Search Results (44)

Background: Adolescents with autism spectrum disorder (ASD) display distinct neurodevelopmental trajectories marked by atypical neural activation and white matter maturation compared to neurotypical peers. Introduction: While improvements in face recognition and cognitive skills occur during childhood and adolescence, individuals with ASD often experience a plateau in these areas as they transition to adulthood, impacting daily living, executive function, social cognition, and emotional awareness. Results: Neuroimaging studies reveal altered white matter growth and connectivity in brain regions associated with social processing, which may underlie these functional challenges. Intellectual disability further compounds developmental difficulties by limiting foundational abilities and slowing progress. Discussion: The multifaceted and persistent service needs spanning legal, educational, vocational, health, and psychosocial domains highlight the necessity for coordinated, individualized, and family-centered approaches, particularly during the transition to adulthood. Advances in research integrating genetic, neurobiological, and behavioral data hold potential for refining diagnostic subgroups and personalizing interventions. Conclusion: Continued advocacy and innovation in service delivery are essential to address gaps in adult support systems and enhance long-term outcomes for individuals with ASD. Full article

Population aging and the rising prevalence of disability are reshaping demographic dynamics worldwide, underscoring the need for inclusive environments that accommodate diverse functional abilities. While legal mandates for accessibility exist, structural and institutional barriers often hinder implementation. Universal Design (UD) provides a transformative framework that shifts the focus from individualized accommodations to systemic inclusion; however, its application in Lithuania, particularly in rural settings, remains underexplored. This study addresses this gap by investigating the integration of UD principles in the Ignalina region, a rural Lithuanian locality experiencing pronounced demographic decline and aging. Using the design thinking model, this research examined how public institutions navigate UD implementation across the phases of empathization, definition, ideation, prototyping, and testing. The findings reveal both promising developments and persistent challenges. Community-engaged initiatives, such as micro-grants, volunteer services, and digital accessibility platforms, have begun to enhance service inclusivity. However, issues such as outdated infrastructure, unclear legislative guidelines, and funding limitations continue to constrain progress. This study concludes that UD can serve not only as a mechanism for promoting accessibility but also as a strategic tool for rural socio-economic resilience, contributing to the discourse on inclusive spatial planning and policy development in aging and diversifying societies. Full article

Federal law and judicial rulings in the United States direct educators to provide special education services to students with disabilities that enable them to demonstrate meaningful progress, considering their circumstances. The services are to comprise evidence-based practices and must account for students’ unique learning characteristics and the time allotted for instruction. Accordingly, this paper reports on two interconnected investigations involving four high school students with autism and an intellectual disability who were taught to read and define finance vocabulary via a systematic instructional approach presented during short-duration lessons (5–8 min). A multiple-probe, nonconcurrent single-case design established a functional relationship between the lessons and the students’ vocabulary acquisition. All four students learned to read their targeted words. One student demonstrated acquisition of all the definitions, whereas the other three demonstrated variable acquisition before the study was discontinued because of the end of the school year. The students also demonstrated variable skill maintenance and generalization. The results suggest an appropriate structure for a short-duration lesson and a corresponding research agenda for investigating parameters associated with its effectiveness and efficiency. The study offers teachers instructing students with moderate-significant disabilities a practical evidence-based instructional strategy that accounts for their time management challenges. Furthermore, the strategy’s framework offers a theoretical way for investigating the impacts of increased academic learning time and practice opportunities. Full article

Background and aims: Rheumatic diseases are chronic, progressive conditions associated with severe pain, joint damage, disability, and even death. Healthcare interventions play a critical role in symptom management, patient education, and adherence to treatment plans. This study evaluates the role of healthcare interventions in the management of patients with rheumatic diseases, focusing on pain management, functional rehabilitation, patient education, and multidisciplinary collaboration. In addition, barriers to optimal care and potential solutions, including digital health technologies, are explored. Materials and methods: We conducted a narrative review of the scientific literature. Studies published between 2014 and 2025 were selected from PubMed, Scopus, Web of Science, Elsevier, Springer, Frontiers, and Wiley Online Library. Key areas of review included nurse-led pain management, education programs, and the impact of interdisciplinary care on patient outcomes. Results: Nursing interventions significantly improve pain control, treatment adherence, and self-management skills in patients with rheumatic diseases. Multidisciplinary approaches improve functional rehabilitation and increase quality of life in patients with rheumatic conditions. However, barriers such as insufficient health care resources, lack of patient awareness, and disparities in the availability of services hinder effective care delivery. Conclusions: A structured, multidisciplinary approach integrating healthcare interventions, digital health solutions, and patient-centered education is essential to optimize the management of rheumatic diseases. Future research should focus on improving access to non-pharmacological therapies and standardizing healthcare protocols for better patient outcomes. Full article

Background and Objectives: Low back pain (LBP) is a highly prevalent musculoskeletal condition that frequently recurs, leading to increased healthcare utilization and socioeconomic burden. While short-term management strategies are well-documented, long-term recurrence patterns remain insufficiently studied. This study aims to describe the long-term recurrence patterns and healthcare utilization associated with LBP in a nationwide cohort over a 17-year period. Materials and Methods: This descriptive, retrospective longitudinal cohort study utilized data from the Korean National Health Insurance Service (NHIS) database (2002–2018). We included 3,086,665 patients who sought medical care for LBP (ICD-10 code M54.5) at least once in 2010. Patients with a history of disability rating assessments were excluded. The primary outcomes included the number of LBP episodes, episode duration, recurrence patterns, and changes in healthcare utilization. We assessed the number of healthcare visits per episode and the interval between episodes over time. Results: Among the study population, 79.4% experienced recurrent LBP, with an average of 5.0 ± 4.9 episodes per patient. Recurrence rates increased with each episode. In addition, episode duration lengthened, and intervals between episodes shortened. Healthcare utilization also increased, with patients requiring more visits per episode over time. The demographic and socioeconomic characteristics of the LBP patients in our sample were also described. Conclusions: In this population-based sample, LBP follows a progressive course, with increasing episode frequency, prolonged duration, and escalating healthcare utilization over time. These findings highlight the need for early intensive management and long-term follow-up strategies to mitigate the growing burden of recurrent LBP on individuals and healthcare systems. Full article

In August 2020, the World Health Assembly approved the global strategy to eliminate cervical cancer, envisioning a world where it seizes to be a public health problem. The cervical cancer elimination initiative reinforces the commitment to fulfilling the rights of adolescent girls and women by reducing both health and economic inequities in the poorest populations that have more limited access to timely and effective services. This initiative improves the quality of life of women and their families by protecting them from a disease that causes disability and preventing avoidable mortality through public health measures. This article discusses the epidemiological situation and vaccination coverage and identifies weaknesses and opportunities in Latin America and the Caribbean to propose actions to reinforce progress toward the cervical cancer elimination goal. Full article

Background: Rare diseases are defined as clinical conditions that affect only a small number of persons in a population, considered fewer than 1 per 2000 in the European Union or fewer than 1 per 1600 in the United States They are serious, often chronic and progressive conditions, characterized by a pronounced clinical polymorphism that crosses all medical specialties. Multiple areas of life beyond just physical health are affected with significant impact on patients, families, and healthcare systems. Objective: To analyze the socio-demographic, medical, and vocational characteristics that correlate with functional status and work disability as a measure of quality of life in rare diseases. Methods: An observational retrospective study of adults with rare diseases evaluated for eligibility for social insurance rights in the National Institute of Medical Assessment and Work Capacity Rehabilitation Bucharest (INEMRCM, the Romanian abbreviation) over a 5-year period was made. Descriptive analysis was used to present sample characteristics. Means and standard deviations (SD) were calculated to describe numerical variables, frequencies were used to describe categorical variables, and logistic regression analysis was conducted to evaluate potential predictors of work capacity. All statistical analyses were performed by PSPP.3 software. p < 0.05 was the cut-off for statistical significance with a 95% confidence interval. Results: 90 consecutive persons were included in the survey. The mean age of the group was 44.5 years ± SD 10.61 years, with a female/male ratio of 48/42 persons. The mean disease duration was 10.61 years ± SD 9.76 years. Men had more severe disease (73.81%); p = 0.018 and significantly younger retirement age, M/F = 39.10 ± 12.26/43.06 ± 9.32; p = 0.037. Less disabling diseases were predominant autoimmune conditions (85.71% of cases); genetic conditions had a more severe functional impact in 63.75% of cases; p = 0.037. People with multisystem diseases but with specific or targeted treatment can work more frequently (76.19%); those with visual impairment have more severe impairments (73.77%); p < 0.001. All individuals who received specific therapy had a better functional status, unlike only 37.21% of those who received symptomatic treatment or treatment for complications; p = 0.023. Logistic regression analysis indicated that the type of impairment and the availability of specific treatments could serve as predictors of a reduced likelihood of employment in rare disease cases. Education level and occupation were not correlated with functional impairment and work disability (NS). Conclusions: Several factors, including some that are modifiable, were associated with better outcomes, such as reduced disability and an increased potential for work participation. Sex, disease etiology, type of impairment, and treatment were all significantly linked to functional capacity. Among these, the type of impairment and the availability of specific treatments might be predictors of employment. Addressing these parameters requires a multidisciplinary team, involving specialized care and comprehensive support services to improve the overall quality of life of individuals affected by rare diseases. Full article

This paper examines a donor-funded development project in the rural mountainous districts of Vietnam aimed at improving water, sanitation, and hygiene (WASH) services for vulnerable households, particularly those with disabilities. The study investigates the project’s impact on disability inclusion at the household and community levels and identifies factors that support or hinder progress towards inclusion for people with disabilities. Data from a survey of 600 households and interviews with household members and village chiefs provide insights into the perceptions and attitudes towards persons with disabilities (PWDs), and practices of disability-inclusive WASH. While progress has been made in changing attitudes towards the rights of PWDs, there is still room to improve practices, especially in engaging with PWDs, offering affordable disability-inclusive WASH services, and including them in WASH policy decisions. This paper highlights the need for a comprehensive approach that extends beyond household interventions and emphasizes a shift in mindset towards disability inclusion at all societal levels. Full article

Universal design and access in transport are essential for ensuring the equal and independent mobility of people with disability and those with reduced mobility. Despite progressive legislation and policies, the implementation of universal design and access standards in transport systems remains inconsistent in the City of Tshwane. This study aims to assess the state of transport and universal access in the City of Tshwane using expert opinion. Transport experts were interviewed using a semi-structured interview guide to gather in-depth insights. Thematic analysis was applied to identify issues related to policy, infrastructure, and service delivery. Experts reported that while legislation supports universal access, implementation is inconsistent, particularly in informal transport sectors like minibus taxis. The findings reveal significant gaps between policy goals and implementation. The inconsistent application of legislation has resulted in new transport modes, such as the BRT systems and the Gautrain high-speed rail, being designed with universal access principles, while other modes lag behind in accessibility standards. An integrated transport system with universally designed infrastructure is recommended to improve transport access for people with disability and those with reduced mobility. Full article

Introduction: Adaptive behavior, defined as a critical set of skills learned and performed throughout daily life to cope with society’s age-appropriate expectations, is a central concept for people with disabilities in both clinical and research contexts. As AB is an essential component of daily functioning, assessment is necessary both for the diagnostic process and for intervention, as it enables scores to be compared with the developmental norm, identifies strengths and weaknesses of the persons and monitors the progress of interventions. AB assessment is common in children with developmental delays but less common in children with visual impairment (VI). The aim of this study was to evaluate the AB of young children with VI through a pilot study and descriptive data. Methods: The participants were recruited through an early childhood special needs education service specialized in VI in the French-speaking part of Switzerland. Overall, 10 families gave their consent for their child to be assessed using the Vineland Adaptative Behavior Scale-II (VABS-II) completed by their early childhood educator. Results: Globally, the results showed that participants were rated between the Adapted to Moderately High levels. The highest domains were in the areas of communication, daily living skills and socialization. Discussion: The results showed a trend that is superior to previous studies assessing the AB of a similar population. As a result, one obvious perspective would be to adapt the scale to ensure that the items assessed are more consistent with the specificities of their development and the intervention priorities, enabling them to achieve adaptive behavior and independence in carrying out activities of daily living. Full article

Good-quality relationships in which individuals with profound intellectual disabilities (intelligence quotient, IQ < 20–25) are recognized by healthcare professionals (HPs) are essential for the quality of healthcare and promoting autonomy. This study examines the impact of an educational intervention on documentation of the interplay between HP and individuals receiving services in supported accommodation in Norway. An educational intervention study was designed to encourage HPs to document their approaches and interplay. The Scale for the Evaluation of Staff-Patient Interactions in Progress Notes (SESPI) was applied to measure documentation before and after the intervention. Journal notes written over a three-month period before the intervention and a three-month period after the intervention were measured. Prior to the intervention, only 23.1% of the journal notes described the resident’s experiences, increasing by 5.4% (p = 0.041) post-intervention. Practical solutions to individual experiences increased from 0.9% to 8.5% (p < 0.001). The educational intervention demonstrated a significant increase in the documentation of residents’ experiences and the interplay between HPs and residents. Future research should explore the generalizability of these findings. Incomplete documentation of HPs’ relational work conceals important aspects of the healthcare provided, potentially resulting in confining autonomy and participation for individuals with intellectual disabilities. Full article

The WHO Dementia Global Action Plan states that rehabilitation services for dementia are required to promote health, reduce disability, and maintain quality of life for those living with dementia. Current services, however, are scarce, particularly for people with young-onset dementia (YOD). This article, written by an international group of multidisciplinary dementia specialists, offers a three-part overview to promote the development of rehabilitation services for YOD. Firstly, we provide a synthesis of knowledge on current evidence-based rehabilitative therapies for early-onset Alzheimer’s disease (EOAD), behavioural variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA), and posterior cortical atrophy (PCA). Secondly, we discuss the characteristics of rehabilitation services for YOD, providing examples across three continents for how these services can be embedded in existing settings and the different roles of the rehabilitation multidisciplinary team. Lastly, we conclude by highlighting the potential of telehealth in making rehabilitation services more accessible for people with YOD. Overall, with this paper, we aim to encourage clinical leads to begin introducing at least some rehabilitation into their services, leveraging existing resources and finding support in the collective expertise of the broader multidisciplinary dementia professional community. Full article

Access to water, sanitation, and hygiene (WASH) resources in schools is critical for disease prevention and control, especially during public health emergencies. In Belize, systematic, national data on WASH in schools are needed to inform public health decisions and interventions. From December 2021 to January 2022, a national survey was sent electronically to government and government-aided primary and secondary schools in Belize (N = 308) to gather information on WASH services. From the survey, 12 pilot schools were selected based on the highest self-reported need for WASH resources to participate in additional evaluation and intervention, which included environmental nudges, supplemental supply provision, and hand hygiene education. To understand how the progression of the COVID-19 pandemic may have influenced hand hygiene, facility assessments to evaluate access to hand hygiene resources were conducted in person when most schools reopened for face-to-face learning during the pandemic (March 2022) and 15 months later (June 2023). Among the schools participating in the national survey (N = 221), 55% reported times when water was not available at the schools. Almost 9 in 10 schools (89%) had a functional handwashing station, and 47% reported always having soap for handwashing. Between baseline and follow-up at the 12 pilot schools, we observed decreases in the proportion of functional handwashing access points (−11%), functional handwashing access points accessible for individuals with disabilities (−17%) and small children (−29%), and functional alcohol-based hand rub dispensers (−13%). Despite the ongoing COVID-19 pandemic, we observed gaps in WASH resources in schools in Belize during the onsite assessments at the pilot schools. Schools should be encouraged and provided with WASH resources to maintain vigilance for disease control measures. Full article

Light chain amyloidosis is a plasma–cell disorder with a poor prognosis. It is a progressive condition, causing worsening pain, disability, and life-limiting complications involving multiple organ systems. The medical regimen can be complex, including chemotherapy or immunotherapy for the disease itself, as well as treatment for pain, gastrointestinal and cardiorespiratory symptoms, and various secondary symptoms. Patients and their families must have a realistic awareness of the illness and of the goals and limitations of treatments in making informed decisions about medical therapy, supportive management, and end-of-life planning. Palliative care services can thus improve patients’ quality of life and may even reduce overall treatment costs. Light chain (AL) amyloidosis is a clonal plasma cell disorder characterized by the excessive secretion of light chains by an indolent plasma cell clone that gradually accumulates in vital organs as amyloid fibrils and leads to end-organ damage. With progressive disease, most patients develop diverse clinical symptoms and complications that negatively impact quality of life and increase mortality. Complications include cardiac problems including heart failure, hypotension, pleural effusions, renal involvement including nephrotic syndrome with peripheral edema, gastrointestinal symptoms leading to anorexia and cachexia, complex pain syndromes, and mood disorders. The prognosis of patients with advanced AL amyloidosis is dismal. With such a complex presentation, and high morbidity and mortality rates, there is a critical need for the establishment of a palliative care program in clinical management. This paper provides an evidence-based overview of the integration of palliative care in the clinical management of AL amyloidosis as a means of reducing ER visits, rehospitalizations, and in-hospital mortality. We also discuss potential future collaborative directions in various aspects of clinical care related to AL amyloidosis. Full article

Despite South Africa having a progressive and liberal sexual and reproductive health (SRH) policy framework, adolescents and young people with disabilities (AYPWDs) are less likely to receive sexual and reproductive healthcare, being consequently predisposed to a long-term detrimental impact on their health. Our study explored the barriers to accessing sexual and reproductive health services (SRHSs) in clinics among AYPWDs in Mpumalanga, South Africa. We conducted a descriptive qualitative study with twenty-seven AYPWDs in four focus group discussions using semi-structured interviews, audiotaped and transcribed verbatim, and then applied a thematic analysis of the data. Employing a socio-ecological model, the findings show a poor socioeconomic status, lack of information on SRH, and the attitudes of AYPWDs as barriers at the individual level, hindering AYPWDs from accessing SRHSs in clinics. AYPWDs also faced difficulties to talk about SRH with parents, a lack of support to seek SRHSs, improper care from family/parents, and negative attitudes of friends, at the interpersonal level. They further expressed barriers at the community/societal level as negative attitudes of non-disabled community members and poor infrastructure for wheelchair use. At the organization level, their access to SRHSs was negatively affected by HCWs’ maltreatment, described in the forms of negative attitudes, being judgmental using verbal abuse, discrimination, and bullying. Furthermore, AYPWDs described difficulties in communication with HCWs, as well as violating their confidentiality and misconceived ideas on their sexuality. Intensified efforts to strengthen public health strategies are needed to improve access to SRHSs by AYPWDs in South Africa, as well as enhancing the proficiency and communication skills of HCWs and educating AYPWDs, parents, and non-disabled community members on SRH. Full article