Search Results (1,135)

Introduction: The optimal management of hallux sesamoid fracture nonunions remains a subject of ongoing debate, particularly in the context of personalized medicine. This systematic review aimed to synthesize current evidence regarding surgical strategies for this rare but disabling condition. Methods: A comprehensive literature search was conducted in accordance with the PRISMA guidelines. Results: Six studies met the inclusion criteria, encompassing a total of 80 patients. Surgical techniques varied and included open and arthroscopic sesamoidectomy, autologous bone grafting (alone or combined with screw fixation), and percutaneous screw fixation. When reported, outcomes were generally favorable, with union rates ranging from 90.5% to 100% and with consistent postoperative improvements in clinical function. Complication and reoperation rates were both 6.5%. The most frequent reoperation was sesamoidectomy for persistent pain or nonunion, followed by hardware removal. Conclusions: Despite the limited and low-quality evidence, available data suggest that individualized surgical planning can lead to favorable outcomes with low complication rates. Sesamoidectomy remains the most reliable salvage procedure in refractory cases. These findings support a personalized, stepwise approach to treatment—prioritizing sesamoid preservation, when feasible, while reserving excision for symptomatic nonunions. Further studies are needed to validate tailored algorithms and refine patient-specific decision-making in this challenging clinical scenario. Full article

Background/Objectives: While artificial intelligence (AI) is rapidly transforming education, its specific effectiveness for students with learning disabilities (LD) requires rigorous evaluation. This systematic review aims to assess the efficacy of AI-based educational interventions for students with LD, with a specific focus on the methodological quality and risk of bias of the available evidence. Methods: A systematic search was conducted across seven major databases (Google Scholar, ScienceDirect, APA PsycInfo, ERIC, Scopus, PubMed) for experimental studies published between 2022 and 2025. This review followed PRISMA guidelines, using the PICOS framework for inclusion criteria. A formal risk of bias assessment was performed using the ROBINS-I and JBI critical appraisal tools. Results: Eleven studies (representing 10 independent experiments), encompassing 3033 participants, met the inclusion criteria. The most studied disabilities were dyslexia (six studies) and other specific learning disorders (three studies). Personalized/adaptive learning systems and game-based learning were the most common AI interventions. All 11 studies reported positive outcomes. However, the risk of bias assessment revealed significant methodological limitations: no studies were rated as having a low risk of bias, with most presenting a moderate (70%) to high/serious (30%) risk. Despite these limitations, quantitative results from the stronger studies showed large effect sizes, such as in arithmetic fluency (d = 1.63) and reading comprehension (d = −1.66). Conclusions: AI-based interventions demonstrate significant potential for supporting students with learning disabilities, with unanimously positive reported outcomes. However, this conclusion must be tempered by the considerable risk of bias and methodological weaknesses prevalent in the current literature. The limited and potentially biased evidence base warrants cautious interpretation. Future research must prioritize high-quality randomized controlled trials (RCTs) and longitudinal assessments to establish a definitive evidence base and investigate long-term effects, including the risk of cognitive offloading. Full article

Inclusive education emphasizes the right of all students, including those with special educational needs and disabilities (SEND), to access equitable learning opportunities in mainstream classrooms. This study presents the implementation and evaluation of a school-based intervention within the BATTIE (Bottleneck Analysis and Teacher Trainings for Inclusive Education) project in Greece, aiming to enhance inclusion through differentiated instruction (DI) and a whole school approach. The intervention was conducted across 26 schools and involved 116 educators and 130 students with SEND. A qualitative methodology was employed, utilizing structured classroom observations, field notes, and semi-structured interviews with teachers. The data were thematically analyzed using NVivo 11. Findings indicated notable improvements in student engagement, academic participation, and classroom collaboration, especially among students with SEND. Teachers reported enhanced professional confidence, better understanding of inclusive strategies, and improved collaboration with special education staff. However, limitations in interdisciplinary cooperation—particularly with school psychologists—were identified. This study concludes that sustained professional development, school-wide collaboration, and differentiated instruction are essential for fostering inclusive practices. It underscores the potential of structured, whole school interventions to improve learning environments for diverse student populations and provides insights for educational policy and practice reform. Full article

Disability Certification is an instrument that can contribute to the identification of persons with disabilities who are potential beneficiaries of social protection programmes. In Colombia, the disability certification process was changed in 2020 to include a human rights perspective. However, little information exists on how far the process aligns with the recommendations made by the Convention on the Rights of Persons with Disabilities or to what extent it provides useful information for the operation of the country’s social protection system. This study aims to analyse how the changes implemented in 2020 have contributed to the identification and determination of persons with disabilities in social protection programmes in Colombia. This research uses an analytical-descriptive design, in which legal documents related to the social protection programme and disability certification were analysed. In addition, we conducted semi-structured interviews in Colombia with people with disabilities, professionals conducting the certification, and with key stakeholders, and we analysed the information using thematic analysis. Colombia changed its certification process in 2020, moving from a capacity-to-work assessment to a process of assessing functioning capacity and participation limitations following the International Classification of Functional Disability and Health. However, the new certification process has not provided an instrument to contribute to determining persons with disabilities who should be prioritised or receive social benefits in Colombia. The certification does not establish the support needs of people with disabilities, does not recommend reasonable adjustments to support their participation in society, and has not been used systematically in social protection programmes. Finally, individuals with disabilities commented that the disability certification is a process that does not open up opportunities to receive social benefits and social transfers, and in most cases, it is an expensive and lengthy process. Disability certification in Colombia is not an instrument that determines the needs of people with disabilities, nor the reasonable accommodations that they require in order to participate in society. Full article

Background: Mobility limitation is a pivotal but under-documented dimension of disability in Saudi Arabia. Leveraging the 2017 National Disability Survey, this cross-sectional study provides a population-wide profile of mobility-related physical difficulty. Objectives: Five research aims were pursued: (1) estimate national prevalence and severity by sex; (2) map regional differentials; (3) examine educational and marital correlates; (4) characterize cause, duration, and familial context among those with multiple limitations; and (5) describe patterns of assistive-aid and social-service use. Methods: Publicly available aggregate data covering 20,408,362 Saudi citizens were cleaned and analyzed across 14 mobility indicators and three baseline files. Prevalence ratios and χ² tests assessed associations. Results: Overall, 1,445,723 Saudis (7.1%) reported at least one functional difficulty; 833,136 (4.1%) had mobility difficulty, of whom 305,867 (36.7%) had mobility-only impairment. Severity was chiefly mild (35% of cases), with moderate (16%) and severe (7%) forms forming a descending pyramid. Prevalence varied more than threefold across the thirteen regions, peaking in Aseer (9.4%) and bottoming in Najran (2.9%). Mobility difficulty clustered among adults with no schooling (36.1%) and widowed status (18.5%), with sharper female disadvantage in both domains (p < 0.001). Among those with additional limitations, chronic disease dominated etiology (56.3%), and 90.1% had lived with disability for ≥25 years; women were overrepresented in the longest-duration band. Aid utilization was led by crutches (47.7%), personal assistance (25.3%), and wheelchairs (22.6%), while 83.8% accessed Ministry rehabilitation services, yet fewer than 4% used home or daycare support. Conclusions: These findings highlight sizeable, regionally concentrated, and gender-patterned mobility burdens, underscoring the need for education-sensitive prevention, chronic-care management, investment in advanced assistive technology, and distributed community services to achieve Vision 2030 inclusion goals. Full article

Information and Communication Technologies (ICTs) are increasingly necessary in the educational context. Digital resources could support socio-educational practices to intervene with vulnerable groups, such as people with disabilities, and improve their accessibility and inclusion. This study aims to analyse educators’ perceptions of ICT resources for socio-educational intervention with people with disabilities, as well as to determine their training needs and the possibilities and risks derived from their use. A qualitative methodology has been used to analyse the content of 12 semi-structured interviews with social educators. All of them work with students with disabilities in the extracurricular field. Based on the results, the educators habitually use popular digital devices, such as computers. They regularly search for content on the internet to obtain and disseminate ideas, perceiving an adequate domain. However, there is a need for training on specific digital resources to intervene with students with disabilities. The study highlights the need to investigate the causes that may limit some ICT uses by educators and foster the design of specific training programmes to harness the potential of ICT in socio-educational intervention. Full article

This article examines the accessibility of public space for individuals with disabilities in the Netherlands, as well as the relevant legal frameworks intended to promote accessibility. It discusses the Convention on the Rights of Persons with Disabilities (UN CRPD) and efforts to implement its provisions at the local level. The article first provides an overview of Dutch legislation and regulations concerning accessibility in public spaces. It then presents an analysis of the experiences of individuals with disabilities in navigating streets and pavements in two Dutch cities, Utrecht and Almere. The central question is to what extent equal participation in public space has been realised. The findings indicate that national legislation remains inadequate in addressing the accessibility of streets and pavements. Despite the constitutional amendment in January 2023, which prohibits discrimination on the grounds of disability, substantive equality is largely dependent on the individual policies and bylaws of the 342 municipalities. The involvement of individuals with disabilities in shaping the inclusive use of public space is therefore crucial at the local level. This article highlights local initiatives that have successfully drawn the attention of municipal policymakers and civil servants to the importance of accessible streets. Full article

The present study investigated the impact of a disability awareness program on the attitudes of university students at Al-Ahliyya Amman University towards people with disabilities. The study employed a randomized, two-group, pre- and post-test design. A total of 60 university students were randomly allocated to either the experimental or control group. The results of a survey showed that those in the experimental group, in comparison with the control group, exhibited a statistically significant increase in the favorability of their attitudes towards people with disabilities following the implementation of the program. Based on the results of this study, we recommend implementing disability awareness programs inside universities and subsequently evaluating their effectiveness in enhancing student attitudes and interactions with people with disabilities, which in turn could lead to a more inclusive society and improve the quality of life for people with disabilities by reducing social barriers and fostering greater understanding and acceptance. The limitations of this study include its restriction to a single university setting and its utilization of a rather small sample size. The study did not assess the long-term effects of the disability awareness program. Full article

Background/Objectives: Platelet-rich plasma (PRP) is emerging as a safe and effective treatment for facet-mediated pain. Studies have demonstrated reductions in pain and improvements in function, both in the short (3 months) and longer term (6 and 12 months). The mechanisms underlying clinical improvements are largely unknown. It is also unclear whether reported outcomes are due to the PRP administered or concurrently applied rehabilitation. Methods: A prospective case series was conducted in a single, multidisciplinary chronic pain centre. Forty-two participants with chronic WAD and cervical facet-mediated pain who received PRP (64% female; mean age (SD) 42.8 (11.6) years; median WAD duration [IQR] 23 [18,29] mths), attended rehabilitation, and reported successful outcomes 3 months post-PRP fulfilled the inclusion criteria. Measures of pain, cervical isometric strength, and range of motion were collected at baseline and 3 months post-PRP. Mediation analyses were performed to determine how these factors influenced disability. Results: Participants demonstrated clinically significant and relevant improvements in pain, disability, and isometric strength measures (all p < 0.01). Causative mediation analyses demonstrated independent direct, but not indirect, effects of both pain and strength on disability (both p < 0.001), with no direct or indirect effects of cervical ROM on disability. Full article

This study explored the experiences of Hungarian minority parents of children with severe disabilities from Romania. Examining individual life paths and becoming a parent is difficult in all aspects, but the issue of parental responsibility for raising a child with a severe disability suggests a much more complex approach. Participants were parents (female = 8; male = 3) who were purposively sampled from an urban setting (Bihor area) and whose children attended SEN schools in the same area. Data were collected using semi-structured interviews and were thematically analysed. It turned out from the interviews that the challenges parents of children with severe disabilities encounter at home, school, and in society are accumulated emotional stress and exhaustion; however, they also face material challenges. The analysis also revealed that the parents were unsure of what was expected of them in making educational or habilitation–rehabilitation decisions on behalf of their children. The parents’ difficulty with decision-making and their unpreparedness put them under serious stress, often characterized by depressive life stages. The findings reveal the need for ongoing professional development and the establishment of organizational–community networks. Parents of children with disabilities face serious, unresolved challenges that are difficult to overcome. In order to overcome these challenges, we need to develop policies that take the needs of parents into consideration. Full article

Background: Multiple Chemical Sensitivity (MCS) is a complex, disabling condition marked by non-specific symptoms in response to low-level chemical exposures. It often leads to substantial impairments in quality of life, psychological health, and daily functioning. Although non-pharmacological approaches—such as lifestyle and psychological interventions—are widely used, their clinical effectiveness remains unclear. Objective: We aim to evaluate the effectiveness of lifestyle-based approaches in improving clinical and psychosocial outcomes in adults with Multiple Chemical Sensitivity. Methods: A systematic review was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420251013537). Literature searches were carried out in MEDLINE (PubMed), CINAHL, Google Scholar, and ResearchGate between March and April 2025. Eligible studies included adults (≥18 years) with a confirmed diagnosis of MCS and reported outcomes such as perceived stress, anxiety, depressive symptoms, or quality of life. Methodological quality and risk of bias were independently assessed using the PEDro scale, NIH Quality Assessment Tool, CEBMa checklist, and Cochrane RoB 2.0. Results: Twelve studies (N = 378) met the inclusion criteria. Cognitive and behavioral therapies demonstrated the most consistent evidence of efficacy, with reductions in symptom severity, maladaptive cognitive patterns, and functional limitations. Mindfulness-based stress reduction showed favorable outcomes, while other mindfulness-based interventions yielded mixed results. Exposure-based therapies contributed to increased chemical tolerance and reduced avoidance behavior. Electromagnetic and biomedical approaches demonstrated preliminary but limited effectiveness. Aromatherapy was well tolerated and perceived as relaxing, though its clinical impact was modest. Conclusions: Cognitive and behavioral therapies appear to be most effective among lifestyle-based interventions for MCS/IEI. However, study heterogeneity limits the generalizability of findings, underscoring the need for more rigorous research. Full article

Background: Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive syndrome caused by loss-of-function mutations in the Neurotrophic Tyrosine Kinase Receptor 1 gene, characterized by recurrent episodes of infections and unexplained fever, anhidrosis, absence of reactions to noxious stimuli, intellectual disability, self-mutilating behaviors, and damage to many body organs, including the eyes. Main text: We systematically searched the Medline/PubMed, Scopus, and Web of Science databases from their inception until March 2025 for papers describing the clinical manifestations of patients with CIPA. The inclusion criterion was papers reporting ocular manifestations of patients diagnosed with CIPA. We excluded non-English papers or those reporting ocular manifestations of patients diagnosed with syndromes other than CIPA. Also, we excluded review articles, clinical trials, gray literature, or any paper that did not report ocular manifestations of patients with CIPA or that reported patients with previous ocular surgeries. Out of 6243 studies, 28 were included in the final analysis, comprising 118 patients. The mean age was 7.37 years, and males represented 63.5% (n = 75). Of the patients, fifty-six had bilateral ocular manifestations. The most common ocular manifestations were the absence of corneal reflex in 56 patients (47.5%, bilateral in 56), whereas corneal ulcerations were the second most common manifestation in 46 patients (38.98%, bilateral in 8), followed by corneal opacity in 32 patients (27.11%, bilateral in 19). Topical lubricants, topical antibiotics, and lateral tarsorrhaphy were common management modalities for these patients. Absent corneal sensitivity, corneal ulcers, and corneal opacities, among other manifestations, are common ocular presentations in patients with CIPA. Conclusions: Self-mutilation, intellectual disability, decreased lacrimation, and absence of the corneal reflex are factors that may explain the development of these manifestations in CIPA. The early detection of these manifestations can improve patient conditions and prevent further complications, in addition to helping to guide the clinical diagnosis of CIPA in these patients. Full article

Background/Objectives: The aging of workers with intellectual and developmental disabilities is an emerging reality attributed to the rise in life expectancy and improved labor market access. In this study, “workers” is used as an inclusive, neutral term covering all individuals engaged in paid labor—whether employees, self-employed, freelancers, or those performing manual or non-manual tasks. It encompasses every form of work. It is crucial to comprehend the reality of aging workers from the perspectives of the primary individuals involved: the workers, their families, and supporting professionals. Methods: A qualitative study was developed, involving 12 focus groups and 107 participants, using NVivo 12 Pro for analysis; we used a phenomenological methodology and grounded theory. Results: A set of concrete needs was highlighted: among them, 33 were related to declining work ability due to aging and disability (WADAD), and 30 to transition to retirement. These needs were grouped into categories: workplace accommodations, coordination and collaboration, personal and family support, counseling and training, and other types of needs. Conclusions: This study establishes an empirical basis tailored to the needs of this group, enabling the development of prevention and intervention protocols that address WADAD and the transition to retirement. Full article

Australian scuba fatalities over 50 years were examined to determine temporal changes over two consecutive periods, 1972–1999 and 2000–2021. The Australasian Diving Safety Foundation database and National Coronial Information System were searched to identify scuba deaths from 1972 to 2021. Historical data, police and witness reports, and autopsies were recorded and comparisons made between the two periods. Of 430 total deaths, 236 occurred during 1972–1999 and 194 during 2000–2021, with average annual fatalities of 8.4 and 8.8, respectively. The proportion of males reduced (83% to 76%) and median ages rose (33 to 47 years) with a large rise in the percentage of casualties among people aged 45 years or older (24% to 57%). There were increases in certified divers (64% to 81%) and in the proportion of divers who were with a buddy at the time of their incident (17% to 27%), as well as a decrease in out-of-gas incidents (30% to 25%). A reduction in primary drowning (47% to 36%) was accompanied by more than a doubling of cardiac-related disabling conditions (12% to 26%). The substantial increase in casualties’ ages and of the proportions of casualties aged 45 or more and of females between the periods indicate the inclusion of a broader cohort of participants and ageing of longtime divers. The reduction in primary drowning was likely due to increased training and improvements in equipment, particularly BCDs and pressure gauges. The rise in cardiac-related deaths was due to an older and more obese cohort. Improved health education and surveillance and improved dive planning are essential to reduce such deaths. Full article

Inclusive Education aims to ensure equitable learning opportunities for all students, including those with special educational needs (SEN) and disabilities, by promoting accessible teaching practices and supportive learning environments. Although its importance for fostering the academic and social development of diverse learners has been widely recognized in international policy and research, its practical implementation is still under investigation, particularly within the Greek primary education system. This study investigates (a) Greek primary school teachers’ perspectives, focusing on their attitudes, knowledge, challenges, and perceived needs in Inclusive Education for SEN students and (b) research trends relating to these perspectives, focusing on publication trends and methodological characteristics, through a systematic literature review using the PRISMA methodology. The analysis revealed a shift in Greek primary teachers’ attitudes towards Inclusive Education for SEN students, trending towards neutral or negative responses, alongside limited knowledge, various challenges, and an absence of targeted support mechanisms. The analysis also highlighted chronological gaps between the identified studies in international journals and a variability in methodological approaches and sample characteristics. These insights point to a pressing need for further targeted and ongoing research on Greek primary teachers’ perspectives and professional development initiatives to enable effective and inclusive practices for SEN students in Greek primary education. Full article