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Special Issue "Disabilities, Health and Well-being"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 June 2019).

Special Issue Editor

Prof. Dr. Tsan-Hon Liou
E-Mail Website
Guest Editor
Department of Physical Medicine and Rehabilitation, Taipei Medical University, Taipei, Taiwan
Interests: rehabilitation; disability; ICF; physical activity; sarcopenia; public health; Implementation of the ICF

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on disability, health and well-being in the International Journal of Environmental Research and Public Health. IJERPH is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://0-www-mdpi-com.brum.beds.ac.uk/journal/ijerph.

The International Classification of Functioning, Disability and Health (ICF) defines disability as an umbrella term for impairments, activity limitations and participation restrictions. Disability is the interaction between individuals with a health condition (e.g. cerebral palsy, spinal cord injury and schizophrenia) and personal and environmental factors (e.g. negative attitudes, inaccessible transportation and public buildings, and limited social support). Over a billion people are estimated to live with some form of disability. This corresponds to about 15% of the world's population. Furthermore, the rates of disability are increasing in part due to ageing populations and an increase in chronic health conditions. Disability is a public health and social issue that has received relatively little attention for years. People with disabilities have the same general health care needs as everyone else. How to maintain their health and well-being is an important issue. Article 25 of the UN Convention on the Rights of Persons with Disabilities (CRPD) reinforces the right of persons with disabilities to attain the highest standard of health care, without discrimination. Research on how to promote health and well-being, decrease health disparity and eliminate discrimination for people with disability, can offer a critical guide for policy efforts and planning for public health.

This Special Issue is open to any subject area related to promotion of health and well-being among people with disability. The listed keywords suggest just a few of the many possibilities.

Prof. Dr. Tsan-Hon Liou
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Disability
  • International Classification of Functioning, Disability and Health (ICF)
  • Health promotion
  • Public health
  • Welfare
  • Special education
  • Quality of life
  • Physical activity
  • Work and employment
  • Social participation
  • Convention on the Rights of Persons with Disabilities
  • Accessibility
  • Health disparities
  • Culture factors
  • Unmet needs for health care
  • Barriers
  • Discrimination

Published Papers (22 papers)

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Research

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Article
Perception of Falls and Confidence in Self-Management of Falls among Older Adults
Int. J. Environ. Res. Public Health 2019, 16(24), 5054; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16245054 - 11 Dec 2019
Cited by 2 | Viewed by 1446
Abstract
Objectives: Fall preventive programs aim to reduce risks for mortality from fall-related injuries among older adults. However, the covariation between personal perceptions of falls and factors and confidence of self-management in falls (CSMoF) is still under-studied despite its importance to fall prevention. We [...] Read more.
Objectives: Fall preventive programs aim to reduce risks for mortality from fall-related injuries among older adults. However, the covariation between personal perceptions of falls and factors and confidence of self-management in falls (CSMoF) is still under-studied despite its importance to fall prevention. We aimed to investigate the relative contribution of CSMoF in relation to fall risk self-perceptions while controlling for demographics and self-reported health and functioning. Method: Participants were 691 older adults recruited from Area Agency on Aging at Arlington, Texas (females = 76.1%, mean age = 76.23, SD = 6.44, with chronic condition = 79.5%). They completed measures of physical functioning, CSMoF, fall risk perceptions and fear of falls. Results: Regression analyses indicated that fear of fall was the most predictive factor of CSMoF among older persons, accounting for about 25% of the variance. Physical function measures of age, chronic illnesses of metabolism, sensory impairment, and health status were also significant predictors of the CSMoF, but to a lesser extent than fear of falls and fall perceptions. The interaction of perception of falls and fall experience attenuated CSMoF, with physical functioning limitations. Conclusion: The joint effects of perception of falls and fear of falls likely explain CSMoF among older adults more than physical functional indicators. Fall prevention programs for older adults should prioritize to address modifiable subjective factors of fall perceptions, fear of falls, and CSMoF across health and functioning statuses. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Physical Activity of Adolescents with and without Disabilities from a Complete Enumeration Study (n = 128,803): School Health Promotion Study 2017
Int. J. Environ. Res. Public Health 2019, 16(17), 3156; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16173156 - 29 Aug 2019
Cited by 1 | Viewed by 1316
Abstract
Evidence suggests that adolescent males take part in more moderate-to-vigorous physical activity (MVPA) than females, and that adolescents with disabilities participate in even less. Public health data are typically based on the international physical activity (PA) recommendations of at least 60 minutes of [...] Read more.
Evidence suggests that adolescent males take part in more moderate-to-vigorous physical activity (MVPA) than females, and that adolescents with disabilities participate in even less. Public health data are typically based on the international physical activity (PA) recommendations of at least 60 minutes of MVPA daily. However, it appears that data are lost because a person who reports MVPA 0–6 days a week is grouped together and is considered as ‘inactive’. Therefore, the purposes of this study were to report differences among adolescents with and without disabilities who were ‘active’ and ‘inactive’ and to explore differences by sex. A complete enumeration study (2017 School Health Promotion Survey; n = 128,803) of Finnish adolescents aged between 14–19 years old was conducted. The single item self-report MVPA was used with items from the Washington Group on Disability Statistics. Data were grouped into physiological and cognitive disabilities and were split into active and inactive adolescents based on the PA recommendations; subsequently, binary logistic regression analyses were performed. Data from the inactive participants were analyzed with multivariate analysis of covariance and effect sizes were reported. Approximately 10% of males and 17% of females reported disabilities. There were fewer adolescents with disabilities who took part in daily PA (OR = 0.90, CI = 0.85–0.94), especially among those with cognitive disabilities (OR = 0.86, CI = 0.82–0.91). There were more active male than female adolescents (OR = 1.48, CI = 1.43–1.52). Of the inactive adolescents, females reported similar MVPA to males, with and without disabilities after controlling for age, school type, and family financial situation. Inactive adolescents with walking difficulties reported the least amount of MVPA (males; mean = 2.24, CI = 2.03–2.44, females; mean = 2.18, CI = 1.99–2.37). The difference in means with adolescents without disabilities according to Cohen’s d effect size was medium for males (0.56) and females (0.58). The effect sizes from all other groups of disabilities were small. The difference in PA between males and females has diminished among the inactive groups, yet there is still a need to improve the gap between males and females, especially for those who meet the PA recommendations. More strategies are needed to improve MVPA among adolescents with disabilities, especially those with cognitive disabilities. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
Article
Managing Medication Cost Burden: A Qualitative Study Exploring Experiences of People with Disabilities in Canada
Int. J. Environ. Res. Public Health 2019, 16(17), 3066; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16173066 - 23 Aug 2019
Cited by 2 | Viewed by 1673
Abstract
Despite the abundant literature on the burden of rising costs of prescription medications, there is limited research to explore how these costs affect people and the decisions they are forced to make within the context of disability. In this qualitative study we explored [...] Read more.
Despite the abundant literature on the burden of rising costs of prescription medications, there is limited research to explore how these costs affect people and the decisions they are forced to make within the context of disability. In this qualitative study we explored strategies adopted, factors influencing, and the impact of some of these strategies to manage the burden of medication cost among persons with disabilities. We interviewed 12 adults with spinal cord injuries living in Canada, using a general inductive approach to analyze the data. We found that before cutting back on medications due to costs, participants generally tried and sought help from the government, employers, and/or their prescribers to improve their drug coverage. The key factors that participants considered while making decisions on the strategies included the cost and perceived importance of medications, their financial status, other competing needs, and their relationship with the prescribers. While some of their efforts were successful, many participants were still not able to obtain their medications as prescribed. In those cases, patients resorted to rationing strategies such as cutting back on medications, other essential needs, or selling assets. These strategies had serious implications on their health, healthcare utilization, and quality of life. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Measuring Work-Related Functioning Using the Work Rehabilitation Questionnaire (WORQ)
Int. J. Environ. Res. Public Health 2019, 16(15), 2795; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16152795 - 05 Aug 2019
Cited by 6 | Viewed by 1601
Abstract
The assessment of work-related functioning is a key process in vocational rehabilitation to identify specific domains of disability that can be considered within return to work strategies. The Work Rehabilitation Questionnaire (WORQ) was developed to evaluate work-related functioning based on the International Classification [...] Read more.
The assessment of work-related functioning is a key process in vocational rehabilitation to identify specific domains of disability that can be considered within return to work strategies. The Work Rehabilitation Questionnaire (WORQ) was developed to evaluate work-related functioning based on the International Classification of Functioning, Disability, and Health (ICF) framework and is available in different languages. The aim of this study was to assess the French version of the WORQ using item response theory to further validate the scale. Rasch analysis of WORQ and the WORQ-BRIEF (a brief version of the WORQ) was performed using a calibration sample of 221 persons with musculoskeletal injuries. A four-testlet solution indicated the unidimensionality of WORQ, with no differential item functioning for age, education, physical job demands, and injury severity. Reliability was 0.969 and 0.918 for WORQ and WORQ-BRIEF, respectively. The minimal detectable change was calculated to be 4.2% of its operational range for WORQ and 8.5% for WORQ-BRIEF. Consequently, the French version of WORQ can be considered a good measure of work-related functioning in musculoskeletal conditions. WORQ can be used in rehabilitation practice to comprehensively identify the disability and guide clinical decision making and intervention planning. Further studies are needed to evaluate the psychometric properties of WORQ in other health conditions. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Evaluation of a Care Coordination Initiative in Improving Access to Dental Care for Persons with Disability
Int. J. Environ. Res. Public Health 2019, 16(15), 2753; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16152753 - 01 Aug 2019
Cited by 3 | Viewed by 1395
Abstract
In French law, the state is responsible for ensuring equal access to health care for people with disabilities. No system exists within dentistry to guarantee this—there are no salaried public service workers, over 85% of dentists work in general practice, and hospital dentistry [...] Read more.
In French law, the state is responsible for ensuring equal access to health care for people with disabilities. No system exists within dentistry to guarantee this—there are no salaried public service workers, over 85% of dentists work in general practice, and hospital dentistry is poorly developed. Public funding is available for care coordination initiatives termed “Health Networks”. The objective of this study is to report on an internal evaluation of the Réseau Santé Bucco-Dentaire et Handicap de la région Rhône-Alpes (RSBDH), a Health Network coordinating dentistry for persons with disability in the Rhône-Alpes region, and to discuss the French model of Health Networks as a response to improve access to care. Existing governmental guidelines for the evaluation of Networks were adapted for the RSBDH. The RSBDH coordinated dentists to ensure screening, prevention, and treatment for 3219 persons with disability in 2015. Identified strengths included the identification of vulnerable persons, improved access to treatment and collaboration with primary care services. Weaknesses included training of professionals, continuity of care, information sharing, and stakeholder participation. In 2015, the cost was €501 per patient. This model raises major issues of cost, training, equity, and quality of care within special care dentistry. This discussion is relevant to many countries where models of service provision are currently being developed. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
Article
Feasibility and Reliability of a Physical Fitness Test Battery in Individuals with Down Syndrome
Int. J. Environ. Res. Public Health 2019, 16(15), 2685; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16152685 - 27 Jul 2019
Cited by 5 | Viewed by 1749
Abstract
Background: Down syndrome (DS) is a genetic disorder that occurs because of an abnormal division between cells that results in an extra copy of chromosome 21. Some studies show that physical exercise in people with DS increases some cognitive capacities, such as memory, [...] Read more.
Background: Down syndrome (DS) is a genetic disorder that occurs because of an abnormal division between cells that results in an extra copy of chromosome 21. Some studies show that physical exercise in people with DS increases some cognitive capacities, such as memory, and improves the quality of life. Aim: The main aim of this study was to perform an analysis of the reliability and feasibility of the SAMU-Disability Fitness (DISFIT) battery in adults with DS. Methods: A cross-sectional study with a test–retest design was performed in a maximum interval of 2 weeks in 37 subjects (11 women and 26 men) aged between 21 and 58 years old with DS. Eight field-based fitness tests were proposed to assess the physical fitness (PF) of adults with DS: Body Mass Index (BMI), Waist Circumference (WC), the Timed Up and Go test (TUG), the Deep Trunk Flexibility test (DTF), the Hand Grip test (HG), the Timed Stand Test (TST), the 30-s Sit-Up (SUP) and the 6-Min Walk Test (6MWT). Results: The intra-class correlation coefficient (ICC) in all the tests was good and high (>0.80), except for the 6MWT, whose reliability was fair. Conclusion: The SAMU-DISFIT battery is a reliable and feasible physical fitness battery which has been created with the purpose of establishing tests which measure the four basic components of PF (flexibility, cardiorespiratory fitness, musculoskeletal fitness and motor fitness) in adults with DS. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Differences in Autonomy and Health-Related Quality of Life between Resilient and Non-Resilient Individuals with Mild Cognitive Impairment
Int. J. Environ. Res. Public Health 2019, 16(13), 2317; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16132317 - 30 Jun 2019
Cited by 2 | Viewed by 1343
Abstract
The dramatic increase in the number of older people with Mild Cognitive Impairment (MCI) entails a serious public health problem. MCI involves different degrees of dependence that has been previously related to a decrease in Health-Related Quality of Life (HRQoL), due to impairment [...] Read more.
The dramatic increase in the number of older people with Mild Cognitive Impairment (MCI) entails a serious public health problem. MCI involves different degrees of dependence that has been previously related to a decrease in Health-Related Quality of Life (HRQoL), due to impairment in the performance of activities of daily living. Resilient coping, as an adaptive coping style, could reduce the associated limitations derived by the characteristic deficits of MCI, and hence improve HRQoL. The principal objective of this work was to compare the level of autonomy (measured in terms of independence in the performance of basic (ADL) and instrumental (IADL) activities of daily living), and HRQoL between resilient and non-resilient individuals with MCI. The results showed a positive relationship between resilience, autonomy, and HRQoL. Hence, resilient participants exhibited higher independence in daily living activities and better HRQoL than non-resilient individuals. Mediation analyses confirmed an indirect influence of resilience on HRQoL through the mediation effect of better performance in IADLs. These findings underline the relevance of resilience as a coping style to compensate deficits in daily living in people with MCI. The inclusion of intervention programs, oriented to the promotion of resilience coping for older adults, might increase the autonomy levels in this population, improving their HRQoL. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Dementia-Related Functional Disability in Moderate to Advanced Parkinson’s Disease: Assessment Using the World Health Organization Disability Assessment Schedule 2.0
Int. J. Environ. Res. Public Health 2019, 16(12), 2230; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16122230 - 24 Jun 2019
Cited by 7 | Viewed by 1626
Abstract
Dementia is a common nonmotor condition among people with moderate or advanced Parkinson’s disease (PD). Undoubtedly, profound motor symptoms cause remarkable impairment in daily activities; however, dementia-related disabilities have not been thoroughly investigated, especially not with consideration of differences according to sex. The [...] Read more.
Dementia is a common nonmotor condition among people with moderate or advanced Parkinson’s disease (PD). Undoubtedly, profound motor symptoms cause remarkable impairment in daily activities; however, dementia-related disabilities have not been thoroughly investigated, especially not with consideration of differences according to sex. The present study used the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) to compare the functional disability between men and women with PD (PwP) with and without dementia. This study employed a registry of disability evaluation and functional assessment using the Taiwan Data Bank of Persons with Disability between July 2012 and October 2018. To investigate dementia-related disability in PwP, 1:1 matching by age and Hoehn-Yahr stage was conducted, which resulted in the inclusion of 1605 study participants in each group. The present study demonstrated that among the six major domains of WHODAS 2.0, the section of “Getting alone with others” was significantly worse in both genders of PwP with dementia; however, a greater disability in fulfilling activities of daily living was only noted in male PwP with dementia but not in their female counterparts. Neither the inability to provide self-care nor participation were significantly different between the sexes. Our findings suggested that deteriorating social relationships were a dementia-related disability in all PwP at the moderate and advanced disease stages. Regarding the performance of activities of daily living, deterioration was related to dementia only in male PwP. Such disabilities could indicate cognitive impairment in people with moderate or advanced PD and could be used as an indicator for the early detection of dementia in PwP by healthcare professionals through the easier functional assessment of the WHODAS 2.0. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Association between Ambulatory Status and Functional Disability in Elderly People with Dementia
Int. J. Environ. Res. Public Health 2019, 16(12), 2168; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16122168 - 19 Jun 2019
Cited by 3 | Viewed by 1676
Abstract
Dementia is highly comorbid with gait disturbance, and both conditions negatively impact the ability of elderly people to conduct daily living activities. The ambulatory status of older adults with dementia may cause variable functional disability, which is crucial for the progression of dementia. [...] Read more.
Dementia is highly comorbid with gait disturbance, and both conditions negatively impact the ability of elderly people to conduct daily living activities. The ambulatory status of older adults with dementia may cause variable functional disability, which is crucial for the progression of dementia. The present study investigated the association between ambulatory status with functional disability in elderly people and dementia by using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). In total, 34,040 older adults with mild-to-advanced dementia were analyzed and categorized according to their ambulatory status into three groups: Nonambulatory, assisted ambulatory, and ambulatory. In general, poor ambulatory status was associated with both greater severity of dementia and functional disability. The study participants were further segregated according to their ages and dementia severity levels, which demonstrated that the WHODAS 2.0 domains of functioning for getting along, life activities, and participation (domains 4, 5–1, and 6) were all associated with ambulatory status. In addition, nonambulatory status was significantly associated with institution residency among older adults with dementia. In conclusion, the present study clearly demonstrated the role of ambulatory status in functional disability in older adults with dementia, and the association persisted among older adults of different ages and severities of dementia. This finding indicates the importance of maintaining walking ability in the management of dementia in older adults. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Design and Development of a Mobile App for Accessible Beach Tourism Information for People with Disabilities
Int. J. Environ. Res. Public Health 2019, 16(12), 2131; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16122131 - 16 Jun 2019
Cited by 9 | Viewed by 2083
Abstract
The global increase in the proportion of the population with disabilities has caused a greater awareness toward guaranteeing their use of public services. In particular, there is emphasis on the accessibility and inclusivity of tourism resources, to improve the enjoyment and well-being for [...] Read more.
The global increase in the proportion of the population with disabilities has caused a greater awareness toward guaranteeing their use of public services. In particular, there is emphasis on the accessibility and inclusivity of tourism resources, to improve the enjoyment and well-being for people with motor disabilities. This paper presents a case study on accessibility to beaches in the Region of Murcia, Spain, which is one of the main tourist areas in the country. First, the most important elements that allow for the accessible use of beaches are analyzed and exposed in detail. Then, an extensive field-work in the area of interest has been carried out and its results are evaluated. Finally, the development of a new mobile app is described. The objective of this tool is to provide updated, accurate, and reliable accessibility information regarding the beaches. As a result, more than a third of the beaches analyzed had a high level of accessibility, while almost another third are totally inaccessible. The proposed application is a valuable tool, not only to help people with physical and motor disabilities, but also to raise awareness among local authorities to create and improve accessible services. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Maintenance and Development of Social Connection by People with Long-term Conditions: A Qualitative Study
Int. J. Environ. Res. Public Health 2019, 16(11), 1875; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16111875 - 28 May 2019
Cited by 5 | Viewed by 1600
Abstract
Social connection is important for people’s health and well-being. Social isolation arising from a lack of meaningful connection with others can result in deterioration of well-being with negative consequences for health. For people living with multiple long-term conditions, the building and maintaining of [...] Read more.
Social connection is important for people’s health and well-being. Social isolation arising from a lack of meaningful connection with others can result in deterioration of well-being with negative consequences for health. For people living with multiple long-term conditions, the building and maintaining of social connection may be challenging. The aim of this study was to explore with people with long-term conditions how they perceive they maintain and develop social connections. We undertook semi-structured interviews with seventeen adults, and analyzed the data for themes. Themes were “Meaningful connection”, “Wherewithal for social connection” and “Impact of a major change in life course”. The findings suggest that social connection is valued, and facilitates meaningful ways to reciprocate support with others, thus enabling access to knowledge and resources for better health and well-being. However, people with long-term conditions can experience challenges to developing and maintaining social connectedness after a major change in life course. We suggest that healthcare providers are well placed to facilitate ways for people with long-term conditions to socially connect with others in their neighbourhood and community, and that this in particular be attended to after a major life change. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
Article
The Prevalence of Smoking, Determinants and Chance of Psychological Problems among Smokers in an Urban Community Housing Project in Malaysia
Int. J. Environ. Res. Public Health 2019, 16(10), 1762; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16101762 - 18 May 2019
Cited by 3 | Viewed by 1480
Abstract
Objective: This study was conducted to assess the prevalence, pattern of smoking and sociodemographic factors among Kerinchi residents in Kuala Lumpur, as well as to identify the association between smoking, stress, anxiety and depression. Methods: This study was carried out at four community [...] Read more.
Objective: This study was conducted to assess the prevalence, pattern of smoking and sociodemographic factors among Kerinchi residents in Kuala Lumpur, as well as to identify the association between smoking, stress, anxiety and depression. Methods: This study was carried out at four community housing projects in the Lembah Pantai area in Kuala Lumpur. Data was collected between 3 February 2012, and 29 November 2012. Data collectors made house visits and used interviewer administered questionnaires containing questions on demographic data and smoking patterns. Depression anxiety stress scale (DASS) was used to assess psychological symptoms. Alcohol smoking and substance involvement screening tool (ASSIST) scale was used to assess nicotine use. Results: Data from 1989 individuals (833 households) showed the age of respondents ranged from 18 to 89 years and the mean age was 39.12 years. There were 316 smokers indicating the prevalence of smoking was 15.85%, with 35.5% among males and 1.8% among females. Further, 86.6% of smokers were Malay and 87% were Muslims. Divorce was associated with smoking. Unemployment and housewives were less associated with smoking. Depression and anxiety were significantly associated with smoking (OR = 1.347. 95% CI: 1.042–1.741) and (OR = 1.401. 95% CI: 1.095–1.793) respectively. Conclusion: Screening for depression and anxiety should be routinely performed in the primary care setting and in population-based health screening to intervene early in patients who smoke. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
Article
Physical Activity and Sedentary Time in Active and Non-Active Adults with Intellectual Disability: A Comparative Study
Int. J. Environ. Res. Public Health 2019, 16(10), 1761; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16101761 - 18 May 2019
Cited by 8 | Viewed by 1692
Abstract
This study describes and compares physical activity (PA) levels and sedentary time (ST) of active (AG) and a non-active (NAG) groups of adults with intellectual disability (ID) versus a group of adults without ID. Thirty-seven participants from the AG, 29 from the NAG, [...] Read more.
This study describes and compares physical activity (PA) levels and sedentary time (ST) of active (AG) and a non-active (NAG) groups of adults with intellectual disability (ID) versus a group of adults without ID. Thirty-seven participants from the AG, 29 from the NAG, and 31 adults without ID participated in this study. Height and weight were obtained to calculate body mass index (BMI). PA levels and ST were assessed with GT3X Actigraph accelerometers for 7 days. Results revealed that the AG engaged in higher values of moderate to vigorous PA compared with the NAG (all p < 0.05), but were similar to adults without ID. Adults without ID performed less ST and more light PA than the ID groups (all p < 0.05). The participants of the AG did not demonstrate less ST than the NAG. It is concerning that adults with ID (AG or NAG) are spending a higher time in ST and less time in light PA than adults without ID. Our results suggest that integrated, well-designed PA programmes into the ID population workdays can lead to increased PA levels. Nevertheless, these interventions and exercise programmes implemented for adults with ID should be tailored to also reduce ST. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Justice in Dementia Care Resource Allocation: How Should We Plan for Dementia Services?
Int. J. Environ. Res. Public Health 2019, 16(10), 1754; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16101754 - 17 May 2019
Cited by 1 | Viewed by 1109
Abstract
Dementia care resources in Taiwan have not been allocated taking into account patients’ needs and the distance between service users and providers. The objective of this study was to use two newly developed indicators; profit willing distance (PWD) and tolerance limited distance (TLD), [...] Read more.
Dementia care resources in Taiwan have not been allocated taking into account patients’ needs and the distance between service users and providers. The objective of this study was to use two newly developed indicators; profit willing distance (PWD) and tolerance limited distance (TLD), to profile the service availability and accessibility of the 22 administrative areas in Taiwan and facilitate justice-based resource allocation by the central government. The study employed secondary data analysis by using a geographic information system (GIS) and geocoding to identify distances between service users and providers. The study samples were drawn from the databank of the National Disability Eligibility Determination System and grouped by the acuteness of registrants’ needs. Both the PWD and TLD were found in 15 of the administrative areas, and neither was found in three areas (Penghu, Kinmen, and Lienchiang County). Either the PWD or TLD (but not both) were found in four areas (only have PWD: Hsinchu and Chiayi City; only have TLD: Yunlin and Taitung County). How the priorities should be set for dementia service allocation based on these findings was also addressed. We conclude that the indicators of PWD and TLD can add value to the policy decision-making process, help set priorities, and facilitate efficient and fair resource allocation by defining specifics of the resources needed. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
WHODAS 2.0 Can Predict Institutionalization among Patients with Traumatic Brain Injury
Int. J. Environ. Res. Public Health 2019, 16(9), 1484; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16091484 - 26 Apr 2019
Cited by 1 | Viewed by 1267
Abstract
Patients with traumatic brain injury (TBI) often present with disabilities associated with a high burden of care for caregivers or family members at home. When family members cannot afford to care for patients with TBI, they are often required to find them residence [...] Read more.
Patients with traumatic brain injury (TBI) often present with disabilities associated with a high burden of care for caregivers or family members at home. When family members cannot afford to care for patients with TBI, they are often required to find them residence in long-term care institutions. To date, there are no quantitative assessment tools developed to predict institutionalization. Therefore, this study analyzed the accuracy of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for predicting the institutionalization of patients with TBI. We designed a cross-sectional study using a nationwide disability database. We analyzed the data of 8630 patients with TBI with injury for more than six months from the Taiwan Data Bank of Persons with Disability during July 2012–October 2018. The demographic data and WHODAS 2.0 standardized scores of patients with TBI who resided in community and long-term care institutions were analyzed. Receiver operating characteristic curve (ROC) analysis was performed to investigate the predictive accuracy of WHODAS 2.0 for being institutionalized, and the optimal cut-off point was determined using the Youden index. Binary logistic regression was employed to determine the predictors of the participants being institutionalized. The WHODAS 2.0 scores in each domain were lower in the community group than in the institutionalized group. ROC analysis revealed the highest accuracy for the summary scores of WHODAS 2.0 (area under the curve = 0.769). Binary logistic regression revealed that age, gender, work status, urbanization level, socioeconomic status, severity of impairment, and WHODAS 2.0 domain scores were factors associated with the institutionalization status of patients with TBI. Our results suggest that WHODAS 2.0 may be a feasible assessment tool for predicting the institutionalization of patients with TBI. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
Article
Cultural Adaptation and Validation of the Inflammatory Bowel Disease Disability Index in a Spanish Population and Its Association with Sociodemographic and Clinical Factors
Int. J. Environ. Res. Public Health 2019, 16(4), 635; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16040635 - 21 Feb 2019
Cited by 2 | Viewed by 1269
Abstract
Inflammatory bowel diseases generate disability. We aimed to adapt and validate the Inflammatory Bowel Disease Disability Index in a Spanish population and to analyze the sociodemographic and clinical factors associated with disability in patients with Crohn’s disease and ulcerative colitis. Cultural adaptation and [...] Read more.
Inflammatory bowel diseases generate disability. We aimed to adapt and validate the Inflammatory Bowel Disease Disability Index in a Spanish population and to analyze the sociodemographic and clinical factors associated with disability in patients with Crohn’s disease and ulcerative colitis. Cultural adaptation and validation of psychometric properties in the index were done, along with an observational, cross-sectional, and analytical approach to determine associations with sociodemographic and clinical factors. Sociodemographic data, quality of life (using the Inflammatory Bowel Disease Questionnaire-32), and indicators of disease activity were collected, among others. A total of 170 subjects participated. The index showed high internal consistency, with a Cronbach’s alpha of 0.869 and concurrent validity with the Inflammatory Bowel Disease Questionnaire-32 (r = 0.723, p < 0.001). The average score of the index was −3.91. Greater degrees of disability were found in women (mean = −6.77) than in men (mean = −1.25) (p = 0.018), in patients with Crohn’s disease (mean = −5.94) rather than those with ulcerative colitis (mean = −0.94) (p = 0.028), and in patients in the moderately active disease phase (mean = −20.94) rather than those in the mildly active disease phase (mean = −2.65) and/or those in remission (mean = −1.40) (p < 0.001). The Disability Index is a valid tool for the Spanish population and is associated with sex, type of illness, and disease activity. It is a useful index in evaluating and monitoring disability in patients with inflammatory bowel disease. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Evaluating Successful Aging in Older People Who Participated in Computerized or Paper-and-Pencil Memory Training: The Memoria Mejor Program
Int. J. Environ. Res. Public Health 2019, 16(2), 191; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16020191 - 11 Jan 2019
Cited by 2 | Viewed by 1687
Abstract
Background. The evaluation of successful aging includes objective criteria to measure cognitive function and psychological well-being and levels of functional capacity needed to perform daily activities related to the preservation of autonomy. In addition, the emergence of computerized cognitive training programs has allowed [...] Read more.
Background. The evaluation of successful aging includes objective criteria to measure cognitive function and psychological well-being and levels of functional capacity needed to perform daily activities related to the preservation of autonomy. In addition, the emergence of computerized cognitive training programs has allowed us to use a new class of tools to verify the theoretical postulates of neural plasticity in aging. Objective. The present study investigates subjective and objective criteria of successful aging in healthy older adults participating in a memory training program offered as two versions: computer and paper-and-pencil. Method. Fifty-four healthy older adult participants recruited for the study were organized into two training groups. Group 1 (G1) used the computer program and Group 2 (G2) used the paper-and-pencil program. Results. The analysis revealed no significant differences in psychological well-being between the two training groups. However, the groups did differ significantly in objective evaluations of successful aging, as measured by attention and everyday memory, and brain activity as measured by sLORETA, with G1 outperforming G2 on both measures. Conclusion. Computerized memory training programs show promise for restoring cognitive and cerebral functioning in older adults, and consequently, may be better suited to achieving the objective criteria of successful aging than paper-and-pencil memory training programs. However, this conclusion should be taken with caution since differences in age and educational level may have influenced the results. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
“Living an Obstacle Course”: A Qualitative Study Examining the Experiences of Caregivers of Children with Rett Syndrome
Int. J. Environ. Res. Public Health 2019, 16(1), 41; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16010041 - 25 Dec 2018
Cited by 8 | Viewed by 2580
Abstract
Background: Rett syndrome has considerable effects on the quality of life of affected children, impairing everyday activities and potentially impacting the life of both the caregivers and the family. Our aim was to explore the experiences of a group of caregivers of [...] Read more.
Background: Rett syndrome has considerable effects on the quality of life of affected children, impairing everyday activities and potentially impacting the life of both the caregivers and the family. Our aim was to explore the experiences of a group of caregivers of children with Rett syndrome with regards to living and caring for their children. Methods: We conducted a qualitative case study to examine how 31 caregivers of children with Rett syndrome perceived living with their children. Data were collected through in-depth interviews, focus groups, researchers’ field notes and caregivers’ personal documents. A thematic analysis was performed following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline. Results: The experience of being a caregiver of a child with Rett syndrome was expressed as being akin to an “obstacle course”, and was described via three main themes: (a) looking for answers, with two subthemes identified, namely ‘the first symptoms’, and ‘the need for a diagnosis’; (b) managing day to day life, with the subthemes ‘applying treatments’, and ‘learning to care’; and (c) money matters. Conclusions: Rett syndrome has a considerable impact on the lives of the caregivers involved. The health-care process and the management of economic resources are some of the aspects highlighted by caregivers. These findings have important implications for the planning of support services, health systems and health policies. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
Article
A Comparison of Mercury Exposure from Seafood Consumption and Dental Amalgam Fillings in People with and without Amyotrophic Lateral Sclerosis (ALS): An International Online Case-Control Study
Int. J. Environ. Res. Public Health 2018, 15(12), 2874; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15122874 - 14 Dec 2018
Cited by 10 | Viewed by 2471
Abstract
Exposures to toxic metals such as mercury have been suggested to be risk factors for amyotrophic lateral sclerosis (ALS). Human intake of mercury commonly occurs via consumption of seafood or from mercury-containing amalgam dental restorations (‘mercury fillings’). We therefore compared mercury exposures from [...] Read more.
Exposures to toxic metals such as mercury have been suggested to be risk factors for amyotrophic lateral sclerosis (ALS). Human intake of mercury commonly occurs via consumption of seafood or from mercury-containing amalgam dental restorations (‘mercury fillings’). We therefore compared mercury exposures from these sources in 401 ALS and 452 non-ALS respondents, using an internationally-available online questionnaire that asked respondents how often they ate seafood and what their favourite types of seafoods were. Respondents were also asked to record numbers of current or former mercury fillings. ALS and non-ALS respondents did not differ in their frequency of seafood consumption or in monthly mercury intake from favourite seafoods. Both groups had similar numbers of current, as well as former, mercury fillings. In conclusion, this study found no evidence that mercury exposure from eating seafood, or from mercury dental fillings, was associated with the risk of developing ALS. Therefore, if mercury does play a role in the pathogenesis of ALS, other sources of exposure to mercury in the environment or workplace need to be considered. Alternatively, a susceptibility to mercury toxicity in ALS, such as genetic or epigenetic variations, multiple toxic metal interactions, or selenium deficiency, may be present. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Large-Scale Assessment of Function and Disability in Patients with Parkinson’s Disease Using the Functioning Disability Evaluation Scale-Adult Version
Int. J. Environ. Res. Public Health 2018, 15(12), 2788; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15122788 - 09 Dec 2018
Cited by 3 | Viewed by 1853
Abstract
This study assesses the functioning and disability related to Parkinson’s disease using the Functioning Disability Evaluation Scale-Adult Version (FUNDES-Adult), based on the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in a large-scale database; this study describes, discusses and clarifies the predictive [...] Read more.
This study assesses the functioning and disability related to Parkinson’s disease using the Functioning Disability Evaluation Scale-Adult Version (FUNDES-Adult), based on the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in a large-scale database; this study describes, discusses and clarifies the predictive factor of not being in an ambulatory status. Of 7455 patients included in this study, 3561 were not ambulatory and 3894 were ambulatory or assisted ambulatory. Patients with poor walking status revealed higher FUNDES-Adult scores in all domains. Age, modified Hoehn–Yahr stage, living in an institution and the standardized score of FUNDES-Adult domains 1 and 2 were positive independent predictors of the not ambulatory status. The FUNDES-Adult could evaluate multifaceted disability and predict the walking status in patients with Parkinson’s disease. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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Article
Association between Occupational Dysfunction and Metabolic Syndrome in Community-Dwelling Japanese Adults in a Cross-Sectional Study: Ibara Study
Int. J. Environ. Res. Public Health 2018, 15(11), 2575; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15112575 - 17 Nov 2018
Cited by 2 | Viewed by 1844
Abstract
The purpose of this study was to investigate the relationship between occupational dysfunction and metabolic syndrome (MetS) and its component factors in community-dwelling Japanese adults (N = 1,514). Self-reported lifestyle behaviors, Classification and Assessment of Occupational Dysfunction (CAOD) scores, and metabolic traits were [...] Read more.
The purpose of this study was to investigate the relationship between occupational dysfunction and metabolic syndrome (MetS) and its component factors in community-dwelling Japanese adults (N = 1,514). Self-reported lifestyle behaviors, Classification and Assessment of Occupational Dysfunction (CAOD) scores, and metabolic traits were measured. CAOD levels were divided into tertiles (low, moderate, and high), and their associations with MetS and its components were evaluated through logistic regression analysis. The association of MetS with CAOD was demonstrated in the total number of individuals [OR = 1.92 (95% CI 1.17–3.17)] and in older individuals [OR = 1.90 (95% CI 1.04–3.46)]. The association of dyslipidemia and CAOD was evident for overweight individuals [OR = 2.08 (95% CI 1.17–3.68)]. A higher association of high blood pressure with CAOD was evidenced in younger individuals [OR = 2.02 (95% CI 1.05–3.89)] who belonged to the highest-CAOD-score group in comparison to those who registered the lowest-CAOD-score group. The evaluation of MetS and interventions related to its prevention may be more effective if the viewpoint of occupational dysfunction is taken into account. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)

Review

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Review
Perspectives on Disability and Non-Communicable Diseases in Low- and Middle-Income Countries, with a Focus on Stroke and Dementia
Int. J. Environ. Res. Public Health 2019, 16(18), 3488; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16183488 - 19 Sep 2019
Cited by 12 | Viewed by 1981
Abstract
Non-communicable diseases (NCD) and disability are both common, and increasing in magnitude, as a result of population ageing and a shift in disease burden towards chronic conditions. Moreover, disability and NCDs are strongly linked in a two-way association. People living with NCDs may [...] Read more.
Non-communicable diseases (NCD) and disability are both common, and increasing in magnitude, as a result of population ageing and a shift in disease burden towards chronic conditions. Moreover, disability and NCDs are strongly linked in a two-way association. People living with NCDs may develop impairments, which can cause activity limitations and participation restriction in the absence of supportive personal and environmental factors. In other words, NCDs may lead to disabilities. At the same time, people with disabilities are more vulnerable to NCDs, because of their underlying health condition, and vulnerability to poverty and exclusion from healthcare services. NCD programmes must expand their focus beyond prevention and treatment to incorporate rehabilitation for people living with NCDs, in order to maximize their functioning and well-being. Additionally, access to healthcare needs to be improved for people with disabilities so that they can secure their right to preventive, curative and rehabilitation services. These changes may require new innovations to overcome existing gaps in healthcare capacity, such as an increasing role for mobile technology and task-sharing. This perspective paper discusses these issues, using a particular focus on stroke and dementia in order to clarify these relationships. Full article
(This article belongs to the Special Issue Disabilities, Health and Well-being)
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