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Multifaceted interventions show limited impact on community participation among adults with disabilities

GROSS, Judith
MONROE-GULICK, Amalia
DAVIDSON-GIBBS, Debbie
NYE, Chad
June 2020

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This Campbell systematic review and meta-analysis examines the impact of multifaceted interventions on community participation outcomes for adults with disabilities, and aims to find effective components of the interventions. The review summarizes the findings from 15 reports of multifaceted interventions in five countries (USA, China, Germany, Italy, Australia) with the majority from USA (10).

Included studies employ at least two interventions designed to address two or more participant characteristics (e.g., skill enhancement, behavior/attitude change) and/or environmental characteristics (e.g., participant interactions with people, places, or things) resulting in outcomes that provide direct access to the community (e.g., competitive employment, adult learning, housing) or are a dimension of community participation (e.g., self-determination, quality of life, social networking).

A total of 15 studies using a multifaceted intervention were included in this review. Of these, nine were randomized and six were quasi-experimental. Study participants were adults, 18 years or older, with a disability, who had exited secondary school services. Participants identified as having the following disabilities: intellectual disability, mental illness, traumatic brain injury, aging-related disabilities (e.g., dementia, Alzheimer’s, reduction in activities of daily living), or combinations of two or more classifications.

 

Campbell Systematic Reviews. 2020;16:e1092.

https://doi.org/10.1002/cl2.1092

Delivering trauma and rehabilitation interventions to women and children in conflict settings: a systematic review

JAIN, Reena P
METEKE, Sarah
GAFFEY, Michelle F
et al
May 2020

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In recent years, more than 120 million people each year have needed urgent humanitarian assistance and protection. Armed conflict has profoundly negative consequences in communities. Destruction of civilian infrastructure impacts access to basic health services and complicates widespread emergency responses. The number of conflicts occurring is increasing, lasting longer and affecting more people today than a decade ago. The number of children living in conflict zones has been steadily increasing since the year 2000, increasing the need for health services and resources. This review systematically synthesised the indexed and grey literature reporting on the delivery of trauma and rehabilitation interventions for conflict-affected populations.

A systematic search of literature published from 1 January 1990 to 31 March 2018 was conducted across several databases. Eligible publications reported on women and children in low and middle-income countries. Included publications provided information on the delivery of interventions for trauma, sustained injuries or rehabilitation in conflict-affected populations. A total of 81 publications met the inclusion criteria, and were included in the review.

 

BMJ Global Health 2020;5:e001980

http://dx.doi.org/10.1136/bmjgh-2019-001980

Interventions for anxiety in mainstream school-aged children with autism spectrum disorder (ASD)

HILLMAN, Kylie
DIX, Katherine
AHMAD, Kashfee
LIETZ, Petra
TREVITT, Jenny
ULJAREVIC, Mirko
VIVANTE, Giacomo
HEDLEY, Darren
May 2020

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Anxiety is a common problem in school-aged children with autism spectrum disorder (ASD). Cognitive behavioural therapy (CBT) and other psychosocial interventions have been developed as alternatives to pharmacological intervention to treat anxiety in students with ASD.

 

This Campbell systematic review examines the effects of interventions for reducing anxiety in school-aged children with autism spectrum disorder, compared to treatment-as-usual. The review summarises evidence from 24 studies using an experimental or quasi-experimental design.

 

Twenty-four studies, involving 931 school-aged children with ASD (without co-occurring intellectual disability) and clinical anxiety, are summarised in this review. The studies were experimental or quasi-experimental control-treatment trials, deemed to be of sufficient methodological quality and with reduced risk of bias. Studies spanned the period 2005 to 2018 and were mostly carried out in Australia, the UK and the USA.

Examined interventions ranged across clinical, school-based, or home-based settings, with group or individual treatment formats. Twenty-two of the studies used a CBT intervention. One study used peer-mediated theatre therapy and one study examined the benefits of Thai traditional massage for reducing anxiety. Most interventions involved parents/caregivers and were conducted face-to-face.

 

Campbell Systematic Reviews, Volume16, Issue2, June 2020, e1086

 
https://doi.org/10.1002/cl2.1086

 

Coronavirus (COVID-19): Evidence Collection

EVIDENCE AID
2020

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The COVID-19 (Coronavirus) pandemic is leading to a rapidly expanding and evolving literature. Evidence Aid is preparing summaries of relevant research, which are available below in English with links to translations in other languages. 

 

  • Clinical characterization and management
  • Epidemiology
  • Ethical considerations
  • Health systems and services
  • Infection prevention and control, including health care workers’ protection
  • Public health interventions
  • Research & Development: Therapeutics and Vaccines
  • Social science in the response

Systematic review of interventions for reducing stigma experienced by children with disabilities and their families in low and middle-income countries: state of the evidence.

SMYTHE, Tracey
ADELSON, Jaimie
POLACK, Sarah
March 2020

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A literature review was carried out to identify and assess the evidence for interventions to reduce stigma experienced by children with disabilities and their families in low and middle-income settings. A systematic review of seven databases (MEDLINE, EMBASE, Global Health, PsycINFO, Social Policy and Practice, CINAHL, IBSS) for articles published January 2000 to April 2018 was carried out. Data were extracted on study population, study design, intervention level(s) and target group, and type(s) of stigma addressed. A narrative approach was used to synthesise the results.

Twenty studies were included. The majority (65%) of interventions targeted enacted stigma (negative attitudes) and the most common intervention approach was education/training (63%). Over half (54%) of interventions were delivered at the organisational/ institutional level and only four studies targeted more than one social level. The most common disability targeted was epilepsy (50%) followed by intellectual impairment (20%). 

doi: 10.1111/tmi.13388

Trop Med Int Health. 2020 Mar

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

BROOKS, Samantha K
WEBSTER, Rebecca K
SMITH, Louise E
WOODLAND, Lisa
WESSELY, Simon
GREENBERG, Neil
RUBIN, Gideon James
March 2020

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The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

 

RAPID REVIEW VOLUME 395, ISSUE 10227, P912-920, MARCH 14, 2020

DOI:https://doi.org/10.1016/S0140-6736(20)30460-8

Accelerating Disability Inclusive Formal Employment in Bangladesh, Kenya, Nigeria, and Uganda: What are the Vital Ingredients?

WICKENDEN, Mary
THOMPSON, Stephen
MADER, Philip
BROWN, Simon
ROHWERDER, Brigitte
March 2020

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This Working Paper provides an overview of disability as a concept and relevant global treaties and statistics, including evidence of trends and complexities in promoting disability inclusive employment broadly and with some focus on formal employment specifically. We describe the current situation in each of the four focus countries, demonstrating the similarities and differences between them. We then discuss some promising interventions that have been tried, usually on a small scale, in diverse settings, and which may be applicable in our four focus countries (Bangladesh, Kenya, Nigeria, and Uganda). Finally, we present the potential interventions that will be trialled in the Inclusion Works programme, using an innovation-driven, adaptive management approach.

 

The Inclusion Works programme (2018–2022), funded by the UK Department for International Development, aims to improve employment rates for people with disabilities in Bangladesh, Kenya, Nigeria, and Uganda. 

 

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium.

Being differently abled: Disability through the lens of hierarchy of binaries and Bitso-lebe-ke Seromo

LESHOTA, Paul L
SEFOTHO, Maximus M
February 2020

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Background: Despite its acceptability, the term disability has not been able to shirk the sense of incompleteness, lack, deprivation and incapacitation embodied in the prefix ‘dis-’. The current wave of anti-discrimination on disability issues, calls for constant re-examination of the language and the appellations we use in respect of people with disabilities.

 

Objectives: The aim of this study is to subject the term disability to some relevancy litmus test with a view to prevent it from acquiring Lyotard’s ‘grand narrative’ and to propose and argue for the term ‘differently abled’ because of its transformative and anti-discriminatory slant.

 

Method: The study took the form of a literature review using the optic of Derrida’s hierarchy of binaries and the Sesotho proverb, ‘Bitso-lebe-ke seromo’, (A bad name is ominous) to explore the connotations of the term disability as a disenfranchising social construct.

 

Results: Read through the lens of Derrida’s idea of difference, disability as a concept has no inherent meaning and its meaning derives from its being differentiated from other concepts. Viewed through the lens of Bitso-lebe-ke seromo and read in the context of its deep symbolical significance, the term disability holds immense spiritual power.

 

Conclusion: The study concludes that the term disability or disabled is exclusionary, stigmatizing, and anti-transformational. As such it embodies imperfection, incapacitation and inferiority. Not only is it ominous, it places upon people with disability the perpetual mark of unattractiveness. Against this background the term differently abled seems to convey more empowering overtones than the term disability.

 

 

African Journal of Disability, Vol 9, 2020 

Marriages among people with disabilities in 19th-century Sweden: marital age and spouse’s characteristics

VIKSTRÖM, Lotta
HAAGE, Helena
HÄGGSTRÖM LUNDEVALLER, Erling
2020

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While marrying was an expected event in 19th-century Western society and has been subject to much historical research, there are few studies on how disabilities influenced people’s marriage patterns and spouse selection. The aim of this analysis is to contribute clarification on this issue by examining with whom disabled men and women married and the marital age and socio-demographic characteristics of them and their spouses. In total, 188 disabled individuals born in the first half of the 19th century and who married in the Sundsvall region, Sweden, are studied. The results reveal that disabled men and women did not marry each other, and they entered into marriage at a slightly higher age than the average, although there was usually no marked age gap between them and their spouse. Endogamous patterns were primarily found regarding the socio-spatial background of the two spouses. This analysis is one of the few studies identifying the mar- riages among a comparatively large number of disabled people using demographic data. Their participation in the partner pool highlight their agency historically and emphasize that disability did not lead to distance from social life in past society.

 

 

Evidence and gap map of studies assessing the effectiveness of interventions for people with disabilities in low‐and middle‐income countries

SARAN, Ashrita
WHITE, Howard
KUPER, Hannah
January 2020

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The aim of this Evidence Gap Map (EGM) is to identify, map and describe existing evidence of effectiveness studies and highlight gaps in evidence base for people with disabilities in LMICs. The map helps identify priority evidence gaps for systematic reviews and impact evaluations. The EGM included impact evaluation and systematic reviews assessing the effect of interventions for people with disabilities and their families/carers. These interventions were categorized across the five components of community‐based rehabilitation matrix; health, education, livelihood, social and empowerment. Included studies were published from 2000 onwards until January 2018. The map includes 166 studies, of which 59 are systematic reviews and 107 impact evaluation

 

Campbell Systematic Reviews, vol.16, no.1, Mar 2020

DOI: 10.1002/cl2.1070

Decolonising inclusive education: an example from a research in Colombia

KAMENOPOULOU, Leda
2020

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Inclusive education is a concept born in the global North. Research has shown that its relatively recent but widespread adoption by countries in the global South is often done without consideration of the actual needs of these contexts, and by solely focusing on strategies for learners with disabilities. As a result, inclusive education has been criticised as a neo-colonial project in need of renovation. The aim of this article is to show how research can broaden the understanding of inclusive education and make it more relevant to southern contexts. Drawing on an ethnographic research on inclusive education in Colombia, I present some unique examples of vulnerability, but also experiences of belonging in the direst of circumstances. I conclude that in order to decolonise the concept of inclusive education and make its practice sustainable in southern contexts, we need more culturally sensitive research to inform our understanding of these under-researched spaces.

 

Disability & the Global South (DGS), 2020, Vol. 7 No. 1

At the Margins of Society: Disability Rights and Inclusion in 1980s Singapore

ZHUANG, Kuansong Victor
2020

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A new era focused on the inclusion of disabled people in society has emerged in recent years around the world. The emergence of this particular discourse of inclusion can be traced to the 1980s, when disabled people worldwide gathered in Singapore to form Disabled Peoples’ International (DPI) and adopted a language of the social model of disability to challenge their exclusion in society. This paper examines the responses of disabled people in Singapore in the decade in and around the formation of DPI. As the social model and disability rights took hold in Singapore, disabled people in Singapore began to advocate for their equal participation in society. In mapping some of the contestations in the 1980s, I expose the logics prevailing in society and how disabled people in Singapore argued for their inclusion in society as well as its implications for our understanding of inclusion in Singapore today.

 

Disability & the Global South (DGS), 2020, Vol. 7 No. 1

Universal Notions of Development and Disability: Towards Whose Imagined Vision?

RAO, Shridevi
KALYANPUR, Maya
2020

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This paper addresses the epistemological dissonance created by the growing movement to impose universal templates of disability and disability-related practices to countries in the Global South and the subsequent erasure of indigenous understandings of disability. Underlying this dissonance, we argue, are the deeply problematic beliefs in universal notions of disability and global development that are anchored to colonial frameworks of understanding and approaching human differences. We explore the presence of these colonial frameworks in three specific areas: the language of disability; understandings of personhood; and notions of inclusivity. We propose that bringing about transformation in these areas would mean using alternative indigenous strengthsbased frameworks of thinking and practices that uncover and value local epistemologies, understanding the complexities of local cultural, historical, and material contexts, and resisting colonial modes of thinking that label these practices as backward.

 

Disability & the Global South (DGS), 2020, Vol. 7 No. 1

Disability, mobility and transport in Low- and Middle-Income Countries: A thematic review

KETT, Maria
COLE, Ellie
TURNER, Jeff
January 2020

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This paper discusses issues affecting the transport and mobility needs of people with disabilities in middle- and low-income countries and how disability intersects with a range of other factors to impact on transport needs, use and engagement. The paper is intended to stimulate discussion and identify areas for further research, and identifies a number of key issues that are salient to discussions around equitable and inclusive transport provision, including patterns of transport use, behaviour and experiences, solutions and policy directions, measuring access and inclusion, policies and intersectionality. The paper also identifies gaps in knowledge and provision, barriers to addressing these gaps, and some possible solutions to overcoming these barriers. These include shifting the focus from access to inclusion, reconceptualising how ‘special’ transport might be provided, and most importantly listening to the voices and experiences of adults and children with disabilities. Despite lack of transport often being cited as a reason for lack of inclusion of people with disabilities, there is surprisingly little evidence which either quantifies this or translates what this lack of access means to people with disabilities in their daily lives in low- and middle-income countries.

 

Sustainability 2020, 12(2), 589

https://doi.org/10.3390/su12020589

Impact of Exercise Training on Depression among People with Type 2 Diabetes Mellitus: A Narrative Review

KUTTY, N.A.M
PILLAI, D.R
2020

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Purpose: The prevalence of clinically relevant depressive symptoms among clients with Type 2 diabetes mellitus is in the range of 30%. Since these conditions are often under-diagnosed and under-treated in clinical practice, they negatively affect functional recovery, adherence to treatment, and the quality of life. Despite the large body of evidence regarding the effects of exercise training on different aspects of diabetes, no updated conclusive article that reviews depression is available. This article aims to review the current literature on exercise training and its effect on depression in people with Type 2 diabetes mellitus.

 

Method: An electronic search of literature from 2010, highlighting the effects of exercise on depression among Type 2 diabetes mellitus clients, was conducted using Google Scholar and PubMed.  Relevant articles were utilised for this review.  The selected studies are based on relational and rehabilitative exercise training approaches.

 

Results: While most of the studies support the efficacy of exercise training, study settings and described models are not conclusive.  No single clearly defined model exists for exercise training for depression among people with diabetes. There is evidence for the efficacy of supervised aerobic exercise in the treatment of depression, when undertaken three times weekly at moderate intensity, for a minimum of eight weeks. Further research is required to develop specific exercise training models that can be tested in experimental studies for this client group.

 

Conclusion: The current review showed that exercise training can be used to alleviate depression among people with diabetes. Future studies should adopt rigorous methodological criteria to back up the present findings.

The impact of disability on partnership formation in Sweden during 1990-2009

NAMATOVU, Fredinah
HÄGGSTRÖM LUNDEVALLER, Erling
VIKSTRÖM, Lotta
2019

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Evidence suggests that disability negatively affects people’s propen- sity to find a partner. Persons with disabilities that eventually find a partner do so later in life compared to the average population. There is a lack of studies on the differences in partnership opportu- nities for persons with disabilities compared to those without dis- abilities in Sweden. The aim of this study is to assess the impact of disability on partnership formation and to assess whether partner- ship formation varies as a function of individual demographic and socio-economic factors. We use nationwide data available in the Swedish Initiative for Research on Microdata in Social and Medical Sciences (Umeå SIMSAM Lab). We follow persons born from 1973 to 1977 when they were from 16 to 37 years of age and analyze their data using logistic regression. Our findings indicate that regardless of whether a person started to receive a disability pension at an early age or later, it was associated with lower odds for partnership forma- tion. For persons who started receiving disability pension from 16 to 20 years of age, chances for partnership formation reduced with increase in age of partnership. Individuals that started to receive disability pension later were more likely to form partnership prior to receiving disability pension. Partnership formation was less likely among persons born outside Sweden, in persons with mothers born outside Sweden, in individuals born by unmarried mothers and in persons, whose mothers had a high level of education. Partnership was high among women and among persons who had many mater- nal siblings. In conclusion, receiving disability pension was associated with reduced chances for partnership formation. Receiving disability pension might imply financial constraints that negatively influence partnership formation supporting Oppenheimer’s theory on the eco- nomic cost of marriage and the uncertainty hypothesis.

Even we are important: Sexuality and the degenderisation of people with disabilities in the linguistic landscapes of two South African universities in the Western Cape province

ADEKUNLE, Temitope O.
MHETA, Gift
RAPEANE-MATHONSI, Maleshoane
November 2019

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Background: This study focuses on the positioning of gender, sexual orientation and people with disabilities in the linguistic landscapes of two selected South African universities, which are located in the Western Cape province.

 

Objectives: This study aims to answer the question: How are power relations depicted through linguistic landscaping in the universities?

 

Methods: Given that there is minimal empirical data in this field, the researcher approached this question by exploring the way in which sexual orientation and people with disabilities are perceived, via the modal resources used in the categorisation of toilet users at the institutions. Specifically, toilet signage was observed as there were only a few other signage or forms of support (such as ramps and lifts – some of which may seem disability-unfriendly in terms of space) and acknowledgement in other places at the institutions for people with disabilities. Data (signs, images, texts, billboards and posters) were collected by means of photography. The interpretive paradigm was used to determine the choice of methodology: critical discourse analysis and multimodality. These were also used to thematically analyse the collected data.

 

Results: Findings revealed that sexuality, as well as subtle inequality, unfortunately remain unravelled areas in South Africa’s higher institutions of learning. In addition, the degenderisation of people with disabilities appears to be prevalent at the institutions, although this may not necessarily be reflective of practices at all higher education institutions in South Africa.

 

Conclusion: Nonetheless, the examined results are stimulating indicators of hegemonic and preferred practices in public places. They also depict the obtainable dissimilar scales and imbalances in society, which are not addressed may impede other authentic and ongoing measures of social integration and advancement.

 

 

African Journal of Disability, Vol 8, 2019

Exploring barriers to physical activity of patients at the internal medicine and surgical wards: a retrospective analysis of continuously collected data

KOENDERS, Niek
WEENK, Mariska
VAN DE BELT, Tom H
VAN GOOR, Harry
HOOGEBOOM, Thomas J
BREDIE, Sebastian J H
November 2019

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Purpose: To analyse physical activity of patients during their hospital stay and to explore the relationship between physical activity and barriers to physical activity.

 

Methods: This was a secondary analysis of physical activity data for patients admitted to the internal medicine and surgical wards. Physical activity data, collected with a wireless patch sensor, was operationalized as time spent lying, sitting/standing, and walking. Barriers to physical activity included patients’ pain levels, the use of urinary catheters, intravenous tubing, oxygen lines, drains, and level of dependence. Regression analysis explored the relationship between physical activity and barriers to physical activity.

 

Results: Physical activity data were collected in 39 patients (aged 27–88, mean 54 years) during hospital stay. Patients were admitted for a median of 10 d (interquartile range [IQR]: 7–15 d). These patients were lying for a median of 12.1 h (7.6–17.7), sitting/standing 11.8 h (6.3–15.7), and walking 0.1 h (0–0.3) per day. Time lying during the day related to pain levels (β = 0.4 h per unit increase in pain, p < 0.01) and drain use (β = 3.1 h, p < 0.01).

 

Conclusions: Patients spent the most time during the hospital stay lying in bed. Improved pain management and decreased drain use may be worth exploring to increase inpatient physical activity.

Disability inclusion in shelter and settlements programming

PEARCE, Emma
et al
October 2019

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The Global Shelter Cluster (GSC) Working Group on Inclusion of Persons with Disabilities in Shelter Programming was set up to build on existing guidelines and work addressing vulnerability factors to integrate a wider and more systematic disability inclusive approach to shelter and settlements programming, as well as support more general inclusion mainstreaming as prioritized by the GSC Strategy 2018 – 2022. To begin this process, the Working Group undertook a Baseline Mapping of how disability mainstreaming and inclusion is currently addressed within the sector. The Baseline Mapping included review of published literature and project documents, key informant interviews and an online questionnaire.

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