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Tak NY, Ryu JI. Impact of musculoskeletal disability limitations on the economic unmet dental needs in South Korea. BMC Oral Health 2024; 24:793. [PMID: 39004747 PMCID: PMC11247879 DOI: 10.1186/s12903-024-04563-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 07/03/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Musculoskeletal disability (MSD) has been identified as having a negative impact on oral health. Patients with MSD have a greater burden of medical expenses and are expected to have an Economic unmet dental need (UDN). This study aimed to conduct a multifactorial analysis based on the Andersen model to determine the extent to which MSD contributes to inequitable dental care use. METHODS This study used data from the Korea National Health and Nutrition Survey VIII. The study population was 17,903 adults aged 19 years and older. All data were analyzed using IBM SPSS Statistics for Windows version 26 and the level of statistical significance was set at 0.05. RESULTS The people with MSD activity limitations were rare as only 3% in this study population. There were significant differences in sex and education as predisposing factors, income, and marital status as enabling factors, and current smoking, daily brushing, and MSD activity limitation as need factors for experiencing economic UDN. MSD activity limitation was associated with 1.5-fold increased odds of Economic UDN with a fully adjusted Anderson's Behavior Model. CONCLUSIONS This finding suggests poorer access to dental care among adults with MSDs owing to financial difficulties. It is necessary to explore various ways to address oral health inequalities among adults with MSD activity limitations.
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Affiliation(s)
- Na-Yeon Tak
- Department of Preventive and Social Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Jae-In Ryu
- Department of Preventive and Social Dentistry, Kyung Hee University College of Dentistry, Seoul, Republic of Korea.
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2
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Gómez LE, Morán ML, Solís P, Pérez‐Curiel P, Monsalve A, Navas P. Health care for people with intellectual disability in Spain. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2023. [DOI: 10.1111/jppi.12455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- L. E. Gómez
- Department of Psychology University of Oviedo Oviedo Spain
| | - M. L. Morán
- Department of Psychology University of Oviedo Oviedo Spain
| | - P. Solís
- Department of Psychology University of Oviedo Oviedo Spain
| | - P. Pérez‐Curiel
- Department of Psychology and Sociology University of Zaragoza Zaragoza Spain
| | - A. Monsalve
- Department of Psychology University of Oviedo Oviedo Spain
| | - P. Navas
- INICO, Department of Personality, Assessment & Psychological Treatments University of Salamanca Salamanca Spain
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3
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Totsika V, Liew A, Absoud M, Adnams C, Emerson E. Mental health problems in children with intellectual disability. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:432-444. [PMID: 35421380 DOI: 10.1016/s2352-4642(22)00067-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 12/16/2022]
Abstract
Intellectual disability ranks in the top ten causes of disease burden globally and is the top cause in children younger than 5 years. 2-3% of children have an intellectual disability, and about 15% of children present with differences consistent with an intellectual disability (ie, global developmental delay and borderline intellectual functioning). In this Review, we discuss the prevalence of mental health problems, interventions to address these, and issues of access to treatment and services. Where possible, we take a global perspective, given most children with intellectual disability live in low-income and middle-income countries. Approximately 40% of children with intellectual disability present with a diagnosable mental disorder, a rate that is at least double that in children without intellectual disability. Most risk factors for poor mental health and barriers to accessing support are not unique to people with intellectual disability. With proportionate universalism as the guiding principle for reducing poor mental health at scale, we discuss four directions for addressing the mental health inequity in intellectual disability.
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Affiliation(s)
- Vasiliki Totsika
- Division of Psychiatry, University College London, London, UK; Department of Psychiatry, Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, VIC, Australia; Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry, UK; Tavistock & Portman NHS Foundation Trust, London, UK.
| | - Ashley Liew
- Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry, UK; National & Specialist CAMHS, South London and Maudsley NHS Foundation Trust, London, UK; Department of Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK; Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK; Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
| | - Colleen Adnams
- Division of Intellectual Disability, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Eric Emerson
- Centre for Disability Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK; Centre for Disability Research & Policy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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4
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Maia N, Nabais Sá MJ, Melo-Pires M, de Brouwer APM, Jorge P. Intellectual disability genomics: current state, pitfalls and future challenges. BMC Genomics 2021; 22:909. [PMID: 34930158 PMCID: PMC8686650 DOI: 10.1186/s12864-021-08227-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/02/2021] [Indexed: 12/18/2022] Open
Abstract
Intellectual disability (ID) can be caused by non-genetic and genetic factors, the latter being responsible for more than 1700 ID-related disorders. The broad ID phenotypic and genetic heterogeneity, as well as the difficulty in the establishment of the inheritance pattern, often result in a delay in the diagnosis. It has become apparent that massive parallel sequencing can overcome these difficulties. In this review we address: (i) ID genetic aetiology, (ii) clinical/medical settings testing, (iii) massive parallel sequencing, (iv) variant filtering and prioritization, (v) variant classification guidelines and functional studies, and (vi) ID diagnostic yield. Furthermore, the need for a constant update of the methodologies and functional tests, is essential. Thus, international collaborations, to gather expertise, data and resources through multidisciplinary contributions, are fundamental to keep track of the fast progress in ID gene discovery.
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Affiliation(s)
- Nuno Maia
- Centro de Genética Médica Jacinto de Magalhães (CGM), Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal. .,Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), and ITR - Laboratory for Integrative and Translational Research in Population Health, University of Porto, Porto, Portugal.
| | - Maria João Nabais Sá
- Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), and ITR - Laboratory for Integrative and Translational Research in Population Health, University of Porto, Porto, Portugal
| | - Manuel Melo-Pires
- Serviço de Neuropatologia, Centro Hospitalar e Universitário do Porto (CHUPorto), Porto, Portugal
| | - Arjan P M de Brouwer
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Paula Jorge
- Centro de Genética Médica Jacinto de Magalhães (CGM), Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), and ITR - Laboratory for Integrative and Translational Research in Population Health, University of Porto, Porto, Portugal
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5
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Rubenstein E, Ehrenthal DB, Mallinson DC, Bishop L, Kuo HH, Durkin M. Pregnancy complications and maternal birth outcomes in women with intellectual and developmental disabilities in Wisconsin Medicaid. PLoS One 2020; 15:e0241298. [PMID: 33108397 PMCID: PMC7591078 DOI: 10.1371/journal.pone.0241298] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/12/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Women with intellectual and developmental disabilities (IDD) may face greater risk for poor pregnancy outcomes. Our objective was to examine risk of maternal pregnancy complications and birth outcomes in women with IDD compared to women without IDD in Wisconsin Medicaid, from 2007-2016. METHODS Data were from the Big Data for Little Kids project, a data linkage that creates an administrative data based cohort of mothers and children in Wisconsin. Women with ≥1 IDD claim the year before delivery were classified as having IDD. Common pregnancy complications and maternal birth outcomes were identified from the birth record. We calculated risk ratios (RR) using log-linear regression clustered by mother. We examined outcomes grouped by IDD-type and explored interaction by race. RESULTS Of 177,691 women with live births, 1,032 (0.58%) had an IDD claim. Of 274,865 deliveries, 1,757 were to mothers with IDD (0.64%). Women with IDD were at greater risk for gestational diabetes (RR: 1.28, 95% CI: 1.0, 1.6), gestational hypertension (RR: 1.22, 95% CI: 1.0, 1.5), and caesarean delivery (RR 1.32, 95% CI: 1.2, 1.4) compared to other women. Adjustment for demographic covariates did not change estimates. Women with intellectual disability were at highest risk of gestational hypertension. Black women with IDD were at higher risk of gestational hypertension than expected under a multiplicative model. CONCLUSIONS Women with IDD have increased risk of pregnancy complications and adverse outcomes in Wisconsin Medicaid. Results were robust to adjustment. Unique patterns by IDD types and Black race warrant further exploration.
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Affiliation(s)
- Eric Rubenstein
- Waisman Center, University of Wisconsin Madison, Madison, WI, United States of America
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States of America
| | - Deborah B. Ehrenthal
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - David C. Mallinson
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
- Center for Demography and Ecology, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Lauren Bishop
- Waisman Center, University of Wisconsin Madison, Madison, WI, United States of America
- Sandra Rosesnbaum School of Social Work, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Hsiang-Huo Kuo
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Maureen Durkin
- Waisman Center, University of Wisconsin Madison, Madison, WI, United States of America
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
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6
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Anum A, Washington-Nortey M, Dzokoto V. Strategic planning in LAMIC mental health research: A Ghana case study. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1719621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Adote Anum
- Department of Psychology, University of Ghana, Accra, Ghana
| | | | - Vivian Dzokoto
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia, USA
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Abstract
Between 1% and 3% of persons in general population are estimated to have some degree of intellectual disability. A diagnosis of intellectual disability is based on clinical history, level of intellectual ability and level of adaptive function. Both, the intellectual and adaptive functioning are measured using individually administered standardized tests. More than 75% of persons who have intellectual disability have mild intellectual disability and an underlying specific etiology is less likely to be identified; whereas, in a small percentage of persons with severe intellectual disability, an underlying specific biologic cause is highly likely to be identified. Genetic abnormalities, inborn errors of metabolism and brain malformations are major categories of causes identified in severe to profound intellectual disability. The initial clinical presentation and recognition depends on the severity and underlying cause of intellectual disability. The etiology, severity, cognitive abilities, and adaptive function, vary among persons with intellectual disability and need consideration in developing a treatment plan. The physician plays an essential role in the evaluation, treatment of associated medical conditions and preventive care, and in facilitating and coordinating consultative services and community based care.
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Affiliation(s)
- Dilip R Patel
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Maria Demma Cabral
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Arlene Ho
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Joav Merrick
- Hadassah Hebrew University Medical Center, Jarusalem, Israel.,University of Kentucky, Lexington, USA.,School of Public Health, Georgia State University, Atlanta, USA
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8
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Krahn GL. A Call for Better Data on Prevalence and Health Surveillance of People With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 57:357-375. [PMID: 31568742 DOI: 10.1352/1934-9556-57.5.357] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The U.S. approach to the health of people with intellectual and developmental disabilities (IDD) is fraught with paradox. The health of this population has been of longstanding concern, yet we understand their health less well than many other groups. The U.S. spends much more per person on the well-being of people with IDD compared to the general population, yet the outcomes of those expenditures are disappointing and include significant preventable health disparities. Even as expectations for people with IDD have changed to include better health and greater participation in their communities, eligibility for services that support these outcomes is rooted in expectations of dependence and poverty. This article is a call for better data that considers a series of questions to provide context for understanding the need and directions for better health surveillance of people with IDD.
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Affiliation(s)
- Gloria L Krahn
- Gloria L. Krahn, Oregon State University, College of Public Health and Human Sciences, Corvallis
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Lauer E, Nicola ND, Warsett K, Monterrey R. Contributions of Mental and Behavioral Health Conditions to Health Service Utilization Among People With Intellectual and Developmental Disabilities in Massachusetts. ACTA ACUST UNITED AC 2019. [DOI: 10.1352/2326-6988-7.3.188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abstract
Although existing evidence suggests an increased prevalence mental and behavioral health conditions for people with intellectual and developmental disabilities (IDD), little is known about health service utilization patterns related to these conditions. This study provides population-based data on hospital service utilization. Medicaid claims for people under 65 years of age in Massachusetts were used (years 2008-2013) to identify a cohort of people with IDD. Utilization of inpatient hospitalizations and outpatient Emergency Department (ED) was compared with the U.S. and MA general population through risk ratios. Findings suggest mental and behavioral health conditions were major contributors to increased utilization of inpatient and outpatient ED services and underscore the need for community-based service options that understand how to treat these conditions in people with IDD and address the myriad of related factors to identify, treat, and minimize the potential adverse life impact of these conditions for people with IDD.
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Affiliation(s)
- Emily Lauer
- Emily Lauer, University of Massachusetts Medical School; Nassira D. Nicola, Kimberley Warsett, and Rodrigo Monterrey, Massachusetts Department of Public Health
| | - Nassira D. Nicola
- Emily Lauer, University of Massachusetts Medical School; Nassira D. Nicola, Kimberley Warsett, and Rodrigo Monterrey, Massachusetts Department of Public Health
| | - Kimberley Warsett
- Emily Lauer, University of Massachusetts Medical School; Nassira D. Nicola, Kimberley Warsett, and Rodrigo Monterrey, Massachusetts Department of Public Health
| | - Rodrigo Monterrey
- Emily Lauer, University of Massachusetts Medical School; Nassira D. Nicola, Kimberley Warsett, and Rodrigo Monterrey, Massachusetts Department of Public Health
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10
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Zhou M, Du W, Salvador-Carulla L, Glasgow N. Adverse drug event-related hospitalisation in persons with neurodevelopmental disorders: a state-wide retrospective cohort study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:429-440. [PMID: 30609156 DOI: 10.1111/jir.12586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 11/06/2018] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Little is known about the sociodemographic and clinical characteristics of adverse drug events (ADEs) in patients with neurodevelopmental disorders (NDD). OBJECTIVE The objective of this study was to describe and compare the demographic details of people with and without NDD hospitalised due to ADEs. METHODS The all-inclusive New South Wales Admitted Patient Data Collection from 2001 to 2014 was employed to identify ADE-related hospitalisations in patients with NDD using the International Classification of Diseases 10th revision Australian modification codes. We derived case sets specific to different clinical groups and patient characteristics and compared proportional differences between patients with and without intellectual disability using chi squared tests. RESULTS A total of 2173 patients with NDD were admitted for acute care of ADEs, accounting for 0.7% of all ADE-related hospitalisations. Hospitalised ADEs among patients with NDD increased by twofold over the 14-year study period. Psychotropic medications and opioid analgesic medications were leading causes of ADE-related hospitalisations in patients with NDD. Compared with their counterparts, patients with NDD were younger, experienced more socio-economic disadvantage and less private insurance coverage, suffered with less severe but different co-morbid clinical conditions and incurred more challenges in the acute hospital care setting. CONCLUSION Although the pattern of ADE-related hospitalisations in patients with NDD differed from that in patients without NDD, there is a lack of targeted healthcare programmes to meet their special needs. This study suggests the need for countermeasures in primary healthcare settings to reduce the burden of ADEs in this vulnerable group.
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Affiliation(s)
- M Zhou
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
- Pharmacy department, People's Hospital of Xinjiang, Urumqi, China
| | - W Du
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Canberra, Australia
| | - L Salvador-Carulla
- Centre of Mental Health Research, Research School of Population Health, Australian National University, Canberra, Australia
| | - N Glasgow
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Canberra, Australia
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11
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Dew A, Dowse L, Athanassiou U, Trollor J. Current Representation of People With Intellectual Disability in Australian Mental Health Policy: The Need for Inclusive Policy Development. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2018. [DOI: 10.1111/jppi.12239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Angela Dew
- Intellectual Disability Behaviour Support Program; School of Arts and Social Sciences, Arts and Social Sciences; UNSW, Sydney NSW Australia
| | - Leanne Dowse
- Intellectual Disability Behaviour Support Program; School of Arts and Social Sciences, Arts and Social Sciences; UNSW, Sydney NSW Australia
| | - Ulrika Athanassiou
- Intellectual Disability Behaviour Support Program; School of Arts and Social Sciences, Arts and Social Sciences; UNSW, Sydney NSW Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry; UNSW; Sydney NSW Australia
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12
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Wark S, Hussain R, Müller A, Ryan P, Parmenter T. Challenges in providing end‐of‐life care for people with intellectual disability: Health services access. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 30:1151-1159. [DOI: 10.1111/jar.12408] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Stuart Wark
- School of Rural MedicineUniversity of New England Armidale NSW Australia
| | - Rafat Hussain
- ANU Medical School & Research School of Population HealthAustralian National University Canberra ACT Australia
| | - Arne Müller
- School of Rural MedicineUniversity of New England Armidale NSW Australia
| | - Peta Ryan
- School of Rural MedicineUniversity of New England Armidale NSW Australia
| | - Trevor Parmenter
- Centre for Disability StudiesSydney Medical SchoolUniversity of Sydney Sydney NSW Australia
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13
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Xu X, McDermott SW, Mann JR, Hardin JW, Deroche CB, Carroll DD, Courtney-Long EA. A longitudinal assessment of adherence to breast and cervical cancer screening recommendations among women with and without intellectual disability. Prev Med 2017; 100:167-172. [PMID: 28455223 PMCID: PMC5675015 DOI: 10.1016/j.ypmed.2017.04.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/04/2017] [Accepted: 04/23/2017] [Indexed: 11/20/2022]
Abstract
Each year in the United States, about 4000 deaths are attributed to cervical cancer, and over 40,000 deaths are attributed to breast cancer (U.S. Cancer Statistics Working Group, 2015). The purpose of this study was to identify predictors of full, partial, and no screening for breast and cervical cancer among women with and without intellectual disability (ID) who are within the age group for screening recommended by the U.S. Preventive Service Task Force (USPSTF), while accounting for changes in recommendations over the study period. Women with ID and an age matched comparison group of women without ID were identified using merged South Carolina Medicaid and Medicare files from 2000 to 2010. The sample consisted of 9406 and 16,806 women for mammography screening and Papanicolaou (Pap) testing adherence, respectively. We estimated multinomial logistic regression models and determined that women with ID were significantly less likely than women without ID to be fully adherent compared to no screening with mammography recommendations (adjusted odds ratio [AOR]: 0.63, 95% confidence interval [CI] 0.55-0.72), and Pap testing recommendations (AOR: 0.17, 95% CI 0.16-0.19). For the 70% of women with ID for whom we had residential information, those who lived in a group home, medical facility, or supervised community living setting were more likely to be fully adherent with both preventive services than those living alone or with family members. For both outcomes, women residing in a supervised nonmedical community living setting had the highest odds of full adherence, adjusting for other covariates.
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Affiliation(s)
- Xinling Xu
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, 915 Greene Street, Columbia, SC 29208, United States
| | - Suzanne W McDermott
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, 915 Greene Street, Columbia, SC 29208, United States.
| | - Joshua R Mann
- University of Mississippi Medical Center, Department of Preventive Medicine, 2500 North State Street, Jackson, MS 39216, United States
| | - James W Hardin
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, 915 Greene Street, Columbia, SC 29208, United States
| | - Chelsea B Deroche
- University of Missouri Columbia, School of Medicine, Biostatistics and Research Design Unit, Health Management and Informatics Office of Medical Research, One Hospital Drive, Columbia, MO 65212, United States
| | - Dianna D Carroll
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Disability and Health Branch, Atlanta, GA, United States; Commissioned Corps, U.S. Public Health Service, Atlanta, GA, United States
| | - Elizabeth A Courtney-Long
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Disability and Health Branch, Atlanta, GA, United States
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14
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Salvador-Carulla L, Lukersmith S, Sullivan W. From the EBM pyramid to the Greek temple: a new conceptual approach to Guidelines as implementation tools in mental health. Epidemiol Psychiatr Sci 2017; 26:105-114. [PMID: 28290273 PMCID: PMC6998697 DOI: 10.1017/s2045796016000767] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Guideline methods to develop recommendations dedicate most effort around organising discovery and corroboration knowledge following the evidence-based medicine (EBM) framework. Guidelines typically use a single dimension of information, and generally discard contextual evidence and formal expert knowledge and consumer's experiences in the process. In recognition of the limitations of guidelines in complex cases, complex interventions and systems research, there has been significant effort to develop new tools, guides, resources and structures to use alongside EBM methods of guideline development. In addition to these advances, a new framework based on the philosophy of science is required. Guidelines should be defined as implementation decision support tools for improving the decision-making process in real-world practice and not only as a procedure to optimise the knowledge base of scientific discovery and corroboration. A shift from the model of the EBM pyramid of corroboration of evidence to the use of broader multi-domain perspective graphically depicted as 'Greek temple' could be considered. This model takes into account the different stages of scientific knowledge (discovery, corroboration and implementation), the sources of knowledge relevant to guideline development (experimental, observational, contextual, expert-based and experiential); their underlying inference mechanisms (deduction, induction, abduction, means-end inferences) and a more precise definition of evidence and related terms. The applicability of this broader approach is presented for the development of the Canadian Consensus Guidelines for the Primary Care of People with Developmental Disabilities.
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Affiliation(s)
- L. Salvador-Carulla
- Mental Health Policy Unit, Brain and Mind Centre, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - S. Lukersmith
- Mental Health Policy Unit, Brain and Mind Centre, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - W. Sullivan
- Department of Family & Community Medicine, Medical Services, Surrey Place Centre, St. Michael's Hospital, Toronto, Canada
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15
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Transition to adulthood for young people with intellectual disability: the experiences of their families. Eur Child Adolesc Psychiatry 2016; 25:1369-1381. [PMID: 27170424 DOI: 10.1007/s00787-016-0853-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 04/15/2016] [Indexed: 10/21/2022]
Abstract
Whilst the transition from school to adult roles can be challenging for any adolescent, for those with an intellectual disability it can present as a particularly difficult time both for the individual and their family. The process may involve coordinated planning, collaboration and decision-making among school staff, families and community agencies. This mixed-methods study utilised information from two cohorts: young people with Down syndrome in Western Australia (n = 190) and young people with intellectual disability (of any cause) in Queensland, Australia (n = 150). The parent-report questionnaires administered in both states comprised two parts: part 1 collected information about the individual with intellectual disability including information on health, functioning and service needs, and about specific transition related issues; and part 2 collected information about the health and well-being of their family. The majority (87 %) of parents said that they were involved in decision-making about transition planning but less than two-thirds (59.5 %) of young people were involved in this process. The three most helpful strategies indicated by parents that assisted with transition planning related to the provision of more information about financial assistance, the school transition program and the building of informal community-based supports. A number of themes emerged from the qualitative data which included parents' views and concerns about the capacity of their young adult to adapt and change to life in adulthood, their difficulty navigating services and programs, issues and challenges around their young person building connectedness, strain on family wellbeing and finances and worry about the longer term future.
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