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1.
Int J Equity Health ; 20(1): 204, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521433

RESUMO

BACKGROUND: People with disabilities (PwD) have been facing multiple health, social, and economic disparities during the COVID-19 pandemic, stemming from structural disparities experienced for long time. This paper aims to present the PREparedness, RESponse and SySTemic transformation (PRE-RE-SyST): a model for a disability-inclusive pandemic responses and systematic disparities reduction. METHODS: Scoping review with a thematic analysis was conducted on the literature published up to mid-September 2020, equating to the initial stages of the COVID-19 pandemic. Seven scientific databases and three preprint databases were searched to identify empirical or perspective papers addressing health and socio-economic disparities experienced by PwD as well as reporting actions to address them. Snowballing searches and experts' consultation were also conducted. Two independent reviewers made eligibility decisions and performed data extractions on any action or recommended action to address disparities. A thematic analysis was then used for the model construction, informed by a systems-thinking approach (i.e., the Iceberg Model). RESULTS: From 1027 unique references, 84 were included in the final analysis. The PRE-RE-SyST model articulates a four-level strategic action to: 1) Respond to prevent or reduce disability disparities during a pandemic crisis; 2) Prepare ahead for pandemic and other crises responses; 3) Design systems and policies for a structural disability-inclusiveness; and 4) Transform society's cultural assumptions about disability. 'Simple rules' and literature-based examples on how these strategies can be deployed are provided. CONCLUSION: The PRE-RE-SyST model articulates main strategies, 'simple rules' and possible means whereby public health authorities, policy-makers, and other stakeholders can address disability disparities in pandemic crises, and beyond. Beyond immediate pandemic responses, disability-inclusiveness is needed to develop everyday equity-oriented policies and practices that can transform societies towards greater resiliency, as a whole, to pandemic and other health and social emergencies.


Assuntos
COVID-19 , Pessoas com Deficiência , Pandemias , Prática de Saúde Pública , COVID-19/epidemiologia , COVID-19/prevenção & controle , Disparidades nos Níveis de Saúde , Humanos , Modelos Organizacionais , Pandemias/prevenção & controle
2.
Comput Intell Neurosci ; 2021: 9365199, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484325

RESUMO

Eye-tracking technology is advancing rapidly, becoming cheaper and easier to use and more robust. This has fueled an increase in its implementation for Augmentative and Alternative Communication (AAC). Nowadays, Eye-Tracking Communication Devices (ETCDs) can be an effective aid for people with disabilities and communication problems. However, it is not clear what level of performance is attainable with these devices or how to optimize them for AAC use. The objective of this observational study was to provide data on non-disabled adults' performance with ETCD regarding (a) range of eye-typing ability in terms of speed and errors for different age groups and (b) relationship between ETCD performance and bimanual writing with a conventional PC keyboard and (c) to suggest a method for a correct implementation of ETCD for AAC. Sixty-seven healthy adult volunteers (aged 20-79 years) were asked to type a sample sentence using, first, a commercial ETCD and then a standard PC keyboard; we recorded the typing speed and error rate. We repeated the test 11 times in order to assess performance changes due to learning. Performances differed between young (20-39 years), middle-aged (40-59 years), and elderly (60-79 years) participants. Age had a negative impact on performance: as age increased, typing speed decreased and the error rate increased. There was a clear learning effect, i.e., repetition of the exercise produced an improvement of performance in all subjects. Bimanual and ETCD typing speed showed a linear relationship, with a Pearson's correlation coefficient of 0.73. The assessment of the effect of age on eye-typing performance can be useful to evaluate the effectiveness of man-machine interaction for use of ETCDs for AAC. Based on our findings, we outline a potential method (obviously requiring further verification) for the setup and tuning of ETCDs for AAC in people with disabilities and communication problems.


Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Pessoas com Deficiência , Idoso , Comunicação , Tecnologia de Rastreamento Ocular , Humanos , Pessoa de Meia-Idade , Redação
3.
Medicine (Baltimore) ; 100(35): e27068, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477140

RESUMO

ABSTRACT: Many veterans have negative views about the service connection claims process for posttraumatic stress disorder (PTSD), which likely impacts willingness to file service connection claims, re-file claims, and use Veterans Healthcare Administration care. Nevertheless, veterans have reported that PTSD claims are important to them for the financial benefits, validation of prior experience and harm, and self-other issues such as pleasing a significant other. It is unknown if reported attitudes are specific to PTSD claimants or if they would be similar to those submitting claims for other disorders, such as musculoskeletal disorders. Therefore, the purpose of this study was to compare attitudes and beliefs about service connection processes between veterans submitting service connection claims for PTSD and musculoskeletal disorders.Participants were Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans filing service connection claims for PTSD (n = 218) or musculoskeletal disorder (n = 257) who completed a modified Disability Application Appraisal Inventory. This secondary data analysis using multiple regression models tested the effect of demographics, clinical characteristics, and claim type on 5 Disability Application Appraisal Inventory subscales: Knowledge about service connection claims, Negative Expectations about the process, and importance of Financial Benefits, importance of Validation of veteran's experience/condition, and importance of Self-Other attitudes.The PTSD group assigned significantly less importance to financial benefits than the musculoskeletal disorder group. In addition, the subset of the PTSD group without depression had significantly more Negative Expectations than musculoskeletal disorder claimants without depression. Negative Expectations did not differ between the PTSD and musculoskeletal disorder groups with depression. Depression was significantly positively associated with Negative Expectations, importance of Financial Benefits, and importance of Validation.Most perceptions around seeking service connection are not specific to PTSD claimants. Depression is associated with having negative expectations about service connection claims and motivations to file claims. Addressing depression and negative expectations during the compensation and pension process might help veterans at this important point of contact with Veterans Healthcare Administration services.


Assuntos
Atitude Frente a Saúde , Doenças Musculoesqueléticas/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Ajuda a Veteranos Incapacitados/normas , Veteranos/estatística & dados numéricos , Adulto , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Masculino , Análise Multivariada , Doenças Musculoesqueléticas/complicações , Transtornos de Estresse Pós-Traumáticos/complicações , Inquéritos e Questionários , Estados Unidos , United States Department of Veterans Affairs/organização & administração , United States Department of Veterans Affairs/estatística & dados numéricos , Ajuda a Veteranos Incapacitados/estatística & dados numéricos
5.
Lakartidningen ; 1182021 Sep 08.
Artigo em Sueco | MEDLINE | ID: mdl-34498235

RESUMO

A stroke is the most common cause for disability in the adult population. Rehabilitation is the tool to reduce the consequences of impairment. However, the continuum of stroke care is fragmented and rehabilitation is often lacking and unevenly distributed along the care pathway. In order to find potential cost-effective solutions, we have analysed the Swedish stroke care service system by using a three-level framework, i.e. micro, meso, and macro levels. At the micro level, a standardized and regular follow-up including assessment of rehabilitation needs is needed to facilitate effective rehabilitation and timely transition of care. The evidence-based rehabilitation including increasing rehabilitation intensity should be implemented in the whole care chain. At the meso level, a tight collaboration between different medical specialities is necessary to build a cost-effective stroke care. The awareness of rehabilitation needs and possibilities to respond to these require increased education about rehabilitation for the health care staff. Both undergraduate teaching as well as speciality training should include rehabilitation. The use of tele-medicine can be a way forward to provide rehabilitation in the same manner for more people and in different parts of the country.  Together with these micro and meso level solutions, additional recourses need to be prioritized at the macro level in order to facilitate the improvement of the cost-effective continuum of stroke care.


Assuntos
Pessoas com Deficiência , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Atividades Cotidianas , Adulto , Análise Custo-Benefício , Humanos , Acidente Vascular Cerebral/terapia
6.
Sensors (Basel) ; 21(17)2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34502836

RESUMO

Stroke is one of the most significant causes of permanent functional impairment and severe motor disability. Hemiplegia or hemiparesis are common consequences of the acute event, which negatively impacts daily life and requires continuous rehabilitation treatments to favor partial or complete recovery and, consequently, to regain autonomy, independence, and safety in daily activities. Gait impairments are frequent in stroke survivors. The accurate assessment of gait anomalies is therefore crucial and a major focus of neurorehabilitation programs to prevent falls or injuries. This study aims to estimate, using a single RGB-D sensor, gait patterns and parameters on a short walkway. This solution may be suitable for monitoring the improvement or worsening of gait disorders, including in domestic and unsupervised scenarios. For this purpose, some of the most relevant spatiotemporal parameters, estimated by the proposed solution on a cohort of post-stroke individuals, were compared with those estimated by a gold standard system for a simultaneous instrumented 3D gait analysis. Preliminary results indicate good agreement, accuracy, and correlation between the gait parameters estimated by the two systems. This suggests that the proposed solution may be employed as an intermediate tool for gait analysis in environments where gold standard systems are impractical, such as home and ecological settings in real-life contexts.


Assuntos
Pessoas com Deficiência , Transtornos Motores , Acidente Vascular Cerebral , Estudos de Viabilidade , Marcha , Humanos , Acidente Vascular Cerebral/complicações
7.
Health Res Policy Syst ; 19(1): 124, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503537

RESUMO

BACKGROUND: The Sustainable Development Goals (SDGs) and universal design (UD) principles call for inclusive planning. Within the transportation field, this includes the development or improvement of facilities that accommodate people with disabilities. Between 10% and 20% of the African population is affected by disabilities. A lack of understanding of the needs of people with disabilities leads to isolation. Within the transportation field, isolation manifests itself as a reduction in trip-making. METHODS: This paper investigates the availability of transport policies and guidelines in 29 different African countries, focusing on the inclusion of persons with disabilities. A desktop study was conducted creating heat maps for 29 African countries, followed by the analysis of secondary data in the case study area, South Africa, demonstrating that the lack of adequate policies, guidelines, and appropriate implementation leads to a lack of accessibility, opportunities, and social isolation, measured through trip frequencies. RESULTS: The data analysed revealed that many African countries omit, or only superficially include, people with disabilities in their transport policy framework. Ghana has the most inclusive People with Disabilities Act, while South Africa is most inclusive regarding their planning and design of transport facilities and services. In South Africa, 4.5% of the population did not travel at all in the 7 days before the interview, as disability or age prevented them from doing so, or due to a lack of appropriate travel services. When comparing the trip rates per week, people with disabilities travel significantly less, between 27.2% and 65.8%, than their abled counterparts. CONCLUSIONS: The study reveals that people with disability live less integrated, more isolated lives due to the lack of acknowledgement in the transport policy framework and accommodation in infrastructure and services. The results underpin the need for disability-inclusive planning in the African context and provide recommendations for actions that mitigate the isolation challenges faced by people with disabilities. Municipalities play a crucial role in improving the quality of life for people with disabilities.


Assuntos
Pessoas com Deficiência , Qualidade de Vida , Gana , Humanos , África do Sul , Desenvolvimento Sustentável
8.
Neurol India ; 69(4): 979-983, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34507425

RESUMO

Background: Pain is a common and distressing symptom of Parkinson's disease (PD). The relation of pain, its predictors, and its impact on quality of life (QoL) in PD has not been studied in Indian PD patients. Objective: To assess the predictors of pain and investigate its impact on QoL among Indian PD patients. Methodology: We conducted a cross-sectional study on 100 PD patients. The cases were diagnosed according to the UK brain bank criteria. Unified PD Rating Scale (UPDRS) parts III, V, and VI were employed to assess the severity of the disease. King's Parkinson Disease Pain Scale (KPPS) and PD questionnaire-8 (PDQ-8) were used to evaluate pain and QoL, respectively. Results: Prevalence of different pain types in patients with PD was 70%, mainly including musculoskeletal (53%), fluctuation-related (35%), and nocturnal pain (27%). Subjects with pain developed PD symptoms at a younger age and had a longer duration of the disease. A positive correlation was found between KPPS scores and UPDRS parts III and V, while a negative correlation was observed with UPDRS part VI. Pain in PD subjects had a significant impact on the QoL. Conclusions: Most of the PD patients suffered some form of pain with significant correlations with motor disability and poor QoL. Predictors of pain severity among PD patients included a longer disease duration, younger age of disease onset, and a higher levodopa equivalent daily dose (LEDD).


Assuntos
Pessoas com Deficiência , Transtornos Motores , Doença de Parkinson , Estudos Transversais , Humanos , Dor/epidemiologia , Dor/etiologia , Doença de Parkinson/complicações , Doença de Parkinson/epidemiologia , Qualidade de Vida , Índice de Gravidade de Doença
9.
BMC Musculoskelet Disord ; 22(1): 771, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507585

RESUMO

BACKGROUND: Musculoskeletal pain is a risk factor for leaving the labour market temporarily and permanently. While the presence of multi-site pain increases the risk of disability pension, we lack detailed knowledge about pain intensity as a risk factor. This study investigated the association between musculoskeletal pain intensity in different body regions and risk of future disability pension among eldercare workers. METHODS: Eight thousand seven hundred thirty-one female eldercare workers replied to a questionnaire on work and health in 2005 and were followed for 11 years in the Danish Register for Evaluation of Marginalization. Time-to-event analyses estimated hazard ratios (HR) for disability pension from pain intensities (0-9 numeric rating scale (NRS)) in the low-back, neck/shoulders, and knees during the previous 3 months. Analyses were mutually adjusted for pain regions, age, education, lifestyle, psychosocial work factors, and physical exertion at work. RESULTS: During 11-year follow-up, 1035 (11.9%) of the eldercare workers received disability pension. For all body regions among all eldercare workers, dose-response associations were observed between higher pain intensity and risk of disability pension (p < 0.001). The risk for disability pension was increased when reporting "very high" pain levels (≥7 points on the 0-9 NRS) in the low-back (HR 2.19, 95% CI 1.70-2.82), neck/shoulders (HR 2.34, 95% CI 1.88-2.92), and knees (HR 1.89, 95% CI 1.44-2.47). Population attributable risks (PAR) were 15.5, 23.2, and 9.6% for pain > 2 on NRS in the low-back, neck/shoulders, and knees, respectively, indicating that 15.5, 23.2, and 9.6% fewer eldercare workers would likely receive disability pension if the pain intensity was reduced to 2 or less. For workers ≤45 years and > 45 years, PAR was highest for neck/shoulder pain (27.6%) and low-back pain (18.8%), respectively. CONCLUSIONS: The present study found positive dose-response associations between pain intensity in the low-back, neck/shoulders, and knees, and risk of disability pension during 11-year follow-up. Moderate to very high levels of musculoskeletal pain in eldercare workers should, therefore, be considered an early warning sign of involuntary premature exit from the labour market. These findings underscore the importance of preventing, managing, and reducing musculoskeletal pain to ensure a long and healthy working life.


Assuntos
Pessoas com Deficiência , Dor Musculoesquelética , Feminino , Seguimentos , Humanos , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/epidemiologia , Pensões , Estudos Prospectivos , Fatores de Risco
10.
BMJ Open ; 11(9): e048143, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34489277

RESUMO

PURPOSE: The substantial economic burden of work-related injury and illness, borne by workers, employers and social security programmes, is primarily attributed to the durations of work disability among workers whose recovery requires a period of absence from work, with the majority of costs arising from the minority of workers with the longest duration absences. The objective of the Ontario Life After Workplace Injury Study is to describe the long-term health and labour market outcomes of workers disabled by work injury or illness after they are no longer receiving benefits or services from the work disability insurance authority. PARTICIPANTS: Workers disabled by a work-related injury or illness were recruited from a sample frame of disability benefit claimants with oversampling of claimants with longer benefit durations. Characteristics of workers, their employers and claimant benefits were obtained from baseline administrative data. Interviews completed at 18 months post injury (T1) and to be completed at 36 months (T2) measure return-to-work and work status; income; physical and mental health; case manager and healthcare provider interactions and employer accommodations supporting return-to-work and sociodemographic characteristics. Of eligible claimants, 40% (1132) participated in the T1 interview, with 96% consenting to participate in the T2 interview. FINDINGS TO DATE: Preliminary descriptive analyses of T1 data have been completed. The median age was 50 years and 56% were male. At 18 months following injury, 61% were employed by their at-injury employer, 16% had changed employment and 23% were not working. Past-year prescription opioid use was prevalent (34%), as was past-year cannabis use (31%). Longer duration claimants had poorer function, recovery and health and more adverse labour market outcomes. FUTURE PLANS: Multivariate analyses to identify modifiable predictors of adverse health and labour market outcomes and a follow-up survey of 96% of participants consenting to follow-up at 36 months are planned.


Assuntos
Pessoas com Deficiência , Seguro por Invalidez , Humanos , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Retorno ao Trabalho , Indenização aos Trabalhadores , Local de Trabalho
11.
Artigo em Russo | MEDLINE | ID: mdl-34486857

RESUMO

The article analyzes dynamics of main indices of disability in population older than able-bodied age in the Rostov Oblast. The trend of decreasing of scope of examinations of individuals of the mentioned age group, including decreasing the number of first and iteratively recognized as the disabled, against the background of increasing in the population structure of percentage of individuals older than able-bodied age. At the same time, increasing of accumulated disability was established in the studied category of population.


Assuntos
Pessoas com Deficiência , Idoso , Humanos , Federação Russa/epidemiologia , Problemas Sociais
12.
BMC Public Health ; 21(1): 1619, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488700

RESUMO

BACKGROUND: To evaluate global burden of refraction disorders by year, age, region, gender, socioeconomic status and other national characteristics in terms of disability adjusted life years (DALYs) and prevalence from Global Burden of Disease (GBD) study 2019 and World Bank Open Data 2019. METHODS: Global, regional, and national DALY numbers, crude DALY rates, age-standardized DALY and prevalence rates of refraction disorders were acquired from the GBD study 2019. Mobile cellular subscriptions, urban population, GDP per capita, access to electricity and total fertility rate were obtained from the World Bank to explore the factors that influenced the health burden of refraction disorders. Kruskal-Wallis test, linear regression and multiple linear regression were performed to evaluate the associations between the health burden with socioeconomic levels and other national characteristics. Wilcoxon Signed-Rank Test was used to investigate the gender disparity. RESULTS: Globally, age-standardized DALY rates of refraction disorders decreased from 88.9 (95% UI: 60.5-120.3) in 1990 to 81.5 (95% UI: 55.0-114.8) in 2019, and might fall to 73.16 (95% UI: 67.81-78.51) by 2050. Age-standardized prevalence rates would also reduce to 1830 (95% UI: 1700-1960) by 2050, from 2080 (95% UI: 1870-2310) in 1990 to 1960 (95% UI: 1750-2180) in 2019. In low SDI region, age-standardized DALY rates (equation: Y = 114.05*X + 27.88) and prevalence rates (equation: Y = 3171.1*X + 403.2) were positively correlated with SDI in linear regression respectively. East Asia had the highest blindness rate caused by refraction disorders in terms of age-standardized DALY rates (11.20, 95% UI: 7.38-16.36). Gender inequality was found among different age groups and SDI regions. CONCLUSION: Health burden of refraction disorders decreased in recent years, and may continue to alleviate in the next three decades. Older ages, females and lower socioeconomic status were associated with higher refraction disorders health burden.


Assuntos
Pessoas com Deficiência , Carga Global da Doença , Idoso , Feminino , Saúde Global , Humanos , Pessoa de Meia-Idade , Prevalência , Anos de Vida Ajustados por Qualidade de Vida
13.
J Aging Stud ; 58: 100953, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34425985

RESUMO

Within many countries, the policies of disability and old age have been developing on distinct paths. Even though the prevalence of disability is higher in older populations, older persons tend to be excluded from disability discourses. Taking Finland's disability service legislation reform as an example, this article elaborates on the justifications for excluding or including older persons from disability policies. The paper analyses the public statements given in 2017 to a proposal that introduced an age-related restriction to disability services in order to understand how the restriction is argued for and against, and what kind of conceptualisations of old age and disability the statements portray. This study found that although equality is the most important principle underlying the reform, the conceptualisation of equality varies. Depending on who is included in the disability discourse, the idea of what is fair differs. Hence, it is necessary to recognise the differing understandings of equality in the debate regarding the age-related restriction. In addition, I argue that equality research can be helpful in assessing the fairness of public policies at the intersection of ageing and disability.


Assuntos
Pessoas com Deficiência , Idoso , Idoso de 80 Anos ou mais , Finlândia , Humanos , Política Pública
14.
Artigo em Espanhol | PAHO-IRIS | ID: phr-54746

RESUMO

[RESUMEN]. La Comisión Europea y 22 de sus Estados Miembros cofinanciaron durante 2017-2019 la primera acción con-junta para abordar la fragilidad en las personas mayores, denominada ADVANTAGE Joint Action. En el marco de esta iniciativa, se definió una estrategia común, basada en la mejor evidencia científica, para posicionar el envejecimiento saludable y la fragilidad como temas prioritarios de salud pública en los países participantes y contribuir así a un abordaje homogéneo de la fragilidad en toda Europa. En este artículo se detalla la metodo-logía del trabajo realizado y los principales logros de ADVANTAGE y se incluye un análisis de las claves que contribuyeron a su éxito. En los tres años de funcionamiento se formaron y desarrollaron potentes redes de tra-bajo multisectoriales, tanto a nivel nacional como internacional. ADVANTAGE logró marcar rutas prácticas para abordar de manera global la fragilidad y la prevención de la dependencia en 22 países con realidades políticas, económicas, sociales y organizativas muy heterogéneas. ADVANTAGE ha demostrado que acciones de este tipo son factibles y eficaces, y que si se toman en cuenta y aplican los puntos clave de éxito identificados, debi-damente ajustados a cada realidad, esta acción puede ser reproducible en cualquier país decidido a promover el envejecimiento saludable de su población, incluidos los de América Latina y el Caribe.


[ABSTRACT]. The European Commission and 22 of its Member States cofinanced, in 2017-2019, the first joint action to address frailty in older persons, known as ADVANTAGE Joint Action. The initiative developed a common strategy, based on the best scientific evidence, to position healthy aging and frailty as priority public health issues in the participating countries and thus contribute to uniformly addressing frailty across Europe. This article details the methodology and main achievements of ADVANTAGE and includes an analysis of the key factors contributing to its success. In the Action’s three years, powerful multisectoral networks were formed and developed, both nationally and internationally. ADVANTAGE succeeded in mapping out practical routes for comprehensively addressing frailty and dependency prevention in 22 countries with very heterogeneous political, economic, social, and organizational realities. ADVANTAGE has demonstrated that actions of this type are feasible and effective, and that if the key points of success that have been identified are considered and applied, duly adjusted to each reality, this action can be replicable in any country resolved to promoting the healthy aging of its population, including those of Latin America and the Caribbean.


[RESUMO]. De 2017 a 2019, a Comissão Europeia e 22 dos seus Estados Membros cofinanciaram a primeira ação con-junta para abordar a fragilidade em idosos, denominada ADVANTAGE Joint Action. No âmbito dessa iniciativa, foi definida uma estratégia comum, baseada nas melhores evidências científicas, para posicionar o envel-hecimento saudável e a fragilidade como questões prioritárias de saúde pública nos países participantes, contribuindo, assim, para uma abordagem homogênea à fragilidade em toda a Europa. Este artigo detalha a metodologia do trabalho realizado e as principais conquistas da ADVANTAGE, e inclui uma análise das chaves que contribuíram para seu sucesso. Nos três anos de operação da iniciativa, foram formadas e desen-volvidas poderosas redes multissetoriais, tanto nacional quanto internacionalmente. A iniciativa ADVANTAGE foi capaz de criar roteiros práticos para abordar de maneira global a fragilidade e a prevenção da dependên-cia em 22 países com realidades políticas, econômicas, sociais e organizacionais bastante heterogêneas. A ADVANTAGE mostrou que ações deste tipo são viáveis e eficazes, e que se os principais fatores de sucesso identificados forem levados em consideração e aplicados, devidamente ajustados a cada realidade, esta ação pode ser reproduzida em qualquer país determinado a promover o envelhecimento saudável de sua população, inclusive na América Latina e no Caribe.


Assuntos
Fragilidade , Pessoas com Deficiência , Envelhecimento Saudável , Envelhecimento , Idoso , Saúde do Idoso , Dinâmica Populacional , Prevenção de Doenças , Fragilidade , Pessoas com Deficiência , Envelhecimento Saudável , Dinâmica Populacional , Prevenção de Doenças , Idoso , Saúde do Idoso , Envelhecimento , Fragilidade , Pessoas com Deficiência , Envelhecimento Saudável , Envelhecimento , Idoso , Saúde do Idoso , Dinâmica Populacional , Prevenção de Doenças
15.
Artigo em Inglês | PAHO-IRIS | ID: phr-54644

RESUMO

[ABSTRACT]. Objective. To identify the main factors associated with disability in older adults in Colombia, adjusted accord-ing to structural and intermediary determinants of healthy aging.Methods. This study used cross-sectional data from 23 694 adults over 60 years of age in the SABE Colombia nationwide survey. Structural determinants such as demographic and socioeconomic position variables were analyzed. Intermediary variables were classified into three blocks: intrinsic capacity, physical and built envi-ronment, and health care systems. Data analysis employed multivariate logistic regression.Results. The prevalence of overall disability was 21% for activities of daily living, 38% for instrumental activi-ties of daily living, and 33% for mobility disability. Disability was associated with sociodemographic structural determinants such as older age, female sex, rural residence, never married/divorced, living alone, low edu-cational level, and Indigenous/Black ethnicity. With regard to determinants of socioeconomic position, net low income, poor socioeconomic stratum, insufficient income perception, and a subsidized health insurance scheme exerted a major influence on disability. Intermediary determinants of intrinsic capacity, such as poor self-rated health, multimorbidity, low grip strength, sedentary lifestyle, early childhood economic adversity, no social support, and no participation in activities, were significantly associated with disability.Conclusions. Actions that affect the main factors associated with disability, such as reducing health inequities through policies, strategies, and activities, can contribute significantly to the well-being and quality of life of Colombian older adults.


[RESUMEN]. Objetivo. Determinar los principales factores asociados con la discapacidad en personas mayores en Colom-bia, ajustados según determinantes estructurales e intermediarios del envejecimiento saludable.Métodos. Este estudio empleó datos transversales de 23 694 adultos de más de 60 años provenientes de la encuesta nacional Colombia SABE. Se analizaron los determinantes estructurales como las variables demográficas y de situación socioeconómica. Las variables intermediarias se clasificaron en tres bloques: capacidad intrínseca, entorno físico y construido, y sistemas de atención de salud. El análisis de datos empleó la regresión logística con múltiples variables.Resultados. La prevalencia de la discapacidad general fue de 21% en la actividad cotidiana, 38% en la activi-dad cotidiana instrumental y 33% en la discapacidad relacionada con la movilidad. Se asoció la discapacidad con los determinantes estructurales sociodemográficos, como edad avanzada, sexo femenino, residencia en entornos rurales, estar soltero o divorciado, vivir solo, un nivel educativo bajo y tener etnicidad indígena o negra. Con respecto a los determinantes relativos a la situación socioeconómica, la principal influencia en la discapacidad fueron los ingresos netos bajos, la situación socioeconómica baja, una percepción insuficiente de ingresos y un plan de seguro de salud subsidiado. Los determinantes intermediarios de la capacidad intrínseca, como la mala salud informada por la propia persona, la multimorbilidad, la poca fuerza en el puño, un estilo de vida sedentario, las adversidades económicas desde la primera infancia, la carencia de apoyo social y la falta de participación en actividades se asociaron de manera significativa con la discapacidad.Conclusiones. Las medidas que tienen un efecto sobre los principales factores asociados con la discapaci-dad, como la reducción de las inequidades en materia de salud, mediante políticas, estrategias y actividades, pueden contribuir significativamente al bienestar y la calidad de vida de las personas mayores colombianas.


[RESUMO]. Objetivo. Identificar os principais fatores associados à incapacidade em idosos na Colômbia, ajustados de acordo com os determinantes estruturais e intermediários do envelhecimento saudável.Métodos. Este estudo usou dados transversais de 23.694 adultos com mais de 60 anos de idade que partic-iparam da pesquisa nacional SABE Colômbia. Determinantes estruturais, como variáveis demográficas e de condição socioeconômica, foram analisados. As variáveis intermediárias foram classificadas em três blocos: capacidade intrínseca, ambiente físico e construído, e sistemas de saúde. A análise dos dados empregou regressão logística multivariada.Resultados. A prevalência de incapacidade em geral foi de 21% para as atividades da vida diária, 38% para atividades instrumentais da vida diária e 33% para restrição de mobilidade. Constatou-se associação da incapacidade com determinantes estruturais sociodemográficos, como idade avançada, sexo feminino, residência em área rural, estado civil solteiro ou divorciado, viver sozinho, baixa escolaridade e etnia indígena/negra. Com relação aos determinantes da condição socioeconômica, baixa renda líquida, pertencimento ao estrato socioeconômico mais pobre, percepção de renda insuficiente e ter um plano de seguro-saúde sub-sidiado exerceram grande influência sobre a incapacidade. Determinantes intermediários da capacidade intrínseca, como autopercepção de saúde ruim, multimorbidade, força de preensão reduzida, estilo de vida sedentário, adversidade econômica na primeira infância, ausência de suporte social e não participação em atividades foram significativamente associados à incapacidade.Conclusões. Ações que afetem os principais fatores associados à incapacidade, como a redução das iniq-uidades em saúde por meio de políticas, estratégias e atividades, podem contribuir significativamente para o bem-estar e a qualidade de vida dos idosos colombianos.


Assuntos
Envelhecimento Saudável , Determinantes Sociais da Saúde , Pessoas com Deficiência , América Latina , Colômbia , Envelhecimento , Envelhecimento Saudável , Envelhecimento , Determinantes Sociais da Saúde , Pessoas com Deficiência , América Latina , Envelhecimento Saudável , Envelhecimento , Determinantes Sociais da Saúde , Pessoas com Deficiência , Colômbia
16.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(8): 958-964, 2021 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-34445833

RESUMO

Objective: To examine the trend of stroke disease burden and its main risk-attributable factors in China and regions with different Socio-Demographic Index (SDI) from 1990 to 2017. Methods: With 2017 Global Burden of Disease (GBD) data, years lived with disability (YLDs), years of life lost (YLLs) and disability-adjusted of life years (DALYs) were applied to describe the disease burden and major risk factors of stroke in China and different SDI regions from 1990 to 2017, and to analyze the changing trend of the disease burden and major risk factors of stroke. Results: From 1990 to 2017, the YLD crude rate, YLL crude rate and DALY crude rate for stroke in China showed an increasing trend and the rate of change was 126.5%, 14.6%, and 24.4%, respectively. In 2017, the YLD crude rate, YLL crude rate and DALY crude rate for stroke in China were 502.6 per 100 000, 2 633.1 per 100 000 and 3 135.7 per 100 000, respectively. Among them, the YLD crude rate, YLL crude rate, and DALY crude rate of stroke were the highest in the ≥70 age group, which were 2 617.2 per 100 000, 16 789.4 per 100 000 and 19 406.6 per 100 000, respectively. The YLD crude rate in male was 475.5 per 100 000, which was slightly lower than that of female (530.9 per 100 000), while the DALY crude rate and YLL crude rate for stroke were 3 657.1 per 100 000 and 3 181.7 per 100 000, respectively, which were significantly higher than that of female (2 591.8 per 100 000 and 2 060.9 per 100 000). Compared with regions with different SDI, the age standardized YLD rate, the age standardized YLL rate, the age standardized DALY rate in China were all at a high level. Among them, the age-standardized YLD rate increased from 286.2 per 100 000 to 374.5 per 100 000, with a rate of change of 30.9%; the age-standardized YLL rate decreased from 3 215.6 per 100 000 to 1 967.8 per 100 000, with a rate of change of -38.8%; the age-standardized DALY rate increased from 3 501.8 per 100 000 to 2 342.3 per 100 000, with a rate of change of -33.1%. The top five risk factors for stroke in China were hypertension, excessive sodium intake, insufficient fruit intake, insufficient cereal intake, and smoking in 1990 and 2017. High Body-Mass Index and Alcohol Use's rankings rose from the 9th and 10th in 1990 to the 6th and 7th in 2017, respectively. Conclusion: The burden of stroke disease in China is at a high level, and hypertension is the primary risk factor.


Assuntos
Pessoas com Deficiência , Acidente Vascular Cerebral , China/epidemiologia , Efeitos Psicossociais da Doença , Feminino , Carga Global da Doença , Humanos , Masculino , Anos de Vida Ajustados por Qualidade de Vida , Acidente Vascular Cerebral/epidemiologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-34444393

RESUMO

BACKGROUND: Multiple sclerosis (MS) is a chronic disease of the central nervous system that also develops in patients under 18 years of age. The disease negatively affects the quality of life (QoL) of children and adolescents. We conducted a literature review. The aim of the review was to identify the QoL of pediatric patients with MS and assess the factors determining their QoL. METHODS: We analyzed studies published between 2000 and 2020 in PubMed, Scopus, Science Direct, Web of Science, and EBSCO databases. RESULTS: In all, 17 studies were included in the review. The most common tool in assessing QoL was the generic module PedsQL. The range of mean/median global score of QoL was 53.8-81.7. The worst QoL was dominantly reported in the school and emotional spheres, on the contrary, the disease's least determined area of QoL was the social and physical dimension. In particular, disability and fatigue were important predictors of QoL. CONCLUSIONS: MS negatively affects the school and emotional spheres in particular, so it is important to pay greater attention to these spheres of life of MS patients. As the review studies pay insufficient attention to the analysis of positive factors and their impact on the QoL of MS patients, research should integrate these phenomena. The use of MS-targeted tools in future research in the pediatric MS population is also appropriate.


Assuntos
Pessoas com Deficiência , Esclerose Múltipla , Adolescente , Criança , Fadiga , Humanos , Qualidade de Vida
18.
MMWR Morb Mortal Wkly Rep ; 70(34): 1142-1149, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34437518

RESUMO

Adults with disabilities, a group including >25% of U.S. adults (1), experience higher levels of mental health and substance use conditions and lower treatment rates than do adults without disabilities* (2,3). Survey data collected during April-September 2020 revealed elevated adverse mental health symptoms among adults with disabilities (4) compared with the general adult population (5). Despite disproportionate risk for infection with SARS-CoV-2, the virus that causes COVID-19, and COVID-19-associated hospitalization and mortality among some adults with disabilities (6), information about mental health and substance use in this population during the pandemic is limited. To identify factors associated with adverse mental health symptoms and substance use among adults with disabilities, the COVID-19 Outbreak Public Evaluation (COPE) Initiative† administered nonprobability-based Internet surveys to 5,256 U.S. adults during February-March 2021 (response rate = 62.1%). Among 5,119 respondents who completed a two-item disability screener, nearly one third (1,648; 32.2%) screened as adults with disabilities. These adults more frequently experienced symptoms of anxiety or depression (56.6% versus 28.7%, respectively), new or increased substance use (38.8% versus 17.5%), and suicidal ideation (30.6% versus 8.3%) than did adults without disabilities. Among all adults who had received a diagnosis of mental health or substance use conditions, adults with disabilities more frequently (42.6% versus 35.3%; p <0.001) reported that the pandemic made it harder for them to access related care or medication. Enhanced mental health and substance use screening among adults with disabilities and improved access to medical services are critical during public health emergencies such as the COVID-19 pandemic.


Assuntos
COVID-19/psicologia , Pessoas com Deficiência/psicologia , Transtornos Mentais/epidemiologia , Pandemias , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-34444334

RESUMO

Most people in modern society enjoy various benefits due to the development of information and communication technology and smart technology in modern society. However, due to the digital divide, there is a social class that cannot enjoy abundant benefits. The representative class is the class of older people. In the latest four-year national report on the status of the digital divide, the class with largest digital divide among various information disadvantaged groups, such as the disabled, the low-income class, farmers and fishermen, and older people, is the class of older people. In this study, the causes of the digital divide among older people in Korea are analyzed from various perspectives. To this end, various statistical analyses have been conducted based on national statistical survey works over the past four years. The digital informatization level, which is an index used to measure the digital divide, can be classified into three main components: information access, information capability, and information utilization. Among the three components, the information capability is found to be the lowest. Information capability can also be divided into three components for PCs and mobile devices: installation, use, and management. Among them, management capability was found to be the lowest. Based on this analysis, various plans to reduce the digital divide among older people were proposed.


Assuntos
Exclusão Digital , Pessoas com Deficiência , Acesso à Informação , Idoso , Comunicação , Humanos , Internet , República da Coreia
20.
Med Lav ; 112(4): 279-291, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34446684

RESUMO

BACKGROUND: The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure is a widely used patient reported outcome measure. OBJECTIVE: The aim of this study is to evaluate the quality of translation procedures and assessment of the psychometric properties of cross-cultural adaptations of the DASH. METHODS: We reviewed the literature to identify all published studies of cultural adaptations of the DASH questionnaire. For the quality assessment, we used Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures, Quality Criteria for Psychometric Properties of Health Status Questionnaire and COSMIN Checklist for Cross-Cultural Validity. RESULTS: We included 25 articles with 26 versions of the DASH. Only the Puerto Rican version followed all six of the processes of cross-cultural adaptation. None of the versions assessed all eight measurement properties for Quality Criteria for Psychometric Properties of Health Status Questionnaire and none of them had a positive rating from agreement, internal consistency, responsiveness and interpretability. All the studies got a poor rating according to the COSMIN checklist. DISCUSSION: None of the versions got a good rating from all three checklists. We observed that supplementary tests for the adaptations are necessary, especially for assessing agreement, responsiveness and interpretability. We concluded that all versions need more research on psychometric properties.


Assuntos
Comparação Transcultural , Avaliação da Deficiência , Inquéritos e Questionários , Braço , Pessoas com Deficiência , Mãos , Humanos , Psicometria , Reprodutibilidade dos Testes , Ombro
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