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1.
Rev. bioét. derecho ; (50): 369-383, nov. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191363

RESUMO

Durante el periodo de estado de alarma del estado español producido por la emergencia sanitaria derivada de la pandemia de la enfermedad por coronavirus 2019-2020 se han puesto de manifiesto amenazas a los derechos de las personas con discapacidad y oportunidades de desarrollo en relación con su autonomía personal. El respeto a los tratados internacionales en materia de derechos humanos obliga a los estados a abordar desde el modelo de la autonomía personal la situación de vulnerabilidad de las personas con discapacidad y a luchar contra las actitudes basadas en modelos anteriores de tratamiento de la discapacidad


Threats to the rights of persons with disabilities and opportunities to develop in relation to their personal autonomy have been revealed during the period of state of alarm of the Spanish state produced by the health emergency derived from the 2019-2020 coronavirus disease pandemic. Respect for international human rights treaties obliges states to approach the vulnerable situation of people with disabilities from personal autonomy model and to fight against attitudes based on previous models of treatment of disability


Durant el període d'estat d'alarma de l'estat espanyol produït per l'emergència sanitària derivada de la pandèmia de la malaltia per coronavirus 2019-2020 s'han posat de manifest amenaces als drets de les persones amb discapacitat I oportunitats de desenvolupament en relació amb la seva autonomia personal. El respecte als tractats internacionals en matèria de drets humans obliga els estats a abordar des del model de l'autonomia personal la situació de vulnerabilitat de les persones amb discapacitat I a lluitar contra les actituds basades en models anteriors de tractament de la discapacitat


Assuntos
Humanos , Análise de Vulnerabilidade , Pessoas com Deficiência/legislação & jurisprudência , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Direitos Humanos , Triagem , Legislação como Assunto
2.
Rev Prat ; 70(6): 687-689, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-33058620

RESUMO

Inclusion of students with disabilities in school. The inclusive school presupposes a general process of adaptation of the school environment as well as health and medicosocial to the particular educational needs of the students with a view to their citizen participation in our society. This was built in the field of disability as soon as the Law of February 11, 2005 was promulgated, which set up the bases for supporting students in their academic and professional training. The national education system has deployed numerous devices at each level of its organization to accommodate an ever increasing number of students hitherto excluded from the system. It is now to structural changes in the relationships between the health, medicosocial and national education sectors that the future of this inclusion process depends, which everyone is calling for.


Assuntos
Pessoas com Deficiência , Estudantes , Humanos
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3212-3215, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018688

RESUMO

A mobility scooter is a major assistive technology that replaces human ambulatory functions for people with disabilities. A license is often not required for driving a mobility scooter; therefore, less skilled drivers might create safety concerns. An effective way of reducing these safety risks is by assessing the driving skills of users. The existing assessment measures mostly score the task performance using manual observations. In this study, we have developed a novel assessment system that logs the driving operations by using add-on sensors. This system can monitor the operations of a mobility scooter including the angles of the throttle lever and the steering tiller. The subjects were seven older adults who participated in the driving test involving six tasks; the driver performances were video recorded, and the vehicle operation data were logged. The video analysis showed that two subjects crashed their scooters into objects or made contact with objects during the test course. To extract the characteristic patterns of the operations from the logs, 2D histograms of the operational status durations were investigated for each subject and task. Subsequent analysis of the operation logs identified the two subjects who had crashed their vehicles during the test drive. Our results proved that the driving operation logs could be used complementarily as a simple and low-cost tool for assessing a person's driving skills.


Assuntos
Condução de Veículo , Pessoas com Deficiência , Equipamentos de Autoajuda , Idoso , Humanos , Licenciamento , Amplitude de Movimento Articular
5.
Phys Ther ; 100(10): 1862-1871, 2020 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-32949237

RESUMO

OBJECTIVE: Although Medicare assessment files will include Standardized Patient Assessment Data Elements from 2016 forward, lack of uniformity of functional data prior to 2016 impedes longitudinal research. The purpose of this study was to create crosswalks for postacute care assessment measures and the basic mobility and daily activities scales of the Activity Measure for Post-Acute Care (AM-PAC) and to test their accuracy and validity in development and validation datasets. METHODS: This cross-sectional study is a secondary analysis of AM-PAC, the Inpatient Rehabilitation Facility Patient Assessment Instrument, the Minimum Data Set, and the Outcome and Assessment Information Set data from 300 adults receiving rehabilitation recruited from 6 health care networks in 1 metropolitan area. Rasch analysis was used to co-calibrate items from the 3 measures onto the AM-PAC metric and to create look-up tables to create estimated AM-PAC (eAM-PAC) scores. Mean scores and correlation and agreement between actual and estimated scores were examined in the development dataset. Scores were estimated in a cohort of Medicare beneficiaries with hip, humerus and radius fractures. Correlations between eAM-PAC and Functional Independence Measure motor scores were examined. Differences in mean eAM-PAC scores were evaluated across groups of known differences (age, fracture type, dementia). RESULTS: Strong correlations were found between actual and eAM-PAC scores in the development dataset. Moderate to strong correlations were found between the eAM-PAC basic mobility and Functional Independence Measure motor scores in the validation dataset. Differences in basic mobility scores across known groups were statistically significant and appeared to be clinically important. Differences between mean daily activities scores were statistically significant but appeared not to be clinically important. CONCLUSION: Although further testing is warranted, the basic mobility crosswalk appears to provide valid scores for aggregate analysis of Medicare postacute care data. IMPACT: This study reports on a method to take data from different Medicare administrative data sources and estimate scores on 1 scale. This approach was applied separately for data related to basic mobility and to daily activities. This may allow researchers to overcome challenges with using Medicare administrative data from different sources.


Assuntos
Pessoas com Deficiência/reabilitação , Cuidados Semi-Intensivos/métodos , Inquéritos e Questionários/normas , Atividades Cotidianas , Adulto , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Medicare , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Psicometria/estatística & dados numéricos , Recuperação de Função Fisiológica , Estados Unidos , Caminhada
6.
Nutrients ; 12(9)2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32887422

RESUMO

The COVID-19 pandemic has exacerbated economic vulnerabilities and disrupted the Australian food supply, with potential implications for food insecurity. This study aims to describe the prevalence and socio-demographic associations of food insecurity in Tasmania, Australia, during the COVID-19 pandemic. A cross-sectional survey (deployed late May to early June 2020) incorporated the U.S. Household Food Security Survey Module: Six-Item Short Form, and fifteen demographic and COVID-related income questions. Survey data (n = 1170) were analyzed using univariate and multivariate binary logistic regression. The prevalence of food insecurity was 26%. The adjusted odds of food insecurity were higher among respondents with a disability, from a rural area, and living with dependents. Increasing age, a university education, and income above $80,000/year were protective against food insecurity. Food insecurity more than doubled with a loss of household income above 25% (Adjusted Odds Ratio (AOR): 2.02; 95% CI: 1.11, 3.71; p = 0.022), and the odds further increased with loss of income above 75% (AOR: 7.14; 95% CI: 2.01, 24.83; p = 0.002). Our results suggest that the prevalence of food insecurity may have increased during the COVID-19 pandemic, particularly among economically vulnerable households and people who lost income. Policies that support disadvantaged households and ensure adequate employment opportunities are important to support Australians throughout and post the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Abastecimento de Alimentos/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Fatores Etários , Idoso , Infecções por Coronavirus/complicações , Infecções por Coronavirus/economia , Estudos Transversais , Demografia , Pessoas com Deficiência , Escolaridade , Emprego , Família , Feminino , Abastecimento de Alimentos/economia , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Pandemias/economia , Pneumonia Viral/complicações , Pneumonia Viral/economia , Prevalência , Fatores de Risco , População Rural , Fatores Sexuais , Fatores Socioeconômicos , Tasmânia/epidemiologia , Adulto Jovem
7.
BMC Public Health ; 20(1): 1461, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993585

RESUMO

BACKGROUND: The aim of this study is to quantify the burden caused by viral hepatitis in China from 1990 to 2016. METHODS: Data from the GBD 2016 study were extracted to calculate incidence, prevalence and disability-adjusted life years (DALYs). Trends in DALYs were assessed in 33 provinces/regions. RESULTS: From 1990 to 2016, the total incidence of hepatitis decreased by 88.5%. However, the prevalence of hepatitis (counts in thousands), increased by 37.6% from 153,856 (95% UI: 136,047-172,319) in 1990 to 211,721 (95% UI: 179,776-240,981) in 2016, with age-standardized prevalence rates changing slightly. The number and age-standardized rates of prevalence increased by 35.9 and 1.6% for hepatitis B, respectively, and by 81.8 and 30.4% for hepatitis C. Guangxi, Guangdong and Hainan had the highest age-standardized prevalence rates (≥16,500 per 100,000). Tibet, Qinghai and Gansu had the highest age-standardized DALYs rates (≥40 per 100,000). The largest absolute number of DALYs was observed in the 15-49 year age group in 2016. The highest rate of DALYs occurred in males aged 50-69 years and in females aged ≧70 years. CONCLUSION: The incidence and DALYs of viral hepatitis decreased dramatically from 1990 to 2016. However, the prevalence still remains at a high level, which may result in heavy burdens in the future.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Carga Global da Doença/estatística & dados numéricos , Hepatite/epidemiologia , Idoso , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Anos de Vida Ajustados por Qualidade de Vida , Sorogrupo
8.
BMC Public Health ; 20(1): 1475, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993606

RESUMO

BACKGROUND: In Japan, a high-sodium diet is the most important dietary risk factor and is known to cause a range of health problems. This study aimed to forecast Japan's disability-adjusted life year (DALYs) for chronic diseases that would be associated with high-sodium diet in different future scenarios of salt intake. We modelled DALY forecast and alternative future scenarios of salt intake for cardiovascular diseases (CVDs), chronic kidney diseases (CKDs), and stomach cancer (SC) from 2017 to 2040. METHODS: We developed a three-component model of disease-specific DALYs: a component on the changes in major behavioural and metabolic risk predictors including salt intake; a component on the income per person, educational attainment, and total fertility rate under 25 years; and an autoregressive integrated moving average model to capture the unexplained component correlated over time. Data on risk predictors were obtained from Japan's National Health and Nutrition Surveys and from the Global Burden of Disease Study 2017. To generate a reference forecast of disease-specific DALY rates for 2017-2040, we modelled the three diseases using the data for 1990-2016. Additionally, we generated better, moderate, and worse scenarios to evaluate the impact of change in salt intake on the DALY rate for the diseases. RESULTS: In our reference forecast, the DALY rates across all ages were predicted to be stable for CVDs, continuously increasing for CKDs, and continuously decreasing for SC. Meanwhile, the age group-specific DALY rates for these three diseases were forecasted to decrease, with some exceptions. Except for the ≥70 age group, there were remarkable differences in DALY rates between scenarios, with the best scenario having the lowest DALY rates in 2040 for SC. This represents a wide scope of future trajectories by 2040 with a potential for tremendous decrease in SC burden. CONCLUSIONS: The gap between scenarios provides some quantification of the range of policy impacts on future trajectories of salt intake. Even though we do not yet know the policy mix used to achieve these scenarios, the result that there can be differences between scenarios means that policies today can have a significant impact on the future DALYs.


Assuntos
Doença Crônica/tendências , Pessoas com Deficiência/estatística & dados numéricos , Promoção da Saúde/organização & administração , Anos de Vida Ajustados por Qualidade de Vida , Cloreto de Sódio na Dieta/efeitos adversos , Adulto , Doenças Cardiovasculares/epidemiologia , Dieta/estatística & dados numéricos , Previsões , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Insuficiência Renal Crônica/epidemiologia , Fatores de Risco , Cloreto de Sódio na Dieta/administração & dosagem
9.
Rev Fac Cien Med Univ Nac Cordoba ; 77(3): 168-175, 2020 08 21.
Artigo em Espanhol | MEDLINE | ID: mdl-32991104

RESUMO

Introduction: In the context of the COVID-19 pandemic, WHO published considerations regarding people with disabilities. The aim of this work was to know if these considerations can be fulfilled and if there are differences in their fulfillment between age groups. Method: Descriptive study aimed at people with disabilities in Argentina. A survey was conducted about the four WHO recommendations for this population in online mode, between the 28th and 39th days of preventive and compulsory social isolation. Statistical analysis was according to the nature of the variables, X2 with Fisher's correction was used to determine the differences between groups. Results: 309 surveys were collected from 18 provinces of Argentina. 230(74.4%[69.1-79.1]) were answered by caregivers and 79(25.5%[20.7-30.7]) by people with disabilities. Persons with disabilities were 138(44.7%[39.0-50.4]) children and adolescents and 171(55.3%[49.5-60.9]) adults and older adults. People with disabilities were able to comply with the WHO recommendations regarding reducing exposure to COVID-19 and to be prepared in case of contracting it. There were difficulties in the number of caregivers needed, since 266(66.6%[61.0-71.8]) have this possibility, and difficulties in 55(32.1%[25.1-39.6]) adults and older adults that do not carry out educational-therapeutic activities. There are feelings of anxiety, distress, or depression in people with disabilities and their caregivers. Conclusion: In Argentina, it is possible to comply with the WHO recommendations to avoid exposure to the virus and to be prepared in case of infection. Challenges remain to be solved in terms of accompanying people with disabilities in their physical and mental health.


Assuntos
Infecções por Coronavirus/epidemiologia , Pessoas com Deficiência , Cooperação do Paciente , Pneumonia Viral/epidemiologia , Argentina/epidemiologia , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Isolamento Social , Organização Mundial da Saúde
10.
Rev Med Suisse ; 16(708): 1801-1806, 2020 Sep 30.
Artigo em Francês | MEDLINE | ID: mdl-32997450

RESUMO

The health check-up is an opportunity for the general practitioner to carry out preventive measures and screening. Like any other patient, adults with intellectual and developmental disabilities must have access to it without discrimination. The preventive recommendations for people with disabilities follow those of the general population with some specificities, in particular the prevention of sensory disability, attention to the underestimated health problems in this population and those associated with the handicap. Here several types of barriers to the implementation of preventive measures such as patient's participatory and emotional barriers, the caregiver's barriers and the environmental barriers will be discussed. Finally, practical advice for the management of these patients will be presented.


Assuntos
Pessoas com Deficiência , Acesso aos Serviços de Saúde , Programas de Rastreamento , Adulto , Medicina Geral , Humanos
11.
Rev Med Suisse ; 16(708): 1807-1810, 2020 Sep 30.
Artigo em Francês | MEDLINE | ID: mdl-32997451

RESUMO

It is estimated that about 1 712 000 people are suffering from disability in Switzerland, and that 1 to 3% of them present a severe form of disability associated with intellectual deficiency. Management of such patients is complex and faces various challenges. Communication and collaboration with the patients and among all stakeholders are key. In this review, we highlight the value of creating a network supporting people with disabilities. We also present the network available for in- and outpatients in Geneva, which offers consultations and training courses for healthcare workers, and encourages coordination between institutions and network collaboration.


Assuntos
Pessoas com Deficiência , Deficiência Intelectual , Adulto , Pessoal de Saúde , Humanos , Comportamento Social , Suíça
12.
Environ Health Prev Med ; 25(1): 49, 2020 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-32892744

RESUMO

BACKGROUND: The health hazards of indoor air pollution are well-established but studies of the health effects due to pollution from heating are rare. This study investigated the association of heating and disability for activities of daily living among Chinese middle-aged and elderly. METHODS: We used two consecutive surveys in a cohort of over 17,000 adults aged 45 or older, who were interviewed first in 2011-2012 and then in 2013. In these surveys, taking advantage of random survey time, we applied a random effects logit regression model that included an interaction between pollution-producing heating fuel and a dummy variable, which measured interview time based on whether or not it was heating season. RESULTS: Exposure to pollution-producing heating fuel was associated with a 39.9% (OR 1.399; 95%CI 1.227-1.594) and 71.0% (OR 1.710; 95%CI 1.523-1.920) increase in the likelihood of disability in activities of daily living (DADL) and disability in instrumental activities of daily living (DIADL), respectively. In heating season between year 2011 and 2013, moving from clean heating energy for heating to pollution-producing fuel was linked with an increase in the likelihoods having DADL and DIADL, with the OR of 2.014 (95%CI 1.126-3.600) and 1.956 (95%CI 1.186-3.226), respectively. However, disability increases due to change from clean energy to pollution-producing heating energy did not appear in advantaged education respondents. CONCLUSIONS: We found that exposure to heating by burning of coal, wood, or crop residue was associated with disability in performing daily living activities. Health policymakers should take indoor pollution due to heating into consideration as it is a major determinant of activities of daily living in elderly people; especially, such policy should focus on elderly people who have disadvantaged education.


Assuntos
Atividades Cotidianas , Poluição do Ar em Ambientes Fechados/efeitos adversos , Pessoas com Deficiência/estatística & dados numéricos , Calefação/efeitos adversos , Habitação , Idoso , Idoso de 80 Anos ou mais , Poluição do Ar em Ambientes Fechados/análise , China , Feminino , Calefação/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
13.
Rev Fac Cien Med Univ Nac Cordoba ; 77(3): 168-175, 2020 08 21.
Artigo em Espanhol | MEDLINE | ID: covidwho-809516

RESUMO

Introduction: In the context of the COVID-19 pandemic, WHO published considerations regarding people with disabilities. The aim of this work was to know if these considerations can be fulfilled and if there are differences in their fulfillment between age groups. Method: Descriptive study aimed at people with disabilities in Argentina. A survey was conducted about the four WHO recommendations for this population in online mode, between the 28th and 39th days of preventive and compulsory social isolation. Statistical analysis was according to the nature of the variables, X2 with Fisher's correction was used to determine the differences between groups. Results: 309 surveys were collected from 18 provinces of Argentina. 230(74.4%[69.1-79.1]) were answered by caregivers and 79(25.5%[20.7-30.7]) by people with disabilities. Persons with disabilities were 138(44.7%[39.0-50.4]) children and adolescents and 171(55.3%[49.5-60.9]) adults and older adults. People with disabilities were able to comply with the WHO recommendations regarding reducing exposure to COVID-19 and to be prepared in case of contracting it. There were difficulties in the number of caregivers needed, since 266(66.6%[61.0-71.8]) have this possibility, and difficulties in 55(32.1%[25.1-39.6]) adults and older adults that do not carry out educational-therapeutic activities. There are feelings of anxiety, distress, or depression in people with disabilities and their caregivers. Conclusion: In Argentina, it is possible to comply with the WHO recommendations to avoid exposure to the virus and to be prepared in case of infection. Challenges remain to be solved in terms of accompanying people with disabilities in their physical and mental health.


Assuntos
Infecções por Coronavirus/epidemiologia , Pessoas com Deficiência , Cooperação do Paciente , Pneumonia Viral/epidemiologia , Argentina/epidemiologia , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Isolamento Social , Organização Mundial da Saúde
14.
Rev Med Suisse ; 16(708): 1790-1795, 2020 Sep 30.
Artigo em Francês | MEDLINE | ID: covidwho-807854

RESUMO

Medical care of adults with disabilities, especially those with intellectual disabilities, can be ethically difficult. Several questions arise frequently. Can we administer a life-saving treatment that could impact negatively the patient's quality of life when the patient isn't able to give consent? During this Covid-19 period, can the use of chemical or physical restraints be considered as mistreatment, whereas the aim is to protect others? These are situations where the ethical question holds a central role. Although each clinical situation is unique, this article highlights, through four clinical cases, the ethical principles that should guide physicians in their decision-making process.


Assuntos
Tomada de Decisão Clínica/ética , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Pessoas com Deficiência , Deficiência Intelectual , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Qualidade de Vida , Adulto , Infecções por Coronavirus/epidemiologia , Humanos , Consentimento Livre e Esclarecido/ética , Pandemias , Pneumonia Viral/epidemiologia , Restrição Física/ética
15.
Nutrients ; 12(9)2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: covidwho-742829

RESUMO

The COVID-19 pandemic has exacerbated economic vulnerabilities and disrupted the Australian food supply, with potential implications for food insecurity. This study aims to describe the prevalence and socio-demographic associations of food insecurity in Tasmania, Australia, during the COVID-19 pandemic. A cross-sectional survey (deployed late May to early June 2020) incorporated the U.S. Household Food Security Survey Module: Six-Item Short Form, and fifteen demographic and COVID-related income questions. Survey data (n = 1170) were analyzed using univariate and multivariate binary logistic regression. The prevalence of food insecurity was 26%. The adjusted odds of food insecurity were higher among respondents with a disability, from a rural area, and living with dependents. Increasing age, a university education, and income above $80,000/year were protective against food insecurity. Food insecurity more than doubled with a loss of household income above 25% (Adjusted Odds Ratio (AOR): 2.02; 95% CI: 1.11, 3.71; p = 0.022), and the odds further increased with loss of income above 75% (AOR: 7.14; 95% CI: 2.01, 24.83; p = 0.002). Our results suggest that the prevalence of food insecurity may have increased during the COVID-19 pandemic, particularly among economically vulnerable households and people who lost income. Policies that support disadvantaged households and ensure adequate employment opportunities are important to support Australians throughout and post the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Abastecimento de Alimentos/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Fatores Etários , Idoso , Infecções por Coronavirus/complicações , Infecções por Coronavirus/economia , Estudos Transversais , Demografia , Pessoas com Deficiência , Escolaridade , Emprego , Família , Feminino , Abastecimento de Alimentos/economia , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Pandemias/economia , Pneumonia Viral/complicações , Pneumonia Viral/economia , Prevalência , Fatores de Risco , População Rural , Fatores Sexuais , Fatores Socioeconômicos , Tasmânia/epidemiologia , Adulto Jovem
16.
Rev Fac Cien Med Univ Nac Cordoba ; 77(3): 168-175, 2020 08 21.
Artigo em Espanhol | MEDLINE | ID: covidwho-819574

RESUMO

Introduction: In the context of the COVID-19 pandemic, WHO published considerations regarding people with disabilities. The aim of this work was to know if these considerations can be fulfilled and if there are differences in their fulfillment between age groups. Method: Descriptive study aimed at people with disabilities in Argentina. A survey was conducted about the four WHO recommendations for this population in online mode, between the 28th and 39th days of preventive and compulsory social isolation. Statistical analysis was according to the nature of the variables, X2 with Fisher's correction was used to determine the differences between groups. Results: 309 surveys were collected from 18 provinces of Argentina. 230(74.4%[69.1-79.1]) were answered by caregivers and 79(25.5%[20.7-30.7]) by people with disabilities. Persons with disabilities were 138(44.7%[39.0-50.4]) children and adolescents and 171(55.3%[49.5-60.9]) adults and older adults. People with disabilities were able to comply with the WHO recommendations regarding reducing exposure to COVID-19 and to be prepared in case of contracting it. There were difficulties in the number of caregivers needed, since 266(66.6%[61.0-71.8]) have this possibility, and difficulties in 55(32.1%[25.1-39.6]) adults and older adults that do not carry out educational-therapeutic activities. There are feelings of anxiety, distress, or depression in people with disabilities and their caregivers. Conclusion: In Argentina, it is possible to comply with the WHO recommendations to avoid exposure to the virus and to be prepared in case of infection. Challenges remain to be solved in terms of accompanying people with disabilities in their physical and mental health.


Assuntos
Infecções por Coronavirus/epidemiologia , Pessoas com Deficiência , Cooperação do Paciente , Pneumonia Viral/epidemiologia , Argentina/epidemiologia , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Isolamento Social , Organização Mundial da Saúde
17.
Rev Med Suisse ; 16(708): 1790-1795, 2020 Sep 30.
Artigo em Francês | MEDLINE | ID: covidwho-812997

RESUMO

Medical care of adults with disabilities, especially those with intellectual disabilities, can be ethically difficult. Several questions arise frequently. Can we administer a life-saving treatment that could impact negatively the patient's quality of life when the patient isn't able to give consent? During this Covid-19 period, can the use of chemical or physical restraints be considered as mistreatment, whereas the aim is to protect others? These are situations where the ethical question holds a central role. Although each clinical situation is unique, this article highlights, through four clinical cases, the ethical principles that should guide physicians in their decision-making process.


Assuntos
Tomada de Decisão Clínica/ética , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Pessoas com Deficiência , Deficiência Intelectual , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Qualidade de Vida , Adulto , Infecções por Coronavirus/epidemiologia , Humanos , Consentimento Livre e Esclarecido/ética , Pandemias , Pneumonia Viral/epidemiologia , Restrição Física/ética
18.
J Prim Care Community Health ; 11: 2150132720953680, 2020.
Artigo em Inglês | MEDLINE | ID: covidwho-751257

RESUMO

BACKGROUND: Chronic spinal pain is one of the most common diseases in the United States. Underserved patients are most affected, and disproportionately may use opioid medications as they lack access to other therapies. It is therefore important to develop systems to treat spinal pain within the primary medical home. METHODS: We designed a prospective observational pilot study at a community health center to measure the effectiveness of two interventions among an underserved population: a multidisciplinary pain team and chiropractic care. Study outcomes were pain and functional disability measured by the Pain Disability Questionnaire (PDQ), and reduction of opioid dose at baseline and 6-12 months. Multivariate linear regression was used to determine associating factors for change in PDQ scores. RESULTS: Thirty-five individuals completed baseline and follow-up PDQs from August 2018 to May 2020. Overall, the mean baseline PDQ was 92.4 +/- 6.1 and the mean follow-up PDQ was 81.9 +/- 7.7, resulting in a mean improvement of -10.6 (95% CI 1.2 - -22.3, P = .08). Participants in the chiropractic team (mean change -25.0, P = .01) and those completing the study before COVID-19 (mean change = -22.6, P < .01) were found to have significantly greater improvement at follow-up. CONCLUSION: This observational study within a community health center resulted in improvement in spinal pain and disability with chiropractic care versus a multidisciplinary pain team. Offering similar services in primary care may help to address pain and disability, and hopefully limit external referrals, advanced imaging, and opioid prescriptions.


Assuntos
Dor Crônica/terapia , Prestação Integrada de Cuidados de Saúde/organização & administração , Manipulação Quiroprática , Equipe de Assistência ao Paciente/organização & administração , Doenças da Coluna Vertebral/terapia , Adolescente , Adulto , Canadá , Centros Comunitários de Saúde , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
19.
J Prim Care Community Health ; 11: 2150132720953680, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32909504

RESUMO

BACKGROUND: Chronic spinal pain is one of the most common diseases in the United States. Underserved patients are most affected, and disproportionately may use opioid medications as they lack access to other therapies. It is therefore important to develop systems to treat spinal pain within the primary medical home. METHODS: We designed a prospective observational pilot study at a community health center to measure the effectiveness of two interventions among an underserved population: a multidisciplinary pain team and chiropractic care. Study outcomes were pain and functional disability measured by the Pain Disability Questionnaire (PDQ), and reduction of opioid dose at baseline and 6-12 months. Multivariate linear regression was used to determine associating factors for change in PDQ scores. RESULTS: Thirty-five individuals completed baseline and follow-up PDQs from August 2018 to May 2020. Overall, the mean baseline PDQ was 92.4 +/- 6.1 and the mean follow-up PDQ was 81.9 +/- 7.7, resulting in a mean improvement of -10.6 (95% CI 1.2 - -22.3, P = .08). Participants in the chiropractic team (mean change -25.0, P = .01) and those completing the study before COVID-19 (mean change = -22.6, P < .01) were found to have significantly greater improvement at follow-up. CONCLUSION: This observational study within a community health center resulted in improvement in spinal pain and disability with chiropractic care versus a multidisciplinary pain team. Offering similar services in primary care may help to address pain and disability, and hopefully limit external referrals, advanced imaging, and opioid prescriptions.


Assuntos
Dor Crônica/terapia , Prestação Integrada de Cuidados de Saúde/organização & administração , Manipulação Quiroprática , Equipe de Assistência ao Paciente/organização & administração , Doenças da Coluna Vertebral/terapia , Adolescente , Adulto , Canadá , Centros Comunitários de Saúde , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
20.
MMWR Morb Mortal Wkly Rep ; 69(36): 1238-1243, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32914770

RESUMO

Frequent mental distress, defined as 14 or more self-reported mentally unhealthy days in the past 30 days,* is associated with adverse health behaviors, increased use of health services, mental disorders (e.g., diagnosis of major depressive disorder), chronic diseases, and functional limitations (1). Adults with disabilities more often report depression and anxiety (2), reduced health care access (3), and health-related risk behaviors (4) than do adults without disabilities. CDC analyzed 2018 Behavioral Risk Factor Surveillance System (BRFSS) data to compare the prevalence of frequent mental distress among adults with disabilities with that among adults without disabilities and to identify factors associated with mental distress among those with disabilities. Nationwide, an estimated 17.4 million adults with disabilities reported frequent mental distress; the prevalence of reported mental distress among those with disabilities (32.9%) was 4.6 times that of those without disabilities (7.2%). Among adults with disabilities, those with both cognitive and mobility disabilities most frequently reported mental distress (55.6%). Adults with disabilities who reported adverse health-related characteristics (e.g., cigarette smoking, physical inactivity, insufficient sleep, obesity, or depressive disorders) or an unmet health care need because of cost also reported experiencing more mental distress than did those with disabilities who did not have these characteristics. Adults living below the federal poverty level reported mental distress 70% more often than did adults in higher income households. Among states, age-adjusted prevalence of mental distress among adults with disabilities ranged from 25.2% (Alaska) to 42.9% (New Hampshire). Understanding the prevalence of mental distress among adults with disabilities could help health care providers, public health professionals, and policy makers target interventions and inform programs and policies to ensure receipt of mental health screening, care, and support services to reduce mental distress among adults with disabilities.


Assuntos
Pessoas com Deficiência/psicologia , Pessoas com Deficiência/estatística & dados numéricos , Angústia Psicológica , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza/estatística & dados numéricos , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
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