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Matin BK, Ballan M, Darabi F, Karyani AK, Soofi M, Soltani S. Sexual health concerns in women with intellectual disabilities: a systematic review in qualitative studies. BMC Public Health 2021; 21:1965. [PMID: 34717594 PMCID: PMC8556840 DOI: 10.1186/s12889-021-12027-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies indicate that women with intellectual disabilities (ID) face various personal and socio-environmental barriers in their sexual lives. This study aimed to identify the concerns and sexual health needs experienced by women with ID. METHOD A systematic review of relevant qualitative articles was conducted in PubMed, Web of Science Scopus and PsycINFO databases from June 2018 to August 2018. We designed our search strategy according to two main foci: (1) sexuality; and (2) women with ID. In the study, searches were limited to articles published from January 2000 to December 2017. In this review, studies on women ages 16 and over were included. RESULTS Within the four databases, the search found 274 unique articles. After three steps of screening (title, abstract and full text), 22 studies were included in the final review. The articles mentioned difficulties with lack of sexual experience, negative experiences with sexuality, negative attitudes towards sexuality by nondisabled individuals, limited cognitive capacities to understand sexual identity, difficulty with finding the right partner, lack of access to sexual health information, lack of school-based sexuality education, violence and sexual abuse, lack of support from families and caregivers about sexuality, fear of sexual acts and unwanted pregnancy, shyness in expressing sexual desires, and limited knowledge of sexual behaviors. CONCLUSION Our findings indicate that women with ID need to be provided with school-based sexuality education tailored to the level of understanding needed to attain the requisite knowledge to form relationships, understand sexual and romantic relationships, and practice safe sex when they choose this option. Families along with education and healthcare systems should provide opportunities for women with ID to talk about their sexual needs and make their own choices.
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Affiliation(s)
- Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Michelle Ballan
- School of Social Welfare, Stony Brook University, New York, USA
| | - Fatemeh Darabi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Ali Kazemi Karyani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moslem Soofi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahin Soltani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Hayward H, Louis M, Edwards L, Jacob R. Sleep Disordered Breathing in Adults with Cerebral Palsy: What Do We Know So Far? South Med J 2021; 114:339-342. [PMID: 34075423 DOI: 10.14423/smj.0000000000001264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
As advances in medicine continue to extend the lifespan of patients with cerebral palsy (CP), emphasis must be placed on evaluating patients for chronic health issues common in the general adult population. Sleep-disordered breathing (SDB) affects a large number of otherwise healthy adults and is even more common in individuals with disability. SDB includes the following subtypes: obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation/hypoxemia. SDB consequences include poor daytime functioning from sleepiness and an increased risk of cardiovascular morbidity and mortality. There is a paucity of data available in the literature about the association between SDB and CP in the adult population. More research is needed to understand the true prevalence and management strategies of SDB in patients with CP. This review focuses on three major subtypes of SDB: obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation/hypoxemia.
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Affiliation(s)
- Hannah Hayward
- From the Division of General Internal Medicine, University of Florida College of Medicine, Jacksonville
| | - Mariam Louis
- From the Division of General Internal Medicine, University of Florida College of Medicine, Jacksonville
| | - Linda Edwards
- From the Division of General Internal Medicine, University of Florida College of Medicine, Jacksonville
| | - Rafik Jacob
- From the Division of General Internal Medicine, University of Florida College of Medicine, Jacksonville
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3
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Leyssens L, Van Hecke R, Moons K, Luypaert S, Willems M, Danneels M, Martens S, Dhondt C, Maes L. Vestibular function in adults with intellectual disabilities: feasibility and outcome of a vestibular screening protocol in Special Olympics athletes. Int J Audiol 2020; 60:446-457. [PMID: 33100086 DOI: 10.1080/14992027.2020.1834633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to evaluate the feasibility of a well-adapted vestibular screening battery to objectively examine the (peripheral) vestibular function, and to explore the characteristics of potential vestibular deficits in the adult ID population. DESIGN Cross-sectional study design. STUDY SAMPLE Compared to an age- and gender-weighted control group, a heterogeneous group of forty-five adults with ID participated in the vestibular screening at the National Games of Special Olympics Belgium (2019), which consisted of a bone conduction cervical Vestibular Evoked Myogenic Potential (cVEMP) measurement and video Head Impulse Test (vHIT). RESULTS The screening battery appeared to be feasible in the majority of the participants (cVEMP: 92%; vHIT: 72%). Overall, the occurrence of abnormal cVEMP and vHIT responses was significantly higher in the ID group, with significantly lower corrected peak-to-peak cVEMP amplitudes (p < 0.001), lower vHIT gains (p < 0.001), and higher cVEMP and vHIT asymmetry ratios in the ID group (p = 0.008 and p < 0.001 resp.). CONCLUSIONS Vestibular assessment using the cVEMP and vHIT technique shows a promising feasibility in adults with ID. In addition, this study suggests that people with ID exhibit an increased prevalence of (peripheral) vestibular deficits relative to the general population.
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Affiliation(s)
- Laura Leyssens
- Department of Rehabilitation Sciences, University of Ghent, Ghent, Belgium
| | - Ruth Van Hecke
- Department of Rehabilitation Sciences, University of Ghent, Ghent, Belgium
| | - Karlien Moons
- Department of Rehabilitation Sciences, University of Ghent, Ghent, Belgium
| | - Sofie Luypaert
- Department of Rehabilitation Sciences, University of Ghent, Ghent, Belgium
| | - Melina Willems
- Department of Audiology, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Maya Danneels
- Department of Rehabilitation Sciences, University of Ghent, Ghent, Belgium
| | - Sarie Martens
- Department of Rehabilitation Sciences, University of Ghent, Ghent, Belgium
| | - Cleo Dhondt
- Department of Head and Skin, University of Ghent, Belgium
| | - Leen Maes
- Department of Rehabilitation Sciences, University of Ghent, Ghent, Belgium.,Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
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Rethoré MO, Rouëssé J, Satgé D. Cancer screening in adults with down syndrome, a proposal. Eur J Med Genet 2020; 63:103783. [DOI: 10.1016/j.ejmg.2019.103783] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/29/2019] [Accepted: 10/06/2019] [Indexed: 11/29/2022]
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5
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Jamil NA, Jia Ling C, Md Ibrahim HI, Hamzaid NH, Kok Yong C. Nutritional and bone health status in young men with mild-to-moderate intellectual disability and without intellectual disability residing in community setting in Malaysia. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:632-639. [PMID: 32080943 DOI: 10.1111/jar.12708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 11/15/2019] [Accepted: 01/24/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aimed to compare the nutritional and bone health status between young men with mild-to-moderate intellectual disability and those without intellectual disability and to determine predictors for their bone health status. METHOD A total of 95 men (47 men with intellectual disability; 48 men without intellectual disability), aged 20-39 years, participated in this study. Anthropometric profile, dietary intake, physical activity level and calcaneal speed of sound (SOS) were collected. RESULTS The men with intellectual disability had moderate diet quality whilst the men without intellectual disability had poor diet quality. More participants with intellectual disability (97.9%) were inactive compared with their counterparts (10.4%). The SOS value was similar between groups and was lower than the reference. Increasing age and low physical activity level were negative predictors for bone health status. CONCLUSION Both young men with and without intellectual disability have suboptimal nutritional and bone health status. Strategies to improve their nutritional and bone health status are warranted.
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Affiliation(s)
- Nor Aini Jamil
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chang Jia Ling
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hawa Izzati Md Ibrahim
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Hana Hamzaid
- Centre for Rehabilitation and Special Needs Studies (iCaReHab), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chin Kok Yong
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Khalsa HMK, Baldessarini RJ, Tohen M, Salvatore P. Aggression among 216 patients with a first-psychotic episode of bipolar I disorder. Int J Bipolar Disord 2018; 6:18. [PMID: 30097737 PMCID: PMC6161985 DOI: 10.1186/s40345-018-0126-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 07/05/2018] [Indexed: 12/03/2022] Open
Abstract
Background Aggression by patients with bipolar I disorder (BD-I) is not uncommon. Identifying potential risk factors early in the illness-course should inform clinical management and reduce risk. Methods In a study sample of 216 initially hospitalized, first-psychotic episode subjects diagnosed with DSM-IV-TR BD-I, we identified recent (within 1 month before hospitalization) aggression by ratings on the Brief Psychiatric Rating Scale-Expanded and review of detailed clinical research records. We compared subjects with versus without aggressive behavior for associations with selected demographic and clinical factors. Results Aggression was identified in 23/216 subjects (10.6%). It was associated significantly with recent suicide attempt (OR = 4.86), alcohol abuse (OR = 3.63), learning disability (OR = 3.14), and initial manic episode (OR = 2.59), but not with age, sex, onset-type, personality disorder, time to recovery, or functional status. Conclusions Among first-major episode BD-I patients with psychotic features, recent serious aggression towards others was identified in 10.6%. The odds of aggression increased by 4.9-times in association with a recent suicide attempt, more than 3-times with alcohol-abuse or learning disability, and by 2.6-times if the episode polarity was manic. The findings encourage closer management of alcohol misuse, suicide risk, and manic symptoms, and early detection of learning problems in BD-I patients.
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Affiliation(s)
- Hari-Mandir K Khalsa
- International Consortium for Bipolar & Psychotic Disorders Research, Psychotic Disorders Division, McLean Hospital, Belmont, MA, 02478, USA. .,Division of Mental Health and Wellbeing, Warwick Medical School, Coventry, UK. .,Department of Psychiatry, Harvard Medical School, Boston, MA, 02215, USA.
| | - Ross J Baldessarini
- International Consortium for Bipolar & Psychotic Disorders Research, Psychotic Disorders Division, McLean Hospital, Belmont, MA, 02478, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, 02215, USA
| | - Mauricio Tohen
- International Consortium for Bipolar & Psychotic Disorders Research, Psychotic Disorders Division, McLean Hospital, Belmont, MA, 02478, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, 02215, USA.,Department of Psychiatry & Behavioral Sciences, University of New Mexico, Health Sciences Center, Albuquerque, NM, 87131, USA
| | - Paola Salvatore
- International Consortium for Bipolar & Psychotic Disorders Research, Psychotic Disorders Division, McLean Hospital, Belmont, MA, 02478, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, 02215, USA.,Psychiatry Section, Department of Medicine & Surgery, University of Parma, Parma, Italy
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7
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Parish SL, Son E, Powell RM, Igdalsky L. Reproductive Cancer Treatment Hospitalizations of U.S. Women With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 56:1-12. [PMID: 29389260 DOI: 10.1352/1934-9556-56.1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There is a dearth of existing research on the treatment of reproductive cancers among women with intellectual and developmental disabilities (IDD). This study analyzed the 2010 Healthcare Cost and Utilization Project Nationwide Inpatient Sample and compared the prevalence of reproductive cancer treatment hospitalization discharges among women with and without IDD. Discharges linked to women with IDD had higher incidences of cancer of the uterus and lower prevalence of cancer of the cervix. Moreover, discharges linked to women with IDD indicated these women were younger, had longer hospital stays, and were more likely to have public insurance coverage. Therefore, further research and targeted interventions to increase cancer prevention and screening are urgently needed.
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Affiliation(s)
- Susan L Parish
- Susan L. Parish, Bouvé College of Health Sciences, Northeastern University; Esther Son, Department of Social Work, College of Staten Island, City University of New York; Robyn M. Powell, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University; and Leah Igdalsky, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
| | - Esther Son
- Susan L. Parish, Bouvé College of Health Sciences, Northeastern University; Esther Son, Department of Social Work, College of Staten Island, City University of New York; Robyn M. Powell, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University; and Leah Igdalsky, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
| | - Robyn M Powell
- Susan L. Parish, Bouvé College of Health Sciences, Northeastern University; Esther Son, Department of Social Work, College of Staten Island, City University of New York; Robyn M. Powell, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University; and Leah Igdalsky, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
| | - Leah Igdalsky
- Susan L. Parish, Bouvé College of Health Sciences, Northeastern University; Esther Son, Department of Social Work, College of Staten Island, City University of New York; Robyn M. Powell, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University; and Leah Igdalsky, Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University
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8
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Gentile JP, Cowan AE, Harper B, Mast R, Merrill B. Reaching rural Ohio with intellectual disability psychiatry. J Telemed Telecare 2017; 24:434-439. [DOI: 10.1177/1357633x17706035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Individuals with intellectual disability experience higher rates of mental illness when compared with the general population, and there is a lack of medical and mental health professionals in rural and under-served areas. With the increase in discharge of individuals from institutional settings back to their home communities into the least restrictive environments, there are more patients with complex needs being added to the schedules of physicians in the outpatient delivery care system. Patients with disabilities may not travel well or tolerate changes in routine so may not have access to psychiatry. Utilization of telepsychiatry is well suited to this specialized patient population because it allows a highly traumatized group to meet with a psychiatrist and other mental health professionals from a location of their choice. Ohio’s Telepsychiatry Project for Intellectual Disability was initiated in 2012 to serve outlying communities with a lack of infrastructure and resources, to provide specialized mental health services to individuals with co-occurring mental illness and intellectual disability. After five years, over 900 patients with intellectual disability from 64 of Ohio’s 88 counties receive specialized mental health treatment through this statewide grant-funded project.
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Affiliation(s)
- Julie P Gentile
- Department of Psychiatry, Wright State University, Dayton, OH, USA
| | - Allison E Cowan
- Department of Psychiatry, Wright State University, Dayton, OH, USA
| | - Beth Harper
- Department of Psychiatry, Wright State University, Dayton, OH, USA
| | - Ryan Mast
- Department of Psychiatry, Wright State University, Dayton, OH, USA
| | - Brian Merrill
- Department of Psychiatry, Wright State University, Dayton, OH, USA
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9
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Zhong X, Singh N, Boyd L, Lawson C. Patient-Centered Strategies to Improve Radiographic Practice for Patients with Down Syndrome: A Systematic Review. J Med Imaging Radiat Sci 2016; 47:367-372. [PMID: 31047263 DOI: 10.1016/j.jmir.2016.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 08/18/2016] [Accepted: 09/16/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Down syndrome is a common human genetic disorder caused by trisomy of chromosome 21. Individuals with Down syndrome can present with a range of health issues during their lives that may require imaging for diagnosis. Radiographers, therefore, play a significant role in the management and communication of Down syndrome patients' health. PURPOSE This review identified patient-centered strategies that radiographers should use to provide quality imaging services for Down syndrome patients, who may have limited verbal ability and behavioral issues. METHOD A systematic review using the established PRISMA guidelines was undertaken of current literature obtained through the Ovid and Scopus databases. A total of 189 articles were found, of which 41 were categorized and analyzed in detail. FINDINGS A high level of care for Down syndrome patients will require longer than usual procedures, and the patients will not respond well to being rushed or ignored. Down syndrome patients have difficulty verbalizing, yet they understand more than is often thought. Individuals may require increased imaging time to give them time to respond, especially to pain. Patients are at risk of injury with AAI or other pathologies, and caution should be taken with flexion and extension spine x-rays. Radiographs may reveal undisclosed physical abuse. CONCLUSION Specific strategies with verbal and nonverbal communication help to facilitate communication, reduce anxiety and fear, and improve compliance with Down syndrome patients. Patients may require an increased level of care; increased imaging time; and allowing support people to be present during the examination process.
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Affiliation(s)
- Xiao Zhong
- Medical Imaging, Latrobe Regional Hospital, Traralgon, Victoria, Australia
| | - Nabita Singh
- Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Victoria, Australia
| | - Lori Boyd
- Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Victoria, Australia
| | - Celeste Lawson
- Professional Communication Program, School of Education and the Arts, Central Queensland University, Rockhampton, Queensland, Australia.
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Brown M, Jacobstein D, Yoon IS, Anthony B, Bullock K. Systemwide Initiative Documents Robust Health Screening for Adults With Intellectual Disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 54:354-365. [PMID: 27673736 DOI: 10.1352/1934-9556-54.5.354] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
It is well documented that adults with intellectual disability (ID) experience higher rates of a series of health conditions compared to their peers without disability. These health conditions include cardiovascular disease, obesity, diabetes, gastrointestinal disorders, and psychiatric and behavioral disorders. With life expectancy approximating the general population, adults with ID are also now experiencing health conditions related to aging, further increasing their risk for diminished function and well-being. This increased morbidity poses new challenges in geriatric healthcare planning for this population. Relatively simple health prevention practices, such as the implementation of a health screening tool, can substantially increase disease detection and clinical activities directed toward improved health outcomes for people with ID. This study examines data collected from the District of Columbia Developmental Disabilities Administration's (DC DDA's) health screening component of its Health and Wellness Standards. Findings are presented, along with recommendations and implications for improving preventive health screening practices in the ID population.
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Affiliation(s)
- Marisa Brown
- Marisa Brown, Diane Jacobstein, and Irene Seyoung Yoon, Georgetown University Center for Child and Human Development, University Center for Excellence in Developmental Disabilities; Bruno Anthony, Georgetown University Center for Child and Human Development; and Kim Bullock, Georgetown University, Department of Family Medicine
| | - Diane Jacobstein
- Marisa Brown, Diane Jacobstein, and Irene Seyoung Yoon, Georgetown University Center for Child and Human Development, University Center for Excellence in Developmental Disabilities; Bruno Anthony, Georgetown University Center for Child and Human Development; and Kim Bullock, Georgetown University, Department of Family Medicine
| | - Irene Seyoung Yoon
- Marisa Brown, Diane Jacobstein, and Irene Seyoung Yoon, Georgetown University Center for Child and Human Development, University Center for Excellence in Developmental Disabilities; Bruno Anthony, Georgetown University Center for Child and Human Development; and Kim Bullock, Georgetown University, Department of Family Medicine
| | - Bruno Anthony
- Marisa Brown, Diane Jacobstein, and Irene Seyoung Yoon, Georgetown University Center for Child and Human Development, University Center for Excellence in Developmental Disabilities; Bruno Anthony, Georgetown University Center for Child and Human Development; and Kim Bullock, Georgetown University, Department of Family Medicine
| | - Kim Bullock
- Marisa Brown, Diane Jacobstein, and Irene Seyoung Yoon, Georgetown University Center for Child and Human Development, University Center for Excellence in Developmental Disabilities; Bruno Anthony, Georgetown University Center for Child and Human Development; and Kim Bullock, Georgetown University, Department of Family Medicine
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Erickson SR, Kornexl K. Blood Pressure Screening, Control, and Treatment for Patients With Developmental Disabilities in General Medicine Practices. J Pharm Technol 2016. [DOI: 10.1177/8755122516663219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Little is known about the adequacy of screening for and treatment of hypertension for people with developmental disabilities (DD). Pharmacists may assist in identifying and treating this special patient population. Objective: To characterize and compare the screening, treatment, and control of blood pressure (BP) in patients with DD to patients without DD. Methods: This retrospective study identified adult patients of primary care practices within a large academic health system who had DD (DD group) and a comparator group without DD (GenMed group). Outcomes assessed included percentage of patients screened, mean BP, percentage of patients with controlled BP, and antihypertensive medications prescribed. Results: The DD (n = 183) and GenMed groups (n = 497) were nearly all screened for BP. Mean systolic BP was significantly lower in the DD group (119.9 ± 14.6 mm Hg vs 122.8 ± 15.4 mm Hg GenMed, P = .03), while diastolic BP was no different ( P = .7). Stroke was documented significantly more often in the DD group (5.5% vs 1.4%, P = .005). Of patients with uncontrolled BP, the DD group had significantly higher systolic BP (155.8 ± 14.1 mm Hg vs 147.4 ± 9.5 mm Hg GenMed, P = .02). Hypertension was documented in 32% of DD group versus 38.5% of GenMed group, P = .15. Of this group, 88.1% of the DD group had controlled BP versus 78.0% of the GenMed group, P = .09. Antihypertensive prescribing was not different between the groups. Conclusion: DD group patients had similar outcomes for hypertension therapy compared to patients without DD. Those with uncontrolled BP in the DD group tended to have higher systolic BP. Significantly more DD patients had a history of stroke.
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Affiliation(s)
| | - Kayla Kornexl
- University of Michigan College of Pharmacy, Ann Arbor, MI, USA
- University of Michigan Health System Pharmacy Services, Ann Arbor, MI, USA
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12
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Mapping the Needs of Adults with Autism and Co-Morbid Intellectual Disability. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0071-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Ouellette-Kuntz H, Coo H, Cobigo V, Wilton AS. Uptake of colorectal cancer screening among Ontarians with intellectual and developmental disabilities. PLoS One 2015; 10:e0118023. [PMID: 25689849 PMCID: PMC4331499 DOI: 10.1371/journal.pone.0118023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 12/23/2014] [Indexed: 01/11/2023] Open
Abstract
Under-screening for cancer may contribute to a greater disease burden in individuals with intellectual and developmental disabilities (IDD) as their life expectancy increases. In 2008, the province of Ontario launched Canada’s first population-based colorectal cancer screening program. Our objectives were to compare the proportions of Ontarians with and without IDD who have undergone colorectal cancer screening and to examine factors associated with screening uptake among Ontarians with IDD. Records for Ontario residents 50–64 years of age were linked across various administrative health and social services datasets to identify individuals with IDD and to select a random sample of the age-equivalent Ontario population without IDD as a comparison group. Logistic regression models were fit to examine the odds of screening uptake among individuals with IDD while controlling for age, sex, urban or rural residence, neighbourhood income quintile, expected use of health care resources, and being enrolled with or seeing a physician in a patient enrolment model (any of several primary care practice models designed to improve patient access and quality of care in Ontario), and to examine the association between these variables and colorectal cancer screening in the IDD population. The odds of having had a fecal occult blood test in the previous two years and being up-to-date with colorectal tests were 32% and 46% lower, respectively, for Ontarians with IDD compared to those without IDD. Being older, female, having a greater expected use of health care resources, and being enrolled with or seeing a physician in a primary care patient enrolment model were all significantly associated with higher odds of having been screened for colorectal cancer in the IDD population. These findings underscore the need for targeted interventions aimed at making colorectal cancer screening more equitable.
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Affiliation(s)
- Hélène Ouellette-Kuntz
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
- Ongwanada Resource Centre, Kingston, Ontario, Canada
- Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada
- * E-mail:
| | - Helen Coo
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Virginie Cobigo
- Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrew S. Wilton
- Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada
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14
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Lin LP, Hsu SW, Yao CH, Lai WJ, Hsu PJ, Wu JL, Chu CM, Lin JD. Risk for osteopenia and osteoporosis in institution-dwelling individuals with intellectual and/or developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:108-113. [PMID: 25462471 DOI: 10.1016/j.ridd.2014.09.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 09/22/2014] [Indexed: 06/04/2023]
Abstract
The purpose of this study was to investigate the prevalence of and contributing factors to osteopenia and osteoporosis among people with intellectual disabilities (ID) or/and developmental disabilities (DD) residing in a disability institution in Taiwan. The present study was conducted at one disability institution in Taiwan and recruited 184 institutionalized residents with ID and/or DD (115 men and 69 women aged 18-72 years) for analysis. For all residents with ID and/or DD, information was obtained about their age, gender, level of ID, BMI, and bone mineral density (BMD). BMD is a measurement of calcium levels in bones that can estimate the risk of osteoporosis and bone fractures. Bone tests were divided into three outcome categories based on their calcaneal BMD T-scores: Normal BMD, a T-score≧-1; Osteopenia, -2.5≦T-score<-1; and Osteoporosis, a T-score<-2.5. The results revealed that 46.2% of cases were normal and that 27.7% and 26.1% of cases had osteopenia and osteoporosis, respectively. Multiple logistic regression analyses found that male gender (OR=2.482, 95% CI=1.04-5.93, p<0.05), age≧40 years (OR=3.051, 95% CI=1.07-8.69, p<0.05) and being overweight/obese (OR=0.395, 95% CI=0.17-0.93, p<0.05) were more likely to be associated with osteoporosis. Another model indicated that males (OR=2.169, 95% CI=1.12-4.19, p<0.05) and those aged≧40 years (OR=3.026, 95% CI=1.32-7, p<0.01) tended to have an increased risk for osteopenia and osteoporosis. To improve the bone quality of individuals with ID or/and DD and to decrease the occurrence of osteopenia and osteoporosis, this study highlights that we should pay much attention to the potential risk factors for bone quality in these vulnerable populations.
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Affiliation(s)
- Lan-Ping Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan; Department of Senior Citizen Service Management, Ching Kuo Institute of Management and Health, Keelung, Taiwan
| | - Shang-Wei Hsu
- Department of Healthcare Administration, Asia University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chung-Hui Yao
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Ju Lai
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Pei-Jung Hsu
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jia-Ling Wu
- Chung-Hua Foundation for Persons with Intellectual Disabilities, New Taipei City, Taiwan
| | - Cordia M Chu
- School of Public Health, National Defense Medical Center, Taipei, Taiwan; Center for Environment and Population Health, Griffith University, Brisbane, Australia
| | - Jin-Ding Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan; Chung-Hua Foundation for Persons with Intellectual Disabilities, New Taipei City, Taiwan; Center for Environment and Population Health, Griffith University, Brisbane, Australia; Department of Healthcare Administration, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
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Merrick J, Morad M, Carmeli E. Intellectual and developmental disabilities: male health. Front Public Health 2014; 2:208. [PMID: 25386552 PMCID: PMC4208613 DOI: 10.3389/fpubh.2014.00208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/08/2014] [Indexed: 11/30/2022] Open
Affiliation(s)
- Joav Merrick
- Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services , Jerusalem , Israel
| | - Mohammed Morad
- Clalit Health Services, Yaski Community Medical Center, Ben Gurion University of the Negev , Beer-Sheva , Israel
| | - Eli Carmeli
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, Haifa University , Haifa , Israel
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Wang CT, Greenwood N, White LF, Wilkinson J. Measuring preparedness for mammography in women with intellectual disabilities: a validation study of the Mammography Preparedness Measure. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2014; 28:212-22. [PMID: 25266546 DOI: 10.1111/jar.12123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND Women with intellectual disabilities have similar breast cancer rates as the general population, but lower rates of regular mammography and higher breast cancer mortality rates. Although prior qualitative work demonstrates that women with intellectual disabilities face unique, disability-specific barriers to mammography, the present authors lack standardized, validated instruments for measuring knowledge of breast cancer screening in this population. In addition, much research related to adults with intellectual disabilities focuses on family or carer perspectives, rather than involving women with intellectual disabilities, themselves. METHODS The present authors first pilot tested a general population instrument measuring breast cancer knowledge, and found that it did not perform adequately in women with intellectual disabilities. In response, the present authors developed the Mammography Preparedness Measure (MPM), a direct short interview tool to measure knowledge and preparedness in women with intellectual disabilities, themselves, rather than relying on caregiver or other reports, and using inclusive methodology. The present authors validated the MPM by assessing test-retest reliability. RESULTS Average test-retest per cent agreement of 84%, ranging from 74 to 91% agreement per item, with an overall kappa of 0.59. CONCLUSION The MPM appears to be a valid instrument appropriate for measuring mammography preparedness in women with intellectual disabilities. The success of this innovative tool suggests that direct, rather than informant-directed tools can be developed to measure health knowledge and cancer screening readiness in adults with intellectual disabilities, an important measure in studying and reducing disparities.
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Affiliation(s)
- Claire Tienwey Wang
- Department of Family Medicine, Boston University School of Medicine, Boston, MA, USA
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Race/Ethnicity and the Use of Preventive Health Care Among Adults With Intellectual and Developmental Disabilities. Med Care 2014; 52:S25-31. [DOI: 10.1097/mlr.0000000000000130] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Swaine JG, Parish SL, Luken K, Son E, Dickens P. Test of an intervention to improve knowledge of women with intellectual disabilities about cervical and breast cancer screening. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:651-663. [PMID: 23796162 DOI: 10.1111/jir.12062] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/29/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND There is a critical need for evidence-based health education interventions for women with intellectual disabilities (IDs) to promote receipt of preventive health screenings. Previous research has established Women Be Healthy, an 8-week classroom-style intervention designed to teach women with IDs about breast and cervical cancer screenings, as a promising practice. However, additional research is needed to determine how to further improve screening-related knowledge gains. This study aimed to test a modified version of Women Be Healthy, Women Be Healthy 2, and compare its effectiveness in increasing knowledge gains to the original intervention. METHOD Women living in the community across one state in the United States were randomly assigned to a treatment (n = 98), delayed treatment, (n = 35), or no intervention group (n = 65). Women in the treatment group received Women Be Healthy, and women in the delayed treatment group received the modified Women Be Healthy 2. Baseline and post-intervention interviews were conducted to measure knowledge of cervical and breast cancer screening. Knowledge scores were compared across groups. RESULTS Among the nine knowledge items measured, one breast knowledge measure and one cervical knowledge measure showed statistically significant group differences; marginally significant differences were observed for two other knowledge measures. After adjusting for covariates, women who received Women Be Healthy 2 had increased knowledge overall compared with the women receiving no intervention. CONCLUSION Women Be Healthy 2 is promising, but additional efforts appear necessary to increase the knowledge women with IDs have about cervical and breast cancer screening.
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Affiliation(s)
- J G Swaine
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
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Wilkinson J, Lauer E, Greenwood NW, Freund KM, Rosen AK. Evaluating representativeness and cancer screening outcomes in a state department of developmental services database. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2014; 52:136-146. [PMID: 24725112 DOI: 10.1352/1934-9556-52.2.136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Though it is widely recognized that people with intellectual and developmental disabilities (IDD) face significant health disparities, the comprehensive data sets needed for population-level health surveillance of people with IDD are lacking. This paucity of data makes it difficult to track and accurately describe health differences, improvements, and changes in access. Many states maintain administrative health databases that, to date, have not been widely used for research purposes. In order to evaluate the feasibility of using administrative databases for research purposes, the authors attempted to validate Massachusetts' administrative health database by comparing it to a large safety net hospital system's patient data regarding cancer screening, and to the state's service enrollment tables. The authors found variable representativeness overall; the sub-population of adults who live in 24-hr supported residences were better represented than adults who live independently or with family members. They also found a fairly low false negative rate for cancer screening data as compared with the "gold standard" of hospital records. Despite some limitations, these results suggest that state-level administrative databases may represent an exciting new avenue for health research. These results should lend context to efforts to study cancer and health screening variables using administrative databases. The present study methods may also have utility to researchers in other states for critically evaluating other state IDD service databases. This type of evaluation can assist researchers in contextualizing their data, and in tailoring their research questions to the abilities and limitations of this kind of database.
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20
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Parish SL, Swaine JG, Son E, Luken K. Determinants of cervical cancer screening among women with intellectual disabilities: evidence from medical records. Public Health Rep 2013; 128:519-26. [PMID: 24179263 PMCID: PMC3804095 DOI: 10.1177/003335491312800611] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We examined receipt of cervical cancer screening and determinants of screening for women with intellectual disabilities in one Southeastern state. METHODS Using medical records data from 2006 through 2010 for community-dwelling women with intellectual disabilities who were 18-65 years of age (n=163), we employed descriptive and bivariate statistics and a multivariate regression model to examine receipt of cervical cancer screening and the determinants of cervical cancer screening across women's sociodemographic and health-care provider characteristics. RESULTS Of women 18-65 years of age with intellectual disabilities, 55% received a Papanicolaou (Pap) test during 2008-2010, markedly below the Healthy People 2020 targets or rates of Pap test receipt of women without intellectual disabilities. Women with intellectual disabilities who lived in residential facilities, those who lived in rural communities, and those who had an obstetrician/gynecologist had higher rates of receipt of care than other women with intellectual disabilities. CONCLUSIONS Assertive measures are required to improve the receipt of cervical cancer screening among women with intellectual disabilities. Such measures could include education of women with intellectual disabilities, as well as their paid and family caregivers, and incentives for health-care providers who achieve screening targets.
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Affiliation(s)
- Susan L. Parish
- Brandeis University, Heller School for Social Policy and Management, Lurie Institute for Disability Policy, Waltham, MA
| | - Jamie G. Swaine
- University of North Carolina at Chapel Hill, School of Social Work, Chapel Hill, NC
| | - Esther Son
- Brandeis University, Heller School for Social Policy and Management, Lurie Institute for Disability Policy, Waltham, MA
| | - Karen Luken
- University of North Carolina at Chapel Hill, FPG Child Development Institute, North Carolina Office on Disability and Health, Chapel Hill, NC
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21
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Teaching health care students about disability within a cultural competency context. Disabil Health J 2013; 6:271-9. [DOI: 10.1016/j.dhjo.2013.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/06/2013] [Accepted: 05/08/2013] [Indexed: 11/22/2022]
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22
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Vacek JL, Hunt SL, Shireman T. Hypertension medication use and adherence among adults with developmental disability. Disabil Health J 2013; 6:297-302. [PMID: 24060252 DOI: 10.1016/j.dhjo.2013.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 02/18/2013] [Accepted: 02/22/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND/OBJECTIVE Adults with developmental disability (DD) have high prevalence of coronary artery disease risk factors, as well as impediments to optimal diagnosis and management. We analyzed antihypertensive medication (AM) use and adherence patterns in a Kansas Medicaid cohort. METHODS We studied adults (18-64 years) with DD and claims for HT from 7/1/05 to 8/31/06, with review of prescription records of AM use and adherence from 9/1/06 to 8/31/07. Adherence was calculated as proportion of days covered (PDC). RESULTS Of 3079 eligible people, 280 (9%) had claims for HT: 51% male, mean age 42 ± 13, and 81% Caucasian. Of these, 280 (72%) had claims for at least 1 AM; 57% received ≥2 AM. Angiotensin converting enzyme inhibitor/angiotensin receptor blockers were most commonly prescribed (65%) followed by diuretics (50%), beta blockers (34%), and calcium channel blockers (26%). Mean PDCs by class ranged from 0.622 to 0.693: 55% had a PDC ≥0.80, a common goal for adherence. Younger individuals were more likely to be adherent (p <0.05), but adherence was not significantly associated with comorbid conditions, gender, or race. CONCLUSIONS Of our cohort of adults with DD, 9% had HT of whom 72% submitted claims for AMs. A substantial proportion of subjects had inconsistent AM use suggesting suboptimal therapy. The association between younger ages and higher adherence may reflect better community-based support for younger adults. Further work is needed to identify barriers to optimal care for this vulnerable population.
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Affiliation(s)
- James L Vacek
- Division of Cardiovascular Diseases, School of Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160, USA.
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Swaine JG, Dababnah S, Parish SL, Luken K. Family caregivers' perspectives on barriers and facilitators of cervical and breast cancer screening for women with intellectual disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2013; 51:62-73. [PMID: 23360409 DOI: 10.1352/1934-9556-51.01.062] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Women with intellectual disability do not receive cervical and breast cancer screening at the same number as women without disabilities. Numerous barriers to receipt of screening have been reported by individuals with intellectual disability, paid caregivers, nurses, and other medical professionals. This study utilized semi-structured qualitative interviews to assess barriers to care from the perspective of female familial caregivers (n = 32). Caregivers reported a number of barriers to care including not knowing or not believing the exam was needed for their family member and discomfort during exams. Caregivers also described enablers to screening. The most common response to what enabled the woman with an intellectual disability to receive the exam was preparation prior to the exam. A significant portion of the sample of family caregivers lacked knowledge about the need for cervical and breast cancer screening by women with intellectual disability. Policy recommendations are discussed.
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Shooshtari S, Naghipur S, Zhang J. Unmet Healthcare and Social Services Needs of Older Canadian Adults With Developmental Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2012. [DOI: 10.1111/j.1741-1130.2012.00346.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
BACKGROUND Women with intellectual disabilities have the same rate of breast cancer as other women but are less likely to undergo screening mammography. Characteristics associated with mammography for women with intellectual disabilities in the United States are unknown. METHODS This study was based on a secondary data analysis of the Massachusetts Department of Developmental Services database, comparing women who had a mammogram within 2 years with women who had not on variables related to the ecological model. Bivariate analyses, logistic regression, and assessment of interactions were performed. RESULTS The study sample's (n = 2907) mean age was 54.7 years; 58% lived in 24-hour residential settings, 52% received nursing health coordination, and more than 25% had clinical examination needs (eg, sedation). Residential setting, health coordination, and recent influenza vaccination were all associated with mammography. Having a guardian, higher level of activities of daily living needs, and examination needs (requiring sedation or limited wait time for examinations) were associated with lower rates. Interactions between health coordination and examination needs confirmed the potential of the nurse to ameliorate barriers to mammography. CONCLUSION Several system-level variables were significantly associated with mammography and, in some cases, seemed to ameliorate intrapersonal/behavioral barriers to mammography. Community agencies caring for intellectually disabled women have potential to impact mammography rates by using health coordination.
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Wilkinson JE, Deis CE, Bowen DJ, Bokhour BG. 'It's easier said than done': perspectives on mammography from women with intellectual disabilities. Ann Fam Med 2011; 9:142-7. [PMID: 21403141 PMCID: PMC3056862 DOI: 10.1370/afm.1231] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 10/31/2010] [Accepted: 11/05/2010] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Women with intellectual disabilities (or mental retardation) are living longer, receiving primary care in the community, and have equal rates of breast cancer compared with women in the general population, but they have lower rates of mammography. Although several public campaigns have successfully raised the mammography rate for racial and ethnic minority women, they have not penetrated the community of women with intellectual disabilities. No research to date has explored potential barriers to mammography for these women by involving the women themselves as participants. METHODS We undertook a qualitative study to explore the perceptions and understanding of mammography for women with intellectual disabilities and some of the potential reasons they would or would not have the test. Twenty-seven intellectually disabled women were recruited through a variety of community groups and interviewed using a semistructured interview guide. Data were analyzed using qualitative techniques from grounded theory. RESULTS Participants in this study described being poorly prepared for mammography: they did not understand its purpose and were not prepared for the logistics of the experience. The latter was more upsetting to participants and contributed to their negative perceptions of mammography. Participants reported feeling unprepared and singled out for being unprepared, despite their desire to have at least 1 mammogram, as do other women their age. CONCLUSIONS Women with intellectual disabilities perceive mammography differently than do women who do not have intellectual disabilities, and their perception is informed by inadequate knowledge, anxiety, and inadequate preparation. These themes should be considered when planning cancer prevention interventions with this population and when counseling individual women in the clinical setting.
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Affiliation(s)
- Joanne E Wilkinson
- Department of Family Medicine, Boston University School of Medicine, Massachusetts 02118, USA.
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Lin LP, Lin PY, Chu CM, Lin JD. Predictors of caregiver supportive behaviors towards reproductive health care for women with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:824-829. [PMID: 21167677 DOI: 10.1016/j.ridd.2010.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2010] [Accepted: 10/18/2010] [Indexed: 05/30/2023]
Abstract
Although many previous studies have begun to address the reproductive health needs of women with intellectual disabilities; however, the supportive behaviors of caregivers to assist their reproductive health is not well understood. Data from a cross-sectional survey of "2009 National Survey on Reproductive Health Care Needs and Health Education Strategies for Women with Intellectual Disabilities in Taiwan" were analyzed. Study sample consisted of 1152 caregivers who working in 32 disability institutions have been analyzed in the study. The results showed that the caregiver did not have adequate supportive behaviors towards reproductive health care for women with ID (mean score was 29.84 out of 60), particularly in the arrangement of preventive reproductive health services. We analyzed the potential significant variables in a multiple linear regression model to examine the factors which affect the caregiver's supportive behaviors of reproductive health for women with ID. The model revealed that the factor of respondent's gender, job category, working years in disability setting, helping experience of reproductive health for women with ID, perception of reproductive health knowledge, in-job training of reproductive health, perceived adequacy of public reproductive health service for the client, scores of reproductive health knowledge and reproductive health attitude were significantly correlated to their supportive behavioral score of reproductive health for women with ID. These factors can explain 23.6% of the variation of supportive behavioral score. The present study suggests the reproductive health interventions need to take into account the perspectives of health workers, caregivers and women, as well as the constraints they face in providing and receiving services, respectively.
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Affiliation(s)
- Lan-Ping Lin
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
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Tyler CV, Zyzanski SJ, Panaite V, Council L. Nursing perspectives on cancer screening in adults with intellectual and other developmental disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2010; 48:271-277. [PMID: 20722477 DOI: 10.1352/1934-9556-48.4.271] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Health care disparities have been documented in cancer screenings of adults with intellectual and other developmental disabilities. Developmental disabilities nurses were surveyed to better understand and improve this deficiency. Two thirds of respondents believed that adults with intellectual and developmental disabilities received fewer cancer screenings compared with the general population. The most frequently cited barriers to cancer screenings were as follows: patient need for sedation, unsuccessful attempts at screening, and failure of the primary care clinician to order cancer screening tests. Nurses observed that health care providers frequently did not tailor cancer screening recommendations to individuals' family histories, life expectancies, or their disability-specific cancer risks. The authors suggest interventions to improve cancer screening centered around education and training, accessibility, financing-insurance, modification of procedures, and patient tracking.
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Affiliation(s)
- Carl V Tyler
- Department of Family Medicine, Case Western Reserve University, Cleveland, OH, USA.
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Haveman M, Heller T, Lee L, Maaskant M, Shooshtari S, Strydom A. Major Health Risks in Aging Persons With Intellectual Disabilities: An Overview of Recent Studies. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2010. [DOI: 10.1111/j.1741-1130.2010.00248.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Yen CF, Lin JD, Loh CH, Shi L, Hsu SW. Determinants of prescription drug use by adolescents with intellectual disabilities in Taiwan. RESEARCH IN DEVELOPMENTAL DISABILITIES 2009; 30:1354-1366. [PMID: 19577427 DOI: 10.1016/j.ridd.2009.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Accepted: 06/05/2009] [Indexed: 05/28/2023]
Abstract
Direct family caregivers of population-based adolescents with intellectual disabilities in Taiwan were surveyed regarding their perceptions of the use of prescribed medication and its relationship with health-related behaviors, medical care and preventive health utilization of people with intellectual disabilities. Cross-sectional data on 1419 adolescents 12-17 years of age was collected from the 2007 National Survey on Healthy Behaviors and Preventive Health Utilizations of People with Intellectual Disabilities in Taiwan. Multiple logistic regression models were used to examine risk profiles in relation to the use of prescribed medication and other relevant variables: participant characteristics, health-related behaviors, medical care and preventive health utilization. The results indicate that 47.1% of subjects were accompanied by other impairments, the morbidity prevalence was 16.5% and 23.8% of subjects were reported to have used prescribed medication regularly in the past 6 months. The main reasons for medication use were epilepsy (36.9%), psychiatric problems (24.2%) and gastrointestinal problems (6.3%). A large majority of caregivers reported that the subject's health status was excellent (15.4%), good (38%) or fair (38%), and only 6.5% were reported to be in bad health. Finally, data were analyzed using a logistic regression model to identify possible reasons for drug use. The following factors correlate with the regular use of prescribed medication by adolescents with intellectual disabilities: Down syndrome, possession of a Major Illness Card, a history of smoking, an additional impairment, reported health status, outpatient care and acceptance of other specific medical examinations. Our principal conclusion was that these data indicate a need for more education on a variety of issues, including predisposition, healthy behavior, medical care and preventive health utilization issues as they relate to prescribed medication use, and assessment of the long-term effects of drug use on people with intellectual disabilities.
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Affiliation(s)
- Chia-Feng Yen
- Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
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de Leon J, Greenlee B, Barber J, Sabaawi M, Singh NN. Practical guidelines for the use of new generation antipsychotic drugs (except clozapine) in adult individuals with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2009; 30:613-669. [PMID: 19084370 DOI: 10.1016/j.ridd.2008.10.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Accepted: 10/16/2008] [Indexed: 05/27/2023]
Abstract
New generation antipsychotic (NGA) drugs introduced to the US market after clozapine (aripiprazole, olanzapine, paliperidone, quetiapine, risperidone, and ziprasidone) are frequently used in individuals with intellectual disabilities (ID). However, there is very limited research to fully establish evidence-based or personalized medicine approaches for their use in this population. These guidelines take a pragmatic approach to establishing frameworks for their use by utilizing the prescribing information and reviewing the available literature on other relevant neuropsychiatric disorders. In the absence of expert consensus guidance and well-controlled comparison trials, we present a set of guidelines to inform initiation, dosing and monitoring of use in adults. Further, in these guidelines we provide practical information on drug-drug interactions and adverse drug reactions, and a brief review of discontinuation syndromes, potential for abuse, use during pregnancy and cost considerations. We also provide drug utilization review forms for each NGA to facilitate implementation of these guidelines, these guidelines provide a practical and necessary resource for practitioners treating psychiatric disorders and challenging behaviors in adult individuals with ID.
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Affiliation(s)
- Jose de Leon
- University of Kentucky Mental Health Research Center, Lexington, KY 40508, USA.
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Abstract
Women with intellectual disabilities (ID) need thoughtful, well-coordinated care from primary care physicians. They are particularly susceptible to experiencing disparities in care because of varied participation in shared decision making. This review of the current literature comments on the quantity and quality of existing studies regarding several key women's health issues: menstrual disorders, cervical and breast cancer screening, contraception, and osteoporosis. A review of the current thinking regarding ethical and legal issues in medical decision making for these women is also provided. We found that there are several high-quality studies recommending early and frequent screening for osteoporosis, which is more common in women with ID. Smaller and fewer studies comment specifically on techniques for accomplishing the gynecological examination in women with ID, although the cervical cancer screening recommendation should be individualized for these patients. Consensus data on the management of menstrual problems and contraception in women with ID is provided. There are some data on breast cancer incidence but few articles on methods to improve screening rates in women with ID.
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Affiliation(s)
- Joanne E Wilkinson
- Department of Family Medicine, Boston University School of Medicine, Massachusettes, USA.
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