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Association between social factors and performance during Functional Capacity Evaluations: a systematic review

ANSUATEGUI ECHEITA, Jone
VAN HOLLAND, Berry J
GROSS, Douglas P
KOOL, Jan
OESCH, Peter
TRIPPOLINI, Maurizio
RENEMAN, Michiel F
March 2018

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Purpose: Determine the association of different social factors with Functional Capacity Evaluation (FCE) performance in adults.

 

Materials and methods: A systematic literature search was performed in MEDLINE, CINAHL, and PsycINFO electronic databases. Studies were eligible if they studied social factor’s association with the performance of adults undergoing FCE. Studies were assessed on methodological quality and quality of evidence. The review was performed using best-evidence synthesis methods.

 

Results: Thirteen studies were eligible and 11 social factors were studied. Considerable heterogeneity regarding measurements, populations, and methods existed among the studies. High quality of evidence was found for the association of FCE performance with the country of FCE and examiner’s fear behavior; moderate quality of evidence with previous job salary; and low or very low quality of evidence with compensation status, litigation status, type of instruction, time of day (workday), primary or mother language, and ethnicity. Other social factors were not studied.

 

Conclusions: Evidence for associations of various social factors with FCE performance was found, but robust conclusions about the strength of the associations cannot be made. Quality of evidence ranged from high to very low. Further research on social factors, also within a biopsychosocial context, is necessary to provide a better understanding of FCE performance.

Addressing the rising prevalence of hearing loss

WORLD HEALTH ORGANISATION (WHO)
February 2018

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Hearing loss is the fourth highest cause of disability globally, with an estimated annual cost of over 750 billion dollars. These facts are well known and have contributed to growing global consciousness on the need for accessible hearing care in all regions of the world. Looking forward however, the demand for hearing care is likely to grow significantly in coming decades. This report highlights the potential escalation of hearing loss to the middle of the century, and focusses on the factors responsible for hearing loss and the means to address them. 

WHO estimates in 2008 found that 360 million people worldwide live with disabling hearing loss, including 32 million children and 180 million older adults. The most recent estimations place this figure at over 466 million people with disabling hearing loss in 2018. The main areas of the world affected by disabling hearing loss are the South Asian, Asia Pacific and Sub-Saharan African regions, with a prevalence rate almost four times that of the high income regions.

 

Measures to address these concerns deal with: prevention of infections in mothers and babies; chronic ear infections; noise exposure; and ototoxic hearing loss.

 

Public health aspects are highlighted. 

Challenges in global Indigenous–Disability comparative research, or, why nation-state political histories matter

SOLDATIC, Karen
MELBOE, Line
KERMIT, Patrick
SOMERS, Kelly
2018

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Globally, Indigenous people, also known as First Peoples, have the poorest health outcomes of all population groups, resulting in significantly higher rates of chronic disease, ill-health, and disability. Recent research strongly suggests that Australian First Peoples and the Sami peoples of the Nordic region are positioned at opposite ends of the disability–health spectrum. Australia’s First Peoples, now experience the highest rates of disability in the nation’s recorded history, despite the significant government investment over recent decades in national Indigenous policy. Yet, Nordic Indigenous populations appear to have similar health outcomes and living conditions as the rest of the population in the region. In this paper, we compare some of the global assumptions of the two leading countries of the United Nations Human Development Index– Norway (ranked first) and Australia (ranked second)– and examine the ways in which such rankings act to hide the disparities of life trajectories and outcomes for Indigenous persons living with disability compared to the rest of the population in each country. The findings of the comparative analysis illustrate core areas for consideration when undertaking in-depth comparative research with First Nation’s peoples. This includes issues surrounding the differentiated political significance of national population data systems for local Indigenous peoples in their struggles for recognition, and the nuanced processes of population data categorisation that are developed as a result of First Nation’s localised struggles for recognition, respect and rights under processes of European colonisation.

 

Disability and the Global South, 2018, Vol.5, No. 2

Global AgeWatch Insights. The right to health for older people, the right to be counted

ALBONE, Rachel
et al
2018

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This report considers the progress being made to achieve older people's right to health amid the global drive towards universal health coverage. It explores how older people are currently accessing health services and what changes need to be made to improve on this. It considers the role of data in driving and informing changes to health systems and the services they deliver. Data must be collected with and about older people to ensure adequate evidence for service design and delivery that is targeted and appropriate. This report explores the adequacy of current data systems and collection mechanisms and how, alongside health systems, they must be adapted in an ageing world. 

 

This report is supported by 12 country profiles (for Argentina, Colombia, El Salvador, Kenya, Lebanon, Moldova, Myanmar, Pakistan, Serbia, Tanzania, Vietnam and Zimbabwe; see Appendix 1). These provide national information on trends in the physical and mental health status of older people, and population-level information on access to UHC. The profiles are supplemented by data mapping, showing the national data available on older people’s health in the 12 profile countries, and revealing the data gaps. The data mapping results are available at www.GlobalAgeWatch.org.

Measuring Disability and Inclusion in relation to the 2030 Agenda on Sustainable Development

MADANS, Jennifer
LOEB, Mitchell
EIDE, Arne H
2017

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This paper explores the development of disability measures for use in censuses and surveys that can serve to monitor the UN Convention on the Rights of Persons with Disability (UNCRPD) and to disaggregate indicators identified through the 2030 Agenda on Sustainable Development and implementing the Sustainable Development Goals (SDGs). The need for data to implement policies and the challenges to the collection of valid and reliable disability data are presented, and the work of the Washington Group on Disability Statistics (WG) is provided as a means to the collection of internationally comparable disability data. By standardizing data collection instruments used to identify the population with disabilities it will be possible to provide comparable data cross-nationally for populations living in a variety of cultures with varying economic resources. The resulting data can be used to assess a country’s compliance with the UN Convention and the 2030 Agenda for Sustainable Development and, over time, monitor their improvement in meeting the established requirements.

 

Disability & the Global South (DGS), 2017, Vol. 4 No. 1

Concurrent Validity of Mobility Disability Scale among Community-dwelling Individuals

Manikandan, Natarajan
Kumar, K B
Rajashekhar, B
2016

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Purpose: A new Mobility Disability Scale (MDS) has been developed to assess the level of mobility disability among community-dwelling individuals. For it to be used effectively, a systematic evaluation of the psychometric properties isrequired. This study was conducted to determine the concurrent validity of the MDS among community-dwelling individuals, as compared to the Functional Independence Measure (FIM) and Functional Assessment Measure (FAM).

 

Method: Based on the survey of a semi-urban community, purposive sampling was used to select 52 individuals with mobility disability. All of them were evaluated using MDS and FIM FAM scales at the same time. Spearman’s Rankcorrelation coefficient was used to analyse the correlation of MDS scores with the FIM FAM scale scores.

 

Results: MDS scores had statistically significant negative correlation with FIM FAM total scale scores (r= -0.711) and the correlation was stronger when analysed with the mobility components of FIM FAM scales (r= -0.724).

 

Conclusion: The MDS possesses moderate concurrent validity with an existing functional scale. This indicates that it may be a suitable tool to quantify the level of mobility disability in persons with disability living in community.

 

Limitation: The psychosocial domain, though important, could not be compared with any gold standard measures due to unavailability of suitable scales.

Rapid assessment of disability in the Philippines: understanding prevalence, well-being, and access to the community for people with disabilities to inform the W-DARE project

MARELLA, Manjula
DEVINE, Alexandra
ARMECIN, Graeme
et al
August 2016

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The aim of this study was to estimate the prevalence of disability and compare the well-being and access to the community between people with and without disabilities. A population-based survey was undertaken in District 2 of Quezon City and in Ligao City. 60 clusters of 50 people aged 18 years and older were selected with probability proportion to size sampling from both locations. The Rapid Assessment of Disability (RAD) survey was used to identify people with disabilities based on their responses to activity limitations. The levels of well-being and access to the community for people with disabilities were compared with controls matched by age, gender, and cluster. Information on barriers to accessing the community was also collected.

Popul Health Metrics 14, 26 (2016)

DOI 10.1186/s12963-016-0096-y

Prevalence of Physical Disability among Urban Community-dwelling Adults in Sri Lanka

Weerasinghe, Inoka E
Fonseka, P
Dharmaratne, S D
Jayatilake, J A M S
2015

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Purpose: Assessment of physical disability at the community level is essential for rehabilitation and supply of services. This study aimed to assess the prevalence of physical disability among adults in an urban community in Sri Lanka.

 

Methods: A descriptive cross-sectional study was conducted among 2460 adults (18 -59 years of age) who were selected using cluster sampling. Physical disability was measured using a Physical Impairment Examination Tool (PIET) and World Health Organisation Disability Assessment Schedule II (WHODAS II).

 

Results: Prevalence of physical disability was 4.2% (95% CI= 3.5-5.1). Physical disability was higher among people in the age group of 40-59 years (6.5%, n=64) than among those in the age group of 18-39 years (2.6%, n=39) (P<0.05). Physical disability was more prevalent among females (4.4%, 95% CI= 4.2-4.6) than males (2.6%, 95% CI: 2.4-2.8), and among Tamils (7.8%, 95% CI=5.1%- 10.5%) than Sinhalese (3.3%, 95% CI=2.4%- 4.1%). It was higher among those who were divorced/widowed (58.3%, 95% CI=30.4- 86.2) than among married people (3.6%, 95% CI=2.8- 4.4). The prevalence of physical disability was 7.1% (95% CI=4.6- 9.5) among people with primary education, 4.5% (95% CI=3.4- 5.6) among those with secondary education, and 1.8% (95% CI=0.8- 2.8) among those with tertiary education. It was higher among the unemployed (7.2%, 95% CI=5.7-8.7) than the employed (1.8%, 95% CI=1.1-2.5). Age, gender, ethnicity, marital status, education levels and employment status were significantly associated with physical disability. 

 

Conclusions: Though the prevalence of physical disability appears to be higher among Sri Lankan adults than among people in developed countries, it is less than among people in other South-East Asian countries. Associations with socio-demographic variables were consistent with other studies.

The relationship between HIV and prevalence of disabilities in sub-Saharan Africa : systematic review

BANKS, Lena Morgon
ZUURMOND, Maria
FERRAND, Rashida
KUPER, Hannah
January 2015

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Objective: To systematically review evidence on the prevalence and risk of disabilities among children and adults living with HIV in sub-Saharan Africa.

 

Methods: Articles were identified from 1980 to June 2013 through searching seven electronic databases. Epidemiological studies conducted in sub-Saharan Africa that explored the association between HIV status and general disability or specific impairments, with or without an HIVuninfected comparison group, were eligible for inclusion.

 

Results: Of 12 867 records initially identified, 61 papers were deemed eligible for inclusion. The prevalence of disability was high across age groups, impairment types and study locations. Furthermore, 73% of studies using an HIV- comparator found significantly lower levels of functioning in people living with HIV (PLHIV). By disability type, the results were as follows: (i) for studies measuring physical impairments (n = 14), median prevalence of limitations in mobility and motor function among PLHIV was 25.0% (95% CI: 21.8–28.2%). Five of eight comparator studies found significantly reduced functioning among PLHIV; for arthritis, two of three studies which used an HIV- comparison group found significantly increased prevalence among PLHIV; (ii) for sensory impairment studies (n = 17), median prevalence of visual impairment was 11.2% (95%CI: 9.5– 13.1%) and hearing impairment was 24.1% (95%CI: 19.2–29.0%) in PLHIV. Significantly increased prevalence among PLHIV was found in one of four (vision) and three of three studies (hearing) with comparators; (iii) for cognitive impairment in adults (n = 30), median prevalence for dementia was 25.3% (95% CI: 22.0–28.6%) and 40.9% (95% CI: 37.7–44.1%) for general cognitive impairment. Across all types of cognitive impairment, twelve of fourteen studies found a significant detrimental effect of HIV infection; (iv) for developmental delay in children with HIV (n = 20), median prevalence of motor delay was 67.7% (95% CI: 62.2–73.2%). All nine studies that included a comparator found a significant difference between PLHIV and controls; for cognitive development and global delay, a significant detrimental effect of HIV was found in five of six and one of two studies, respectively. In the nine cohort studies comparing vertically infected and uninfected children, eight showed a significant gap in development over time in children with HIV. Finally, fifteen of thirty-one (48%) studies found a statistically significant dose–response relationship between indicators of disease progression (CD4 or WHO stage) and disability.

 

Conclusions: HIV is widespread in sub-Saharan Africa and the evidence suggests that it is linked to disabilities, affecting a range of body structures and functions. More research is needed to better understand the implications of HIV-related disability for individuals, their families as well as those working in the fields of disability and HIV so that appropriate interventions can be developed.

The Telengana disability study : India

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This report presents the findings of a study that developed and tested a best-practice population-based survey methodology to estimate the prevalence of disability in children and adults in India, and compared the extent to which people with and without disabilities access key mainstream services and opportunities including health, education and livelihoods in Telengana State, India

The Telengana disability study : summary report

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This report presents a summary of the findings of a study that developed and tested a best-practice population-based survey methodology to estimate the prevalence of disability in children and adults in India, and compared the extent to which people with and without disabilities access key mainstream services and opportunities including health, education and livelihoods in Telengana State, India

The north west Cameroon disability study

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This report presents the findings of a study that developed and tested a best-practice population-based survey methodology to estimate the prevalence of disability in children and adults in Cameroon, and compared the extent to which people with and without disabilities access key mainstream services and opportunities including health, education and livelihoods in north west Cameroon

The north west Cameroon disability study : summary report

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This report presents a summary of the findings of a study that developed and tested a best-practice population-based survey methodology to estimate the prevalence of disability in children and adults in Cameroon, and compared the extent to which people with and without disabilities access key mainstream services and opportunities including health, education and livelihoods in north west Cameroon

Predictors of voluntary HIV counselling and testing services utilization among people with disabilities in Addis Ababa, Ethiopia

ADEREMI, Toyin Janet
et al
June 2014

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“The study investigated HIV testing prevalence and factors associated with the utilization of voluntary HIV counselling and testing (VCT) services among individuals with disabilities in Addis Ababa. The analysis was based on a survey of 209 men and 203 women with disabilities, aged 15–49, who had ever heard about HIV and AIDS in four sub-cities in Addis Ababa. HIV testing prevalence was 53.2%, with no significant difference between males and females. Comprehensive HIV knowledge, living with spouse, and religious affiliations positively predicted utilization of VCT services among participants. Living with both parents and having physical or mental/intellectual disabilities were negative predictors of VCT services utilization. More research on the predictors of utilization of VCT services by gender and urban/rural divides are needed among people with disabilities”

AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, Vol 26, Issue 10

Youth with disabilities: Working Paper 23

GROCE, Nora
KETT, Maria
April 2014

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Of all groups of youth, the group about which we know the least are youth with disabilities. In transition between childhood and adulthood, these are the years when all young people go through physical and psychological maturation, are expected to complete their education, acquire skills and assume a social identity that will enable them to fully participate in their communities and societies. This working paper discusses the issues faced by young people with disabilities and what is known and not known about this distinct age group

Working Paper 23

 

The state of the world's children 2014 in numbers : every child counts

UNITED NATIONS CHILDREN’S FUND (UNICEF)
January 2014

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This report highlights the critical role data and monitoring play in realising children’s rights. It presents an updated compendium of statistics and data (which has been produced thirty years after the initial report) relating to the position of children throughout the world but particularly within the Global South. The data indicators cover a vast range: from demography, health and education, to rate of progression, child mortality, and disparities by household wealth. It emphasises that credible data, disseminated effectively and used correctly, make change possible to target interventions that help right the wrong of exclusion by identifying needs, supporting advocacy, gauging progress and holding duty bearers to account

Spinal cord injury

WORLD HEALTH ORGANIZATION (WHO)
November 2013

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WHO factsheet on spinal cord Injury (SCI) presents key facts related to spinal cord injury (SCI).  It includes the following details: background information; prevalence; demographic trends; mortality; the health, economic and social consequences of SCI; prevention; improving care and overcoming barriers; and WHO response

Fact sheet N°384

The Rapid Assessment of Disability – Informing the Development of an Instrument to Measure the Effectiveness of Disability Inclusive Development Through a Qualitative Study in Bangladesh

HUQ, N L
EDMONDS, T J
BAKER, S
BUSJIA, L
DEVINE, A
FOTIS, K
MARELLA, M
GOUJON, N
KEEFFE, J
2013

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Purpose: The Rapid Assessment of Disability (RAD) questionnaire was developed to provide governments and development agencies with an appropriate instrument to determine the prevalence of people with disability within theirtarget populations, and to design and evaluate the effectiveness of disability inclusive activities in addressing their priorities and needs.

 

Method: The RAD questionnaire was developed using two conceptual frameworks: the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), and the International Classification of Functioning, Disability and Health (ICF). Existing instruments were reviewed to inform the structure and content of the RAD questionnaire. The RAD questionnaire that was developed for field testing in Bangladesh comprised both a household questionnaire and a questionnaire for individuals within each household, with 5 sections: 1) Demographic information, 2) Assessment of functioning, 3) Awareness of rights of people with disability, 4) Well-being and quality of life, 5) Participation in the community. Prior to field-testing the RAD questionnaire in Bangladesh, a qualitative study was conducted to ensure the relevance of the questionnaire in the context of a developing country. In-depth interviews with 9 people with disability and a focus group of 8 parents of children with disability were conducted in Dhaka, Bangladesh. 

 

Results:Qualitative findings highlighted factors relevant to the lives of people with disability in Bangladesh, including discrepancies between the awareness and attainment of rights for people with disability, the wellbeing of people withdisability and their families, as well as numerous barriers to full participation in their community. While the findings confirmed that the design and content of the questionnaire reflected all these aspects, some changes were made to the items in the questionnaire to ensure that it reflected the views of people with disability from the context of a developing country.

 

Conclusion and Implications: This qualitative study was an important step in the development of the RAD questionnaire as it helped to achieve its aim - namely, to establish the prevalence of disability and to assist in the design and evaluation of disability inclusive interventions in the setting of a developing country.

HIV-related disability in HIV hyper-endemic countries : a scoping review

HANASS-HANCOCK, Jill
et al
September 2013

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This article presents the results of the first scoping review to examine the extent, nature and range of disability among people living with HIV in HIV hyper-endemic countries. The studies indicate that people living with HIV experience a variety of disabilities. Impairments in body structure/function comprise the majority of data, with particular focus on mental function. Data on activity limitations and participation restriction were limited, however, they were recorded. They indicate severe impact on people’s life and possible adherence. The review argues that the time has come to elevate the focus holistically on health and life-related consequences of living with HIV and to integrate disability into the discussions and approaches to HIV care

World Journal of Aids, Vol 3, No 3

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