Search Results (37)

Background/Objectives: Sudden cardiac arrest (SCA) is a major global health concern with high mortality despite advances in resuscitation techniques. Achieving return of spontaneous circulation (ROSC) represents merely the initial step in the extensive rehabilitation journey. This review highlights the critical role of structured, multidisciplinary rehabilitation following ROSC, emphasizing the necessity of integrated physiotherapy, neurocognitive therapy, and psychosocial support to enhance quality of life and societal reintegration in survivors. Methods: This narrative review analyzed peer-reviewed literature from 2020–2025, sourced from databases such as PubMed, Scopus, Web of Science, and Google Scholar. Emphasis was on clinical trials, expert guidelines (e.g., European Resuscitation Council 2021, American Heart Association 2020), and high-impact journals, with systematic thematic analysis across rehabilitation phases. Results: The review confirms rehabilitation as essential in addressing Intensive Care Unit–acquired weakness, cognitive impairment, and post-intensive care syndrome. Early rehabilitation (0–7 days post-ROSC), focusing on parameter-guided mobilization and cognitive stimulation, significantly improves functional outcomes. Structured interdisciplinary interventions encompassing cardiopulmonary, neuromuscular, and cognitive domains effectively mitigate long-term disability, facilitating return to daily activities and employment. However, access disparities and insufficient randomized controlled trials limit evidence-based standardization. Discussion: Optimal recovery after SCA necessitates early and continuous interdisciplinary engagement, tailored to individual physiological and cognitive profiles. Persistent cognitive fatigue, executive dysfunction, and emotional instability remain significant barriers, underscoring the need for holistic and sustained rehabilitative approaches. Conclusions: Comprehensive, individualized rehabilitation following cardiac arrest is not supplementary but fundamental to meaningful recovery. Emphasizing early mobilization, neurocognitive therapy, family involvement, and structured social reintegration pathways is crucial. Addressing healthcare disparities and investing in rigorous randomized trials are imperative to achieving standardized, equitable, and outcome-oriented rehabilitation services globally. 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 aims to identify the barriers to accessing social services for persons with disabilities among Ukrainian refugees and to examine how stakeholders can reach them through communication channels. The article analyzes the challenges faced by disabled Ukrainian refugees in Georgia. We employed a mixed methods approach to address this objective, combining quantitative and qualitative research methods. We surveyed 114 Ukrainian refugees with disabilities, aged 18 to 60+ (n = 114), residing in Georgia, and conducted semi-structured interviews with 26 experts from civil society organizations assisting Ukrainian refugees, as well as 6 caregivers with diverse roles (e.g., mother, daughter, husband). The findings reveal significant difficulties faced by Ukrainian refugees with disabilities in accessing essential services such as healthcare, employment, psychological counseling, rehabilitation, early intervention services, legal aid, and information. The primary strategies employed by stakeholders providing humanitarian aid include individualized approaches and communication. However, while many nongovernmental organizations (NGOs) assist Ukrainian refugees, there are currently no NGOs specifically focused on supporting children and adults with disabilities in this population. Full article

Background: Multiple sclerosis (MS) is an autoimmune-mediated neurological disorder and the most frequent neurological disability in young adults. Assessing MS patient satisfaction with care is necessary to evaluate healthcare service quality and factors impacting it. Objectives: We aimed to determine the satisfaction of patients with MS towards the provision of healthcare services, and the factors affecting their satisfaction. Methods: We conducted a cross-sectional survey from November 2022 to December 2022 at King Saud Medical City, Saudi Arabia. The study participants completed the CANHELP Lite27 questionnaire, which consists of 21 items. Results: A total of 300 patients with MS participated in this study. The majority were female (80%), with an average age of 31.6 years and a mean disease duration of 5.22 years. Overall, satisfaction was moderate (63.59 ± 14.54). Patients were most satisfied with general aspects of care (72.00 ± 16.46), doctor relationships (68.58 ± 14.88), and communication (67.72 ± 17.60), but less so with decision-making (64.98 ± 18.37) and illness management (59.60 ± 16.31). Correlation analysis revealed a negative association between disease duration and satisfaction across all domains (correlation coefficient ranged from −0.290 to −0.206, p < 0.01), while age showed no significant correlation (p > 0.05). Multiple linear regression identified age as positively influencing satisfaction, while longer disease duration had a negative impact. Higher education and marital status were associated with increased satisfaction, while employment status and having children showed mixed results. Conclusions: This research uncovered significant insights regarding MS patient satisfaction within healthcare services. Despite moderate satisfaction levels overall, specific interventions are necessary to address shortcomings in decision-making and illness management. The negative correlation between disease duration and satisfaction across all domains underscores the evolving needs of MS patients over time. Future research could examine the effectiveness of illness management programs in improving MS patient satisfaction. Full article

Advancements in Assistive Technologies (ATs) have significantly improved the quality of life and autonomy for people with intellectual disabilities and autistic individuals, enhancing education, social interaction, employment, and mental health. Nevertheless, several barriers still emerge in the daily implementation of such technologies, highlighting the need to explore them in depth. Using a two-round Delphi method, we conducted a research study with an expert panel of 284 participants from 31 European countries, collecting quantitative and qualitative data. We tested ten future-oriented projections and gathered insights on participants’ backgrounds and attitudes towards ATs for this demographic. To enhance representation, experts from academia, service providers, industry, and disability organizations, as well as individuals with disabilities and their families, were included. Although the findings show strong consensus among experts on the positive impact and desirability of ATs for promoting the social inclusion of people with intellectual disabilities and autistic individuals, they also reveal differing perceptions across expert groups and identify two distinct future scenarios linked to different cultural, social, and economic hindrances. In this sense, our study provides diverse global perspectives, with the potential to help governing bodies understand the expectations, concerns, and needs related to ATs for often underrepresented groups–people with intellectual disabilities and autistic individuals in this case. Full article

Disabled people are often excluded from employment, particularly in accessing waged employment. This exclusion persists despite enabling policies and legislature, indicating a need to address gaps in implementation. To improve policy implementation, it is crucial to better understand the gap between policy intention (what was planned) and effect (what happens), including reasons that widen this gap (what explains what happened). This study explores this in the context of Kenya and Bangladesh, drawing on key informant interviews and analysis of policies and programmes related to employment, social protection, and disability. Using the policy triangle framework, we analysed the policy context, process, actors, and content of relevant policies and programmes. The study identified key policy provisions on employment quota, social assistance, job placement services, tax incentives, and training opportunities, all of which were designed to promote employment for disabled people. However, implementation is limited in both countries, for reasons including ambiguity in policies, unavailability of data for monitoring, and lack of transparency among implementers. The data suggest that addressing these aspects would promote accountability among duty-bearers, advocacy power among rights-holders, and ultimately improve implementation and inclusion of disabled people in employment. Full article

Adolescence is a developmental period of significant change and increasing independence, during which parents and caregivers play a critical role guiding their teen toward adulthood. Parents of adolescents with disability face heightened challenges managing their teens’ growing independence and shift to adult-based services across health, recreation, and employment. Using a mixed-methods-treatment-group-only design, this study explored the implementation and outcomes of a program designed to build parenting capacity to support their adolescent with disability. Parents enrolled in one of ten groups were invited to attend three sessions covering content tailored to adolescent development including post-school opportunities, financial support, risk-taking and decision-making, future planning, relationships, and mental health. Surveys were administered pre-program, post-program, and six months after program participation (n = 160) to measure intervention outcomes including parenting self-efficacy, self-advocacy, adolescent self-advocacy, parent confidence to support their adolescent’s growing independence, confidence to support their adolescent through sensitive developmental stages, parental hopes and aspirations, and parental empowerment. A subset of parents (n = 11) also participated in semi-structured interviews about the program’s acceptability and usefulness, and their satisfaction with the program content and delivery. All outcome variables except parent hopes and aspirations increased significantly from pre- to post-program. Parent self-efficacy, self-advocacy, and parental empowerment remained higher 6 months after program completion. Thematic analysis identified program strengths as the co-facilitation model of program delivery, practical and actionable content, the use of narratives and the facilitator’s lived experience as parents of adolescents with disability, the use of visualizations (video, pictures, diagrams), and the service provider’s trusted reputation and credibility. In conclusion, an online co-facilitated group program for parents of adolescents with disability can contribute to positive change for families by improving parent confidence, self-advocacy, and parental empowerment. Full article

For workers living with a disability, pathways to sustainable employment in the open labour market are inhibited by barriers operating at different structural and societal levels. The culture of Australia’s government employment services has applied a ‘work-first’ approach that emphasises finding people employment rather than supporting the acquisition of skills and education. The net effect of this approach is the preferencing of short-term employment solutions, with a focus on individual behaviour or so-called resilience and an emphasis on personal responsibility instead of addressing structural issues. In this paper, we explore how people with disability can be supported in finding employment through a shared resilience approach offered by a Work Integration Social Enterprise (WISE). We suggest that WISEs can provide the conditions for shared resilience by developing and sustaining networks needed to generate hybrid pathways to work and by role modelling inclusive work conditions in the open labour market. Full article

Eye injuries are a major cause of visual disability worldwide and may present a burden to both quality of life of the sufferers and healthcare services. The aim of this study was to extract and triangulate information on the demographic, clinical, and social features of eye-injured adult patients admitted to a tertiary hospital in Greece. The design was a five-year retrospective study of eye-injured adult patients, admitted to the General University Hospital of Heraklion, Crete (GUHH), the single tertiary referral hospital on the island. Drawing the profile of eye-injured patients may add to future health planning. Data collected from 1 January 2015 to 31 December 2019, such as sociodemographic features and clinical information, were extracted. One hundred twenty-eight patients were included. Of those, there was no available information on activity during injury for 6 patients, 78 (60.9%) had work-related ocular injuries, and 44 (34.4%) had non-work-related ocular injuries. Patients with no current formal employment, those who were retired, and formally unemployed and manual force workers had the higher rates of work-related injuries. The most common work-related injuries were closed globe injuries, specifically contusions, while ruptures and penetrating wounds were the most frequent of the open globe injuries. Within the univariate analyses, work-related eye injuries were significantly associated with male gender, middle age, and the place related to daily work activity. Determinants of poor final visual acuity (VA) were the initial VA, the type of injury (p < 0.0001), the distance of the place of residence from the hospital, and the time to hospital admission (p < 0.013). In a multivariate analysis, referred patients and those with open globe injuries arrived at hospital after a two-hour interval compared with those who were not referred and those with closed globe injuries (p ≤ 0.05). A reduction in the time to hospital admission deserves further attention. The interconnection of community and health system services through a capacity increase and networking needs further research in order to obtain targeted and viable access for eye-injured patients. Full article

Information and Communication Technology (ICT) has revolutionized the lives of persons with disabilities globally through opportunities for improved social inclusion. Technology enables persons with disabilities to access information, media, education, employment, and ICT-related assistive technologies. Decision makers must clearly understand the current state of available ICT products and services, their compliance with international accessibility standards, and their usage within the country to propose effective inclusive policies and legislations. This paper presents an e-readiness assessment tool (called MARSAD) created and implemented from 2019 to 2021 to identify factors that influence the adoption of ICT accessibility for people with disabilities in Qatar. It aims to measure the national ICT accessibility adoption rate and develop key recommendations to improve digital access for persons with disabilities to access digital platforms of various Qatari government and semi-government institutions. The tool was administered to 14 institutions in the domains of education and culture. It was found that participating institutions had considerable gaps in their ICT infrastructure to offer an inclusive digital environment, which is in line with the principles of sustainability and SDG 11, to make cities and human settlements inclusive, safe, resilient, and sustainable. The participating institutions demonstrated a genuine willingness to invest in implementing the required changes based on the results acquired by conducting MARSAD. As a suggestion, the tool can be used as a foundation to conduct e-readiness assessment studies to offer accessible ICT products and services catering to the needs of persons with disabilities, women, children, and older persons. Full article

Introduction: The number of young adults (youth) living with childhood-onset disabilities, and requiring transitional support to adult community and rehabilitation services, is increasing. We explored facilitators and barriers to accessing and sustaining community and rehabilitation services during the transition from pediatric to adult care. Methods: A qualitative descriptive study was conducted in Ontario, Canada. Data were collected through interviews with youth (n = 11) and family caregivers (n = 7). The data were coded and analyzed using thematic analysis. Results: Youth and caregivers face many types of transitions from pediatric to adult community and rehabilitation services, e.g., those related to education, living arrangements, and employment. This transition is marked by feelings of isolation. Supportive social networks, continuity of care (i.e., same care providers), and advocacy all contribute to positive experiences. Lack of knowledge about resources, changing parental involvement without preparation, and a lack of system responses to evolving needs were barriers to positive transitions. Financial circumstances were described as either a barrier or facilitator to service access. Conclusions: This study demonstrated that continuity of care, support from providers, and social networks all contribute markedly to the positive experience of transitioning from pediatric to adult services for individuals with childhood-onset disabilities and family caregivers. Future transitional interventions should incorporate these considerations. Full article

Residents in small urban and rural areas frequently depend on unreliable personal transportation to maintain their lifestyle and get to essential destinations within their society. Especially, vulnerable populations, such as seniors and low-income residents, have lower access to personal vehicles and therefore are mobility-challenged. Being challenged in terms of mobility has effects on the health of the population concerned as this constraint not only limits economic activity that leads to perpetuation of lower means and poverty but also social activity that leads to physical and mental isolation. In a study of Michigan public and nonprofit transit systems, the customer satisfaction, particularly of vulnerable populations, with transit services is analyzed through on-board intercept surveys. Results illustrate the significance of employment, age, income, disability, and demand-response services in public transit planning and ultimately public health. Full article

Vocational rehabilitation is an intervention to enhance the return to work and improve quality of life. The aim of this study was to evaluate sociodemographic and occupational factors associated with the length of stay at work among workers with work-related musculoskeletal disorders (WRMDs) who had undergone rehabilitation through the Brazilian public social security system. This was a longitudinal study among 680 workers with histories of disability due to WRMDs who returned to the formal job market after vocational rehabilitation between 2014 and 2018. Survival analysis was performed to identify the factors influencing permanence in work. Job dismissal occurred for 29.26% of the workers. The average duration of employment after returning to the formal job position was 56 months. The following factors were associated with shorter length of employment: living in the southeastern region (HR: 2.78; 95% CI 1.12–6.91) or southern region (HR: 2.68; 95% CI 1.04–6.90) of Brazil; working in transportation, storage or postal services (HR: 2.57; 95% CI 1.07–6.17); or working in financial activities, insurance or related services (HR: 2.70; 95% CI 1.05–6.89). These findings may contribute to the discussion about prevention of disability and interventions to ensure health care for workers with WRMD disabilities who undergo rehabilitation. Full article

Most children with developmental disabilities (DD) live in resource-limited countries (LMIC) or high-income country medical deserts (HICMD). A social contract between healthcare providers and families advocates for accurate diagnoses and effective interventions to treat diseases and toxic stressors. This bio-social model emphasizes reproductive health of women with trimester-specific maternal and pediatric healthcare interactions. Lifelong neuronal connectivity is more likely established across 80% of brain circuitries during the first 1000 days. Maladaptive gene-environment (G x E) interactions begin before conception later presenting as maternal-placental-fetal (MPF) triad, neonatal, or childhood neurologic disorders. Synergy between obstetrical and pediatric healthcare providers can reduce neurologic morbidities. Partnerships between healthcare providers and families should begin during the first 1000 days to address diseases more effectively to moderate maternal and childhood adverse effects. This bio-social model lowers the incidence and lessens the severity of sequalae such as DD. Access to genetic-metabolomic, neurophysiologic and neuroimaging evaluations enhances clinical decision-making for more effective interventions before full expression of neurologic dysfunction. Diagnostic accuracy facilitates developmental interventions for effective preschool planning. A description of a mother-child pair in a HIC emphasizes the time-sensitive importance for early interventions that influenced brain health throughout childhood. Partnership by her parents with healthcare providers and educators provided effective healthcare and lessened adverse effects. Effective educational interventions were later offered through her high school graduation. Healthcare disparities in LMIC and HICMD require that this bio-social model of care begin before the first 1000 days to effectively treat the most vulnerable women and children. Prioritizing family planning followed by prenatal, neonatal and child healthcare improves wellness and brain health. Familiarity with educational neuroscience for teachers applies neurologic diagnoses for effective individual educational plans. Integrating diversity and inclusion into medical and educational services cross socioeconomic, ethnic, racial, and cultural barriers with life-course benefits. Families require knowledge to recognize risks for their children and motivation to sustain relationships with providers and educators for optimal outcomes. The WHO sustainable development goals promote brain health before conception through the first 1000 days. Improved education, employment, and social engagement for all persons will have intergenerational and transgenerational benefits for communities and nations. Full article

Background: Following traumatic injury, an informal carer is often required to support recovery. Understanding the impact of caregiving is important to inform intervention design. Aim: to explore the impact of caring on family and caregiver finances, employment, social life, and psychological wellbeing. Method: Semi-structured interviews conducted with carers of traumatic injury survivors. Interviews were audio recorded, transcribed and thematically analysed, informed by the Roy Adaptation Model (RAM) and International Classification of Functioning, Disability and Health (ICF). Results: Ten participants were interviewed. Key themes included (1) financial impact/employment issues, (2) relationships and support and (3) psychological impact. Most carers did not receive professional support with daily care post-discharge. Carers’ employers responded positively, supporting them even after extensive leave. Carers received inconsistent communication whilst visiting trauma survivors in hospital; carers with healthcare experience were favoured. Navigating and receiving benefits was complex. Some carers found it difficult to accept the trauma survivor’s injury, whilst others focused on achieving goals. Conclusions: Support from professional services is limited outside hospital settings for non-brain injuries. Future interventions and healthcare services should acknowledge the lack of psychological support for carers. Researchers should consider using the ICF/RAM when designing interventions to ensure the full impact on carers is addressed. Full article