Search Results (119)

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/Objectives: Hypertension (HTN) continues to be a leading cause of death and disability in older adults, especially in the southeastern United States. A cross-sectional study was conducted to evaluate the relationships among measured, diagnosed, and treated (HTN) in community-dwelling adults participating in student-led health screenings in eastern Alabama. Methods: Between 2017 and 2019, students from health-related disciplines facilitated screenings at 23 community and independent living sites to conduct health assessments, including measuring blood pressure (BP), obtaining medical history, and evaluating current prescriptions. Statistical analyses including chi-square tests, t-tests, and backward stepwise linear regression were performed. Results: The current sample includes data from 357 adults aged 60 to 99 years (mean age 74.6 ± 8.7), who were 70.9% females, 60.8% identifying as Black/African American (BA), and 36.8% residing in rural areas. The majority of clients had a prior HTN diagnosis (71.1%) and/or currently measured HTN (78.7%). Forty-three percent of adults screened had measured, diagnosed, and pharmaceutically treated HTN, while 31% had measured but untreated HTN. Black clients had higher measured systolic and diastolic BP and were more likely to also have been diagnosed with HTN (p < 0.05 for all). Linear regression indicated that lower systolic BP was predicted by not living alone (p = 0.003), White race (p = 0.004), and previous HTN diagnosis (p = 0.012), while female gender (p = 0.079) and decreasing body mass index (p = 0.053) had marginal predictive value. Conclusions: These results indicate that awareness and screening of HTN in this population are noteworthy, though management of the disease through ongoing screening and referrals is essential to reduce disparities. Full article

Background: Individuals with intellectual disability face an increased risk of mental health issues compared to the general population. Despite the proven efficacy of physical activity (PA) in improving anxiety and depression in the general population, little is known about this relationship in adults with intellectual disability and the factors that influence it. The purpose of the study was to determine whether a correlation exists between PA and perceived levels of anxiety and depression, and assess gender disparities in PA and mental health. Method: People with intellectual disability were recruited from day centers and sports events. The amount of PA was evaluated through the International Physical Activity Questionnaire. Perceived mental health was assessed through the Zung Self-Rating Anxiety (ZAS) and Depression Scale (ZDS). Results: In total, 99 adults (34 females, aged 33 ± 12) participated in the study. A gender disparity was found in anxiety levels, while depression, PA, and type of sport participation did not differ between males and females. Multiple regression analysis highlights how the depression score was significantly predicted by gender (β = −3.57, p = 0.015), intellectual disability level (β =−3.08, p < 0.008), and PA (β =−0.10, p= 0.001), while anxiety was influenced by gender (β = −4.48, p = 0.003) and intellectual disability level (β = −3.23, p = 0.007). Conclusions: These findings underscore the relevance of physical activity as a factor associated with lower depressive symptoms in adults with intellectual disability, highlighting its potential role in mental health promotion within this population. Full article

Inclusion in play, physical education, outdoor life, organized sports, and other movement-based activities can promote resilience and support physical, emotional, and social well-being. These arenas are particularly important for reducing health disparities and preventing social marginalization across the lifespan. Yet, children and adolescents from vulnerable or disadvantaged backgrounds encounter persistent barriers to participation, rooted in broader inequalities related to their socioeconomic position, disability, gender, ethnicity, and access to supportive environments. This perspective outlines how inclusive movement contexts, when informed by developmental systems theory and resilience frameworks, can interrupt trajectories of marginalization and promote long-term equity in health, education, and work inclusion. We emphasize the need for interdisciplinary approaches, combining longitudinal and qualitative methods, to uncover how vulnerability and participation interact dynamically over time. By integrating insights from developmental science, education, public health, and spatial ecology, we identify strategic pathways for research and action. Addressing these challenges requires coordinated efforts across sectors and stakeholders to co-create inclusive, context-sensitive interventions. Full article

Objective: This study aimed to explore the burden attributable to different groups of risk factors (environmental/occupational, behavioral, and metabolic) in Saudi Arabia that were stratified by gender and year and measured by summary exposure values (SEVs) and disability-adjusted life years (DALYs) per 100,000. Design: This study was structured as a systematic analysis. Methods: Using the GBD 2021 data, we extracted information on different risk factors attributed to the disease burden in Saudi Arabia to quantify the differences in exposure value (SEV) and disability-adjusted life year (DALY) rates (per 100,000) between females and males across different years. Results: Over the years, sustained progress in reducing the number of DALYs attributable to specific environmental and occupational risks has been observed, as well as a slight decrease in some behavioral risks. The highest disease burden was attributed to metabolic and behavioral risk factors, with body mass index being the leading risk factor for both genders. Between 1990 and 2021, the age-standardized DALY rate in those with high body mass indices increased by 168.4% and reached 3436.23 (95% UI 1878.7–5031.5) in males and increased by 125.2% to reach 2952.6 (95% UI 1456.9–4.407) in females. The age-standardized SEVs were the highest in females with a high body mass index, reaching an SEV of 57.98 (95% UI: 64.1–49.2), and in males, an SEV of 50.75 (95% UI: 57.1–42.3) was achieved. Regarding their attributable deaths in 2021, metabolic risk factors were identified as the primary contributors to NCD mortality in 2021. Conclusions: These results reveal persistent health disparities between males and females, underscoring the urgent need for gender-specific research, policies, and interventions. Strategies aimed at promoting health and reducing disease burden should acknowledge the unique health challenges encountered by males and females. Full article

Despite advances in cancer care, disparities persist. The collection of the social determinants of health (SDOH) is fundamental to addressing disparities. However, SDOH are inconsistently collected in many regions of the world. This two-phase multiple methods study examined patient and community perspectives regarding SDOH data collection in Canada. In phase 1, a survey was administered to patients at a cancer centre (n = 549) to assess perspectives on an SDOH data collection tool. In phase 2, broader perspectives were sought through a community consultation with patient partners experiencing structural inequality (n = 15). Most participants were comfortable with SDOH data collection. Of survey respondents, 95% were comfortable with the collection of language, birthplace, sex, gender, education, and disability, and 82% to 94% were comfortable with SES, sexual orientation, social support, and race/ethnicity. Discomfort levels did not differ across subgroups, except women were more uncomfortable disclosing SES (OR: 2.00; 95%CI: 1.26, 3.19). Most (71%) preferred face-to-face data collection with a healthcare professional and only half were comfortable with storage of SDOH in electronic health records. Open-ended survey responses (n = 1533) and the community consultation revealed concerns about privacy, discrimination, relevance to care, and data accuracy. SDOH data collection efforts should include a clear rationale for patients, training for providers, strong data privacy and security measures, and actionable strategies to address needs. 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

Achieving health equity for people with disabilities requires addressing the barriers that they face when accessing healthcare. Older adults with disabilities may experience compounded disparities, yet little research has explored their satisfaction with health facility personnel, including non-healthcare staff. This study examines differences in satisfaction with health facility personnel between younger (18–59 years) and older (60+) adults with disabilities in Chile. Data from the 2024 Disability and Citizenship (DISCA) survey were analysed using chi-square tests to examine differences between younger and older people with disabilities with regard to their satisfaction with health facility personnel. Ordered logistic regressions were employed to predict high satisfaction, given socioeconomic and health-related variables. Findings indicated that a higher percentage of older adults with disabilities reported high satisfaction with health facility personnel compared to younger adults. Ordered logistic regressions confirmed that older adults had greater odds of reporting high satisfaction with doctors (OR: 3.83), other health professionals (OR: 4.66), paramedical technicians (OR: 4.31), and administrative staff (OR: 3.13). These results suggest that age influences satisfaction levels among people with disabilities, potentially due to varying expectations, experiences, or interactions with health facility personnel. Understanding the underlying reasons for these age-related differences is essential to inform policies and practices that ensure equitable, person-centred care for people with disabilities across the life course. Full article

Background/Objectives: Climate change is a major factor exacerbating non-communicable diseases (NCDs) such as cardiovascular diseases, neoplasms, respiratory diseases, and diabetes, especially in vulnerable Latin American regions. This study analyzes the impact of environmental exposures related to climate change on the NCD burden in eight Latin American countries by quantifying the disability-adjusted life years (DALYs) attributable to these factors. Using Global Burden of Disease (GBD) data (1990–2021), we performed multiple linear regression to assess associations between DALYs and environmental risk factors—air pollution (particulate matter, nitrogen dioxide), radon, lead, and extreme temperatures—in Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, Peru, and Uruguay. The study included major NCDs, and the population was stratified by age and sex. Results: Ischemic heart disease was the leading cause of DALYs in most countries. Particulate matter pollution was the main environmental risk factor contributing to the NCD burden, mainly affecting cardiovascular and respiratory diseases. Mexico showed the highest DALYs from particulate and ozone pollution; temperature and lead exposure also contributed in some countries. Nitrogen dioxide was the primary risk factor for asthma. Statistically significant relationships between environmental factors and DALYs were confirmed. Conclusions: Climate change-related exposures significantly increase the burden of NCDs in Latin America. Targeted interventions in industry, transportation, and energy, along with sustainable urban policies, are essential to mitigate health impacts and reduce disparities. Integrating environmental health into public policies can improve health outcomes amid ongoing climate challenges. Full article

Background: As national and international reports reveal, significant health care transition (HCT) service disparities exist for youth and young adults with intellectual and developmental disabilities (YYAs with IDD). The development of the HCT model necessitates informed perspectives from a broad constituency, including consumers and families. Parents’ retrospective perspectives of their sons’ or daughters’ HCT experiences are presented to enlarge the understanding of the service need. Methodology: Eleven parents were recruited virtually from parent support/disability advocate groups via an email distribution list of the Children’s Hospital Los Angeles University Center for Excellence in Developmental Disabilities. Parents who consented to participate were interviewed by phone using an interview guide with 11 open-ended items. Three questions focused on the barriers and facilitators associated with the HCT experience are reported. Findings: Four major themes were generated from the analysis of data gathered from parents pertaining to their sons’ or daughters’ health care transition experiences, focusing on the transfer of care. Two major themes were related to HCT barriers—Pediatric Care Contrasted with Adult-Focused Care and Transfer of Care Barriers—and two were related to HCT facilitators—Transfer of Care Facilitators and Transfer of Care Recommendations. Each of the major themes included subthemes. Conclusions: Parents openly shared their sons’ or daughters’ HCT experiences, which illuminated the scope of their challenges and the assistance received. These insights provide rich descriptions of the barriers they and their adult children faced as they proceeded with navigating new systems of health care. The reported data find support in other previously conducted studies. Full article

Background/Objectives: Neurological disorders often result in a broad spectrum of disabilities that impact mobility, communication, cognition, and sensory processing, leading to significant limitations in independence and quality of life. Assistive technologies (ATs) offer tools to compensate for these impairments, support daily living, and improve quality of life. The World Health Organization encourages the adoption and diffusion of effective assistive technology (AT). This narrative review aims to explore the integration, benefits, and challenges of assistive technologies in individuals with neurological disabilities, focusing on their role across mobility, communication, cognitive, and sensory domains. Methods: A narrative approach was adopted by reviewing relevant studies published between 2014 and 2024. Literature was sourced from PubMed and Scopus using specific keyword combinations related to assistive technology and neurological disorders. Results: Findings highlight the potential of ATs, ranging from traditional aids to intelligent systems like brain–computer interfaces and AI-driven devices, to enhance autonomy, communication, and quality of life. However, significant barriers remain, including usability issues, training requirements, accessibility disparities, limited user involvement in design, and a low diffusion of a health technology assessment approach. Conclusions: Future directions emphasize the need for multidimensional, user-centered solutions that integrate personalization through machine learning and artificial intelligence to ensure long-term adoption and efficacy. For instance, combining brain–computer interfaces (BCIs) with virtual reality (VR) using machine learning algorithms could help monitor cognitive load in real time. Similarly, ATs driven by artificial intelligence technology could be useful to dynamically respond to users’ physiological and behavioral data to optimize support in daily tasks. Full article

Background: Rheumatic heart disease (RHD) remains a major contributor to childhood cardiovascular morbidity and mortality globally, particularly in low-resource settings. This study offers a thorough evaluation of the global, regional, and national burden of RHD among children aged 0–14 years, from 1990 to 2021, utilizing data from the 2021 Global Burden of Disease (GBD) study. Methods: We analyzed age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for RHD in 204 countries and territories. Novel methodological approaches included APC analysis to decompose temporal trends into age, period, and cohort effects, and inequality analysis to assess socioeconomic disparities. We calculated age-standardized rates and average annual percentage changes (AAPC) by sex, region, and socio-demographic index (SDI) level. Results: From 1990 to 2021, the global age-standardized death rate due to RHD in children declined by approximately 74%, from 1.24 to 0.32 per 100,000 (AAPC: −4.27%). Similarly, DALY rates dropped from 117.22 to 41.56 per 100,000 (AAPC: −3.30%). Despite this progress, the global age-standardized incidence rate increased modestly from 55.84 to 66.76 per 100,000 (AAPC: 0.58%), and prevalence rates also rose (AAPC: 0.53%). Females consistently experienced higher burden across all metrics. Inequality analysis demonstrated a concerning divergence: while mortality and DALY inequalities narrowed substantially (mortality slope index of inequality (SII) improved from −1.35 to −0.31), incidence and prevalence inequalities widened (incidence SII worsened from −112.60 to −131.90), indicating growing disparities in disease occurrence despite improved survival. Conclusions: While global mortality and DALYs from childhood rheumatic heart disease have declined substantially over the past three decades, a troubling paradox has emerged: rising incidence rates alongside widening socioeconomic inequalities in disease occurrence. This represents a critical public health challenge demanding targeted intervention strategies. The divergent trends in health outcomes, namely, improved survival rates but increased disease burden, reveal that while access to treatment has advanced, upstream prevention efforts remain critically inadequate among socioeconomically disadvantaged populations. Full article

Background: The provision of education, health, and social care for children with special educational needs and disabilities (SEND) in England has long been criticised for its inequities and chronic underfunding. These systemic issues were further exacerbated by the onset of the COVID-19 pandemic and the accompanying restrictions, which disrupted essential services and resulted in widespread unmet needs and infringements on the rights of many children with SEND. This study aimed to use a three-phase consensus-building approach with 1353 participants across five stakeholder groups to collaboratively develop evidence-informed priorities for policy and practice. The priorities sought to help address the longstanding disparities and respond to the intensified challenges brought about by the pandemic. Methods: A total of 55 children with SEND (aged 5–16), 893 parents/carers, and 307 professionals working in SEND-related services participated in the first phase through online surveys. This was followed by semi-structured interviews with four children and young people, ten parents/carers, and 15 professionals, allowing for deeper exploration of lived experiences and priorities. The data were analysed, synthesised, and structured into five overarching areas of priority. These were subsequently discussed and refined in a series of activity-based group workshops involving 20 children with SEND, 11 parents/carers, and 38 professionals. Results and Conclusions: The consensus-building process led to the identification of key priorities for both pandemic response and longer-term recovery, highlighting the responsibilities of central Government and statutory services to consider and meet the needs of children with SEND. These priorities are framed within a children’s rights context and considered against the rights and duties set out in the United Nations Convention on the Rights of the Child (1989). Priorities include protecting and promoting children with SEND’s rights to (1) play, socialise, and be part of a community, (2) receive support for their social and emotional wellbeing and mental health, (3) feel safe, belong, and learn in school, (4) “access health and social care services and therapies”, and (5) receive support for their parents/carers and families. Together, they highlight the urgent need for structural reform to ensure that children with SEND receive the support they are entitled to—not only in times of crisis but as a matter of routine practice and policy. Full article

Background/Objectives: Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide, posing a substantial health and economic burden. Despite advances in screening and treatment, significant socioeconomic and healthcare-related disparities persist across European Union (EU) member states. This study aims to identify trends and inequality in CRC burden over time and to explore the relationship between country-level socioeconomic and healthcare indicators and CRC burden across EU member states. Methods: Age-standardized mortality, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALY) rates were extracted from Global Burden of Diseases Study 2021 for 24 EU countries. Socioeconomic and healthcare indicators were extracted from Eurostat between 2005 and 2021. The Gini index was calculated to evaluate CRC-related health inequality, and generalized linear mixed models were used to assess the link between indicators and disease burden. Results: The Gini index for age-standardized YLDs declined from 0.19 to 0.12 between 1990 and 2021, while inequality in YLL (from 0.11 to 0.16), DALY (from 0.11 to 0.15), and mortality rates (from 0.12 to 0.14) increased. The number of practicing physicians (p < 0.05) and higher levels of education (p < 0.001) were related to lower death, DALY, YLD, and YLL rates. Conversely, greater income inequality was linked to higher mortality, DALY, and YLL rates (p < 0.05). Conclusions: Our findings underscore that, in addition to expanding organized screening programs, enhancing physician availability and addressing socioeconomic inequalities are essential for reducing the burden of CRC. Full article

Māori, the Indigenous people of Aotearoa New Zealand, experience wide-ranging inequities compared with non-Māori. This survey aimed to explore the holistic health, wellbeing, and disability experiences of New Zealand’s Indigenous Māori population from a Māori worldview, addressing gaps in culturally relevant data often overlooked by standard health surveys. A robust cross-sectional survey was conducted with 7359 participants of Māori descent using Kaupapa Māori Research principles. Data were analysed using the Te Pae Māhutonga framework, a Māori health promotion model. Participants demonstrated strong cultural identity, with 32.3% understanding spoken Māori fairly well and 97.3% defining a broad non-nuclear concept of whānau (family). While over half reported high life satisfaction, 58.4% experienced discrimination, mainly based on ethnicity and appearance. Access to healthcare revealed that 32.6% were unable to contact a general practitioner due to cost. Socioeconomic challenges were prevalent; nearly a quarter borrowed from family or friends to meet daily living costs, and over a third economized on fresh produce to save money. This study reveals significant gaps in mainstream health data and demonstrates that a culturally aligned, methodological approach is feasible and crucial for informing policies that address the needs and rights of Māori, as guaranteed under Te Tiriti o Waitangi. These results could inform global, indigenous research addressing culturally relevant health, wellbeing and disability inequities. Full article