Search Results (113)

Background/Objectives: Agricultural workers in Spain with a migratory background face challenging working and living conditions that significantly affect their health. This study aimed to explore how professionals in healthcare, social services, civil society organisations, and labour institutions perceive that the working conditions affect the physical health of this population. Methods: A qualitative descriptive study was conducted through 92 semi-structured interviews with professionals from six provinces in Spain. Data were analysed using thematic analysis following Braun and Clarke’s six-phase framework. Rigour was ensured through triangulation, independent coding, and interdisciplinary consensus. Results: Two overarching themes were identified: (1) the health consequences of workplace demands and environmental hazards, and (2) navigating health services such as sick leave and disability permits. These findings highlight how the impact of precarious working conditions and limited access to healthcare affect the physical health of migrant agricultural workers. Conclusions: The professionals interviewed described and relate precarious working conditions with adverse health outcomes among migrant agricultural workers. Their insights reveal the need for systemic reforms to enforce labour rights, ensure access to health services, and address the structural factors that contribute to exclusion and vulnerability. Full article

Persons with disabilities face barriers to accessing sexuality education. For those who identify as queer, these challenges are compounded by stigma, ableism, and heteronormativity, resulting in distinct and overlooked experiences. This study explored the sexuality education needs of persons with disabilities who identify as queer in Kenya—a neglected demographic—using a phenomenological approach. Data were collected through a focus group discussion with six participants and analyzed thematically. Three themes emerged: invisibility and erasure; unprepared institutions and constrained support networks; and agency and everyday resistance. Educational institutions often overlook the intersectional needs of persons with disabilities who identify as queer, leaving them without adequate tools to navigate relationships, sexuality, and rights. Support systems are often unprepared or unwilling to address these needs. Societal attitudes that desexualize disability and marginalize queerness intersect to produce compounded exclusion. Despite these challenges, participants demonstrated agency by using digital spaces and informal networks to resist exclusion. This calls for policy reforms that move beyond tokenism to address the lived realities of multiply marginalized groups. Policy reform means not only a legal or governmental shift but also a broader cultural and institutional process that creates space for recognition, protection, and participation. Full article

Osteoarthritis is a disabling condition with highly complex overall management and persistent shortcomings, contributing significantly to the global disease burden. Although research in the field has grown considerably in recent years alongside technological advancements, a cohesive and structured understanding of the evolution of the scientific literature, particularly regarding clinical management and outcome evaluation, remains insufficiently developed. To date, most bibliometric analyses in osteoarthritis have focused narrowly on specific subdomains, leaving a notable gap in comprehensive assessments of the broader clinical framework. This study addresses that gap through an integrated, structured, and visual approach using multiple bibliometric techniques targeting osteoarthritis diagnosis and management, aiming to guide future research and improve strategic development. Scientific publication in osteoarthritis has expanded exponentially, peaking in 2024 with 1234 documents. The United States led in both output and citation impact, while China showed rapid growth. Osteoarthritis and Cartilage emerged as the most influential journal. Australian institutions, especially the University of Sydney, demonstrated a remarkable ascent. Five global research clusters were identified, with the U.S. as the central node and Australia serving as a bridge between Western and Asian collaborations. Research themes evolved toward integrated models connecting biological mechanisms, therapeutic strategies, and patient-centered outcomes. This bibliometric assessment underscores exponential growth in osteoarthritis research and highlights the urgent need for more personalized, multidimensional evaluation strategies to enhance clinical translation. Full article

Background and Objectives: Lateral epicondylitis, commonly known as tennis elbow, is a prevalent condition characterized by pain and tenderness over the lateral epicondyle. Various treatment options, including corticosteroids, platelet-rich plasma (PRP), and saline injections, are utilized, yet their comparative efficacy remains unclear. Hypothesis: This study hypothesizes that PRP injections result in superior functional and clinical outcomes compared to corticosteroid and saline treatments, as assessed by clinical scoring systems and radiological findings. Materials and Methods: The study enrolled patients aged 18 years and older with pain and tenderness over the lateral epicondyle persisting for at least three months and no prior treatment. Patients with comorbidities affecting the upper extremity were excluded. Fifty-five elbows from 50 patients were randomized into three groups (glucocorticoid, PRP, and saline). Functional outcomes were assessed using the Visual Analog Scale (VAS), Patient-Rated Tennis Elbow Evaluation (PRTEE), and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Radiological evaluations included vascularity and superb microvascular imaging (SMI) indices via ultrasonography before injection and three months post-injection. Results: Fourteen patients were lost to follow-up, leaving 36 patients (36 elbows, 16 males and 20 females; mean age 42.4 ± 6.15 years) for analysis. The glucocorticoid group included 13 elbows, PRP group 14 elbows, and saline group 14 elbows. Baseline functional and radiological scores were similar across groups. At three months, PRP and glucocorticoid groups showed no significant differences in VAS scores (p = 0.7), but PRP outperformed both of the other groups in DASH and PRTEE scores, with the saline group performing the worst (p < 0.001). PRP consistently achieved the best outcomes at both three and six months. Radiological assessments revealed no significant group differences in vascularity or SMI indices (p = 0.3 and p = 0.2, respectively). Conclusions: PRP treatment demonstrated superior functional outcomes in early and mid-term evaluations compared to glucocorticoid and saline. However, ultrasonographic measures of vascularity and SMI did not correlate with functional outcomes. Clinical Relevance: PRP offers a promising treatment option for lateral epicondylitis, with superior functional improvements over other commonly used injections. Radiological assessments of vascularity and SMI may not reliably predict clinical outcomes. Full article

Introduction: Patients in intensive care units (ICUs) face factors that cause anxiety, fear, pain, depression, and adverse health behaviors. This qualitative study aims to determine patients’ experiences when transferred from the ICU to the ward. Methods: Thirteen individuals who were transferred from the ICU to the ward were included in this study. Interviews were conducted using a face-to-face method in the patient’s room. The interviews were recorded with a voice recorder with the consent of the patients. Codes, categories, and themes were created, and content analysis and descriptive analysis were carried out after the audio recordings were converted into text. Results: Patients reported receiving adequate physical and personal care in the ICU and were satisfied with its continuity. They felt safe due to the close attention of healthcare professionals and continuous treatment. Although they received psychological and social support from nurses, they were negatively affected by constant lights, patient noises, and nursing conversations. Patients experienced anxiety about not knowing the health status and time of day, about their relatives, their homes, and other critically ill patients in intensive care. Some patients reported fear of not being able to leave the intensive care unit, relapse, disability, or death. Patients reported pain due to the cold environment, lighting, probes, drains, and positioning. Patients suggested that healthcare personnel communicate better with them, have a clock they can see, reduce noise, and have caregivers of the same gender. They emphasized the need for moral support. Conclusions: Constant light in the intensive care unit, sounds from other patients, nurses talking among themselves, not being able to see their relatives, not knowing what time of day it is, and wondering caused anxiety in the patients. It was determined that patients experienced pain due to catheter, drain, aspiration procedures, cold environment, and position in bed. Notably, patients reported that they needed moral support and wanted to receive care from caregivers of the same gender. Full article

The importance of mathematical problem solving (MPS) has been widely recognized. While there has been significant progress in developing and studying interventions to support teaching and learning MPS for students with disabilities, the research on how to accurately and effectively assess the impact of those interventions has lagged, leaving a gap in understanding whether interventions are truly achieving their intended outcomes. The purpose of this mixed-method study was to explore how a dynamic assessment (DA) approach can be used in the context of an evidence-based MPS intervention, Enhanced Anchored Instruction, as an alternative means of assessing the MPS of students with disabilities. Our findings suggest that DA is an adequate assessment tool and can provide additional information for teachers to better understand the MPS strengths and challenges of students with disabilities such as MPS ownership transition. Study limitations, considerations for future research, and implications for practice are discussed, emphasizing the importance of rigorous evaluation of the DA approach to improve teaching and learning MPS for students with disabilities. Full article

Background: Knowledge of the relative contributions to different growth areas in the proximal femur and acetabulum is limited due to the complex anatomy and lack of growth markers in children. There is increasing interest in using guided growth to improve hip joint stability and decrease dysplasia in children with neurological disability. Some children with cerebral palsy (CP) are treated with bisphosphonates for bone insufficiency, which leaves a dense growth arrest band in the bone at the time of treatment. The aim of this study was to develop a novel approach to understand the growth and maturation impact on hip development in children with CP using this growth arrest band. Methods: Pelvic radiographs of children with CP Gross Motor Function Classification System (GMFCS) level IV/V treated with bisphosphonate were analyzed. We measured neck–shaft angle (NSA), head–shaft angle (HSA), and migration percentage (MP) based on pamidronate bands (PamMP), NSA based on pamidronate bands (PamNSA), and HSA based on pamidronate bands (PamHSA). These measurements were compared using t-test. Results: Seven children (two GMFCS IV and five GMFCS V) were included. The mean age of the radiographic assessment was 11.4 ± 1.3 (range, 8.6–12.5) years, mean MP 22 ± 7% (range, 13–39%), PamMP 33 ± 7% (range, 18–46%), NSA 151 ± 7° (range, 140–161°), PamNSA 153 ± 4° (range, 142–163°), HSA 164 ± 12° (range, 142–175°), and PamHSA 169 ± 8° (range, 154–175°). MP decreased by 10.5% compared with PamMP (p < 0.001). NSA compared with PamNSA (p = 0.117) and HSA compared with PamHSA (p = 0.325) were not statistically different. Conclusions: This novel assessment method demonstrates that ossification of the lateral acetabulum and femoral head in children with CP GMFCS IV/V from age 8 to 12 years undergoes a mean decrease of 10% MP. A decrease of 10% MP after proximal femoral-guided growth has been reported as a positive outcome. However, based on the current measurements, this may be due to normal development. HSA and NSA remained unchanged. Full article

Lymphatic filariasis (LF), or elephantiasis, is a neglected tropical disease caused by filarial worms, primarily Wuchereria bancrofti, transmitted through mosquito bites. It often begins in childhood but may not show symptoms until later, leaving many individuals asymptomatic for long periods. LF disrupts the lymphatic system, causing severe swelling in the limbs and genitals, leading to deformities and disabilities. The World Health Organization estimates that around 51 million people are affected globally, with 36 million suffering from chronic conditions like lymphedema and hydrocele. In 2021, approximately 882.5 million people in 44 countries required preventive chemotherapy, making LF the second leading parasitic cause of disability, significantly impacting socioeconomic status. The immune response to filarial parasites is complex, involving both innate and adaptive immune cells. A key feature of LF immunology is the antigen-specific Th2 response, expansion of IL-10-producing CD4⁺ T cells, and a muted Th1 response. This T cell hypo-responsiveness is crucial for sustaining long-term infections with high parasite densities. While the correlates of protective immunity are not fully understood—due in part to a lack of suitable animal models—T cells, particularly CD4⁺ Th2 cells, and B cells, play essential roles in immune protection. Moreover, host immune responses contribute to the disease’s pathological manifestations. A failure to induce T cell hypo-responsiveness can lead to exaggerated inflammatory conditions such as lymphedema, hydrocele, and elephantiasis. Filarial infections also induce bystander effects on various immune responses, impacting responses to other infectious agents. This intricate immune interplay offers valuable insights into the regulation of immune responses to chronic infections. This review explores recent immunological research on lymphatic filarial worms, highlighting their effects on both innate and adaptive immune responses in humans and the mechanisms underlying this neglected tropical disease. Full article

Background: Narcolepsy impacts both patients and society, yet there is limited data on its socioeconomic consequences. Methods: This retrospective longitudinal cohort study used pseudonymized patient-level data from Swedish registers and included narcolepsy patients from January 2015–December 2019 and age–sex matched controls. All patients received an index date corresponding to their first narcolepsy diagnosis. Results: This study included 466 incident narcolepsy patients and 2330 matched controls. During the years studied, healthcare resource utilization was 2–5 times higher for incident narcolepsy patients compared to matched controls (p < 0.0001). Modafinil, stimulants, and antidepressants were prescribed more often to incident narcolepsy patients (p < 0.0001). Work productivity was significantly impacted, as incident narcolepsy patients took 7.0–10.5 more sick leave days than their matched controls (p < 0.0001) and had an average of 14.8 net days of disability leave (associated with indirect costs of EUR 1630) versus only 5.8 days among matched controls (EUR 638) during the year of the index (p = 0.027). After controlling for age, sex, and the Charlson comorbidity index, the odds of disability leave were 3.3 times higher in incident narcolepsy patients. Conclusions: This study provides evidence of the magnitude of the substantial societal economic burden due to narcolepsy in Sweden, evidenced by higher healthcare resource utilization and indirect costs. Full article

Traumatic brain injury (TBI) has a complex and multifactorial pathology and is a major cause of death and disability for humans. Immediately after TBI, astrocytes and microglia react with complex morphological and functional changes known as reactive gliosis to form a glial scar in the area immediately adjacent to the lesion, which is the major barrier to neuronal regeneration. The flavonoid agathisflavone (bis-apigenin), present in Poincianella pyramidalis leaves, has been shown to have neuroprotective, neurogenic, and anti-inflammatory effects, demonstrated in vitro models of glutamate-induced toxicity, neuroinflammation, and demyelination. In this study, we evaluated the effect and mechanisms of agathisflavone in neuronal integrity and in the modulation of gliosis in an ex vivo model of TBI. For this, microdissections from the encephalon of Wistar rats (P6-8) were prepared and subjected to mechanical injury (MI) and treated or not with daily agathisflavone (5 μM) for 3 days. Astrocyte reactivity was investigated by measuring mRNA and expression of GFAP protein in the lesioned area by immunofluorescence and Western blot. The proportion of microglia was determined by immunofluorescence for Iba-1; mRNA expression for inflammasome NRPL3 and interleukin-1 beta (IL-1β) was determined by RT-qPCR. It was observed that lesions in the cortical tissue induced astrocytes overexpressing GFAP in the typical glial scar formed and that agathisflavone modulated GFAP expression at the transcriptional and post-transcriptional levels, which was associated with a reduction of the glial scar. MI induced an increase in the proportion of microglia (Iba-1+), which was not observed in agathisflavone-treated cultures. Moreover, the flavonoid modulated negatively both the NRLP3 and IL-1β mRNA expression that was increased in the lesioned area of the tissue. These findings support the regulatory properties of agathisflavone in the control of the inflammatory response in glial cells, which can impact neuroprotection and should be considered for future studies for TB and other pathological conditions of the central nervous system. Full article

Background: The COVID-19 lockdown posed unprecedented psychological challenges worldwide. In Spain, Mutual Collaborators with Social Security manage work-related disabilities, including mental health cases. Objectives: To describe and analyze work-related disabilities with mental health diagnoses during the COVID-19 lockdown in Spain from the perspective of a Mutual Collaborator with Social Security in the Spanish healthcare system. Methods: Descriptive, retrospective, and cross-sectional study of a sample of 5135 patients. Descriptive statistics reported mean values and standard deviation by sex and age. Inferential analyses were conducted using the Mann–Whitney U-test and correlation analysis. Results: The study population included 5135 patients managed by a Mutual Collaborator with Social Security during the COVID-19 lockdown, 63.5% of whom were women. Cantabria reported the highest average sick leave duration (62.80 days), while La Rioja had the lowest (39.19 days). Generalized anxiety disorder was the most prevalent diagnosis (69.17%), followed by adaptive disorders and mild depression. Women had a slightly higher prevalence of anxiety, while men showed higher rates of adaptive disorders. Conclusions: The findings underscore the psychological impact of the COVID-19 lockdown, revealing significant sex and regional differences in mental health diagnoses and sick leave duration. Generalized anxiety disorder was the predominant diagnosis, highlighting the need for targeted mental health interventions during crises. Full article

Fucosidosis is a rare lysosomal storage disease caused by α-L-fucosidase deficiency following a mutation in the FUCA1 gene. This enzyme is responsible for breaking down fucose-containing glycoproteins, glycolipids, and oligosaccharides within the lysosome. Mutations in FUCA1 result in either reduced enzyme activity or complete loss of function, leading to the accumulation of fucose-rich substrates in lysosomes. Lysosomes become engorged with undigested substrates, which leads to secondary storage defects affecting other metabolic pathways. The central nervous system is particularly vulnerable, with lysosomal dysfunction causing microglial activation, inflammation, and neuronal loss, leading to the neurodegenerative symptoms of fucosidosis. Neuroinflammation contributes to secondary damage, including neuronal apoptosis, axonal degeneration, and synaptic dysfunction, exacerbating the disease process. Chronic neuroinflammation impairs synaptic plasticity and neuronal survival, leading to progressive intellectual disability, learning difficulties, and loss of previously acquired skills. Inflammatory cytokines and lysosomal burden in motor neurons and associated pathways contribute to ataxia, spasticity, and hypotonia, which are common motor symptoms in fucosidosis. Elevated neuroinflammatory markers can increase neuronal excitability, leading to the frequent occurrence of epilepsy in affected individuals. So, fucosidosis is characterized by rapid mental and motor loss, along with growth retardation, coarse facial features, hepatosplenomegaly, telangiectasis or angiokeratomas, epilepsy, inguinal hernia, and dysostosis multiplex. Patients usually die at an early age. Treatment of fucosidosis is a great challenge, and there is currently no definitive effective treatment. Hematopoietic cell transplantation studies are ongoing in the treatment of fucosidosis. However, early diagnosis of this disease and treatment can be effective. In addition, the body’s immune system decreases due to chemotherapy applied after transplantation, leaving the body vulnerable to microbes and infections, and the risk of death is high with this treatment. In another treatment method, gene therapy, the use of retroviral vectors, is promising due to their easy integration, high cell efficiency, and safety. In another treatment approach, enzyme replacement therapy, preclinical studies are ongoing for fucosidosis, but the blood–brain barrier is a major obstacle in lysosomal storage diseases affecting the central nervous system. Early diagnosis is important in fucosidosis, a rare disease, due to the delay in the diagnosis of patients identified so far and the rapid progression of the disease. In addition, enzyme replacement therapy, which carries fewer risks, is promising. Full article

Objectives: Vocational rehabilitation plays a vital role in helping breast cancer survivors overcome physical, psychological, and occupational challenges, enabling a smoother return to work and improving quality of life. The aim of this study was to evaluate the effect of vocational rehabilitation as part of early integrated rehabilitation compared to conventional rehabilitation on sick leave duration, work ability, and disability rates. Methods: The study was designed as a prospective, interventional study. We enrolled 435 breast cancer patients, 211 patients in the control group, and 224 in the intervention group. The control group received the conventional rehabilitation as offered to breast cancer patients before the pilot study on individualized, integrated rehabilitation, while patients in the intervention group were referred for additional treatments and vocational rehabilitation. Results: There were no differences between the control and the intervention group of patients in terms of patient demographics, tumor size, disease stage, or oncologic treatment. However, compared to the control group, the intervention group had 50 days shorter sick leave (p = 0.002), better work ability (p < 0.001), and a lower proportion of patients with disabilities (p < 0.001) and better work ability (p < 0.001) one year after the beginning of cancer treatment. Vocational rehabilitation was likely associated with shorter sick leave (p < 0.069). Conclusions: Integrated rehabilitation was associated with shorter sick leave, and vocational rehabilitation was likely associated with shorter sick leave. Integrated rehabilitation was associated with improved work ability and disability rate. Full article

Objectives: Whiplash trauma is a worldwide significant public health issue, with post-collision chronic pain and physical and mental disability; the prevalence of whiplash trauma in the Japanese general population is estimated at 1.2% and in the Danish general population the whiplash condition has been reported to be 2.9%. Pre-collision welfare benefits and illness perceptions have been found to predict poor recovery after whiplash trauma. In this study, we examined whether illness perceptions measured shortly post-collision moderated the effect of welfare benefits five years before the collision on neck pain and neck-related disability one-year post-collision. Methods: Patients consulting emergency rooms or general practices with neck pain after acute whiplash trauma were invited to complete questionnaires during the week after the collision and at three and 12-months post-collision. Further, we obtained register data on the number of weeks on three types of welfare benefits (sick leave benefits, unemployment benefits, and social assistance benefits) for a five-year period before the collision. Multiple logistic regression was applied. Results: 740 patients were included. We did not find a significant moderating effect of illness perceptions on the association between pre-collision welfare benefits and chronic neck pain and related disability. However, there was a trend towards illness perceptions at baseline and at the three-month follow-up having a moderating effect on the relationship between long-term sick leave and neck pain one year after the whiplash collision. Conclusions: Regarding long-term sick leave, we might have overlooked a substantial moderating effect due to methodological matters and recommend a replication of this study on a larger sample, also focusing on other recovery outcomes. Full article

People with disabilities experience inequitable exposure to social determinants of health (SDOH) that contribute to disparate health outcomes, including psychological distress. There is little research examining which SDOH have the strongest effect on psychological distress among people with disabilities. This leaves healthcare providers and policy makers with insufficient information to make well-informed treatment decisions or allocate resources effectively. We explored the association between SDOH and disability and which factors may moderate the association between disability and psychological distress. Using data from the US Census Bureau’s Household Pulse Survey (Phase 3.5), we examined SDOH among people with and without disability (n = 26,354). Among people with disability, the odds of severe psychological distress were highest among those who had low incomes (OR = 4.41, 95% CI: 3.51–5.60), were food insecure (OR = 3.75, 95% CI: 3.43–4.10), housing insecure (OR = 3.17, 95% CI: 2.82–3.58), or were unable to work (OR = 1.98, 95% CI: 1.80–2.18). Only difficulty paying for household expenses moderated the association between disability and severe psychological distress (OR = 9.81, 95% CI: 7.11–13.64). These findings suggest that supporting employment and economic opportunities and improving access to safe and affordable housing and food may improve psychological well-being among people with disabilities. Full article