persons with fare economic status could offset the detrimental effects of other (rich or poor) ratings on the changes. The enlarged inequality was also attributable to the increasing importance of regular exercise and its distributional changes, as well as the accumulative long-term effect of farming in earlier life. They outweighed the counteracting effects of rural residency, living with chronic conditions and in an institution. CONCLUSIONS: Socioeconomic inequality in functional disability of older populations in China increased over the period from 2008 to 2018. Re-distribution of wealth remains to be a powerful instrument for addressing the inequality issue, but alone it is not enough. The detrimental accumulative effect of farming will not disappear any time soon. While rural residents are catching up with their urban counterparts, new challenges such as physical inactivity are emerging.


Asunto(s)
Actividades Cotidianas , Personas con Discapacidad , Anciano , Anciano de 80 o más Años , China/epidemiología , Evaluación de la Discapacidad , Estado de Salud , Humanos , Estudios Longitudinales , Factores Socioeconómicos
16.
PLoS One ; 17(4): e0265827, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35363802

RESUMEN

BACKGROUND: Childhood cancer survivors are at high risk of chronic health conditions. We aimed to explore future long-term sickness absence and disability pension in young adult childhood cancer survivors and matched references. METHODS: We performed a prospective cohort study using microdata from five Swedish nationwide registers. Among all individuals born 1976-1998 and living in Sweden, we included 3632 childhood cancer survivors and 17,468 matched references that could be followed-up for 15, 10, or 5 years, respectively. A group-based trajectory model was applied to identify trajectories of mean annual sickness absence and/or disability pension days (SADP) in each sub-cohort, with 95% confidence intervals (CI). Potential risk factors for trajectory belonging were explored using χ2 test and multinomial logistic regression. RESULTS: Most young adult childhood cancer survivors (90.2-96.5%) and references (97.4-98.8%) followed a No SADP trajectory. A larger proportion of childhood cancer survivors than references followed a Moderate (33-102 days/year) or High (115-260 days/year) SADP trajectory (15-year follow-up cohorts: Moderate 4.6% versus 1.2%; High 5.1% versus 1.5%). Childhood cancer survivors of central nervous system (CNS) tumors were at higher risk of the High SADP trajectory than childhood cancer survivors of hematological or non-CNS solid tumors (hematological versus CNS: odds ratio = 2.30, 95% CI 1.23-4.30; hematological versus non-CNS: odds ratio = 0.32, 95% CI 0.13-0.79). CONCLUSIONS: Although most young adult childhood cancer survivors had no SADP during follow-up, 9.7% experienced moderate or high numbers of SADP days/year throughout the 15-year follow-up; compared to 2.7% among references. CNS tumor survivors were at particular risk of SADP long-term and need extra attention in their future work prospect.


Asunto(s)
Supervivientes de Cáncer , Personas con Discapacidad , Neoplasias , Niño , Estudios de Cohortes , Humanos , Neoplasias/epidemiología , Pensiones , Estudios Prospectivos , Ausencia por Enfermedad , Suecia/epidemiología , Adulto Joven
17.
PLoS One ; 17(4): e0266350, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35395055

RESUMEN

Item response theory (IRT) is the statistical paradigm underlying a dominant family of generative probabilistic models for test responses, used to quantify traits in individuals relative to target populations. The graded response model (GRM) is a particular IRT model that is used for ordered polytomous test responses. Both the development and the application of the GRM and other IRT models require statistical decisions. For formulating these models (calibration), one needs to decide on methodologies for item selection, inference, and regularization. For applying these models (test scoring), one needs to make similar decisions, often prioritizing computational tractability and/or interpretability. In many applications, such as in the Work Disability Functional Assessment Battery (WD-FAB), tractability implies approximating an individual's score distribution using estimates of mean and variance, and obtaining that score conditional on only point estimates of the calibrated model. In this manuscript, we evaluate the calibration and scoring of models under this common use-case using Bayesian cross-validation. Applied to the WD-FAB responses collected for the National Institutes of Health, we assess the predictive power of implementations of the GRM based on their ability to yield, on validation sets of respondents, ability estimates that are most predictive of patterns of item responses. Our main finding indicates that regularized Bayesian calibration of the GRM outperforms the regularization-free empirical Bayesian procedure of marginal maximum likelihood. We also motivate the use of compactly supported priors in test scoring.


Asunto(s)
Evaluación de la Discapacidad , Personas con Discapacidad , Teorema de Bayes , Calibración , Humanos , Modelos Estadísticos
18.
Front Public Health ; 10: 752311, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35392475

RESUMEN

Background: India is undergoing a rapid demographic and epidemiologic transition. Thus demanding prioritization of diseases based on burden estimation is befitting our cultural diversity. Disability weights (DWs) by Global burden of disease (GBD) studies may not be representative. Hence, a study was conducted to estimate state-specific disability weights to capture the community health perceptions that included urban-rural settings as well as different socio-economic and literacy levels. Methods: A total of 2,055 community members (participants) from two distinct states of India, Odisha and Telangana, were interviewed to assign disability weights to the selected 14 health states based on the state burden and relevance. Each health state was described to the participants using pictorial representations of the health states and valuated using visual analog scale and card sort methods. Results: We noted that DWs in Odisha ranged from 0.32 (0.30-0.34) for upper limb fracture due to road traffic accident (least severe) to 0.90 (0.88-0.93) for breast cancer (most severe) among the 14 health states. While, in Telangana, diarrhea was considered least severe [DW = 0.22 (0.19-0.24)] and breast cancer remained most severe [DW = 0.85 (0.83-0.88)] as in Odisha. Marked difference in the DWs for other health states was also seen. Further, on comparison of community weights with GBD weights using Spearman correlation, we observed a low correlation (ρ = 0.104). Conclusion: Our study provides community-based findings that show how participants valued noncommunicable diseases higher than short-term ailments or infectious diseases. Additionally, the low correlation between GBD also suggests the need for local disability weights rather than universal acceptance. We therefore recommend that decisions in policy-making, especially for resource allocation and priority setting, need to be based not only on expert opinion but also include community in accordance with high scientific standards.


Asunto(s)
Neoplasias de la Mama , Personas con Discapacidad , Femenino , Humanos , India/epidemiología , Población Rural
19.
J Law Med ; 29(1): 62-66, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35362279

RESUMEN

This article provides an overview of recent scholarship calling for the defence of mental impairment to be abolished on the grounds that it breaches international human rights law. It outlines how differing interpretations of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) suggest that arguments for abolition will continue to be contested. On a practical level, no Australasian law reform body has called for the abolition of the defence and it seems unlikely that government policy will shift towards this in the absence of such a recommendation from these bodies. However, highlighting the obligations on States Parties to the CRPD to ensure the right to equal treatment before the law necessitates a careful consideration of whether the defence of mental impairment is still fit for purpose.


Asunto(s)
Personas con Discapacidad , Trastornos Mentales , Derechos Humanos , Humanos , Naciones Unidas
20.
J Integr Neurosci ; 21(2): 65, 2022 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-35364653

RESUMEN

BACKGROUND: The cerebellum integrates a multitude of motor and cognitive processes through ample spinal and supratentorial projections. Despite emerging evidence of adaptive neuroplasticity, cerebellar reorganisation in response to severe spinal insult early in life is poorly characterised. The objective of this study is the systematic characterisation of cerebellar integrity metrics in a cohort of adult poliomyelitis survivors as a template condition for longstanding lower motor neuron injury. METHODS: A total of 143 participants, comprising 43 adult poliomyelitis survivors and 100 age- and sex-matched healthy controls were recruited in a prospective, single-centre neuroimaging study with a uniform structural and diffusion imaging protocol. First, standard voxelwise grey and white matter analyses were performed. Then, the cerebellum was anatomically segmented into lobules, and cortical thickness and grey matter volumes were evaluated in each lobule. The integrity of cerebellar peduncles was also assessed based on their diffusivity profiles. RESULTS: Compared to healthy controls, poliomyelitis survivors exhibited greater cortical thickness in lobules I, II, and III in the right hemisphere and in lobules VIIIA and VIIIB bilaterally. A trend of higher cortical thickness was also detected lobules I, II and III in the left hemisphere. Enhanced cerebellar peduncle organisation was detected, particularly within the middle cerebellar peduncles. CONCLUSIONS: Increased cerebellar integrity measures in poliomyelitis survivors are primarily identified in lobules associated with sensorimotor functions. The identified pattern of cerebellar reorganisation may represent compensatory changes in response to severe lower motor neuron injury in childhood and ensuing motor disability.


Asunto(s)
Personas con Discapacidad , Trastornos Motores , Poliomielitis , Adulto , Cerebelo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética/métodos , Plasticidad Neuronal , Estudios Prospectivos , Sobrevivientes
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