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Seijas V, Maritz R, Fernandes P, Bernard RM, Lugo LH, Bickenbach J, Sabariego C. Rehabilitation delivery models to foster healthy ageing-a scoping review. Front Rehabil Sci 2024; 5:1307536. [PMID: 38660395 PMCID: PMC11041397 DOI: 10.3389/fresc.2024.1307536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/15/2024] [Indexed: 04/26/2024]
Abstract
Introduction Rehabilitation is essential to foster healthy ageing. Older adults have unique rehabilitation needs due to a higher prevalence of non-communicable diseases, higher susceptibility to infectious diseases, injuries, and mental health conditions. However, there is limited understanding of how rehabilitation is delivered to older adults. To address this gap, we conducted a scoping review to describe rehabilitation delivery models used to optimise older adults' functioning/functional ability and foster healthy ageing. Methods We searched Medline and Embase (January 2015 to May 2022) for primary studies published in English describing approaches to provide rehabilitation to older adults. Three authors screened records for eligibility and extracted data independently and in duplicate. Data synthesis included descriptive quantitative analysis of study and rehabilitation provision characteristics, and qualitative analysis to identify rehabilitation delivery models. Results Out of 6,933 identified records, 585 articles were assessed for eligibility, and 283 studies with 69,257 participants were included. We identified six rehabilitation delivery models: outpatient (24%), telerehabilitation (22%), home (18.5%), community (16.3%), inpatient (14.6%), and eldercare (4.7%). These models often involved multidisciplinary teams (31.5%) and follow integrated care principles (30.4%). Most studies used a disease-centred approach (59.0%), while studies addressing multimorbidity (6.0%) and prevalent health problems of older adults, such as pain, low hearing, and vision, or incontinence were scarce. The most frequently provided interventions were therapeutic exercises (54.1%), self-management education (40.1%), and assessment of person-centred goals (40%). Other interventions, such as assistive technology (8.1%) and environmental adaptations (7.4%) were infrequent. Conclusions Focusing on primary studies, this scoping review provides an overview of rehabilitation delivery models that are used to foster healthy ageing and highlights research gaps that require further attention, including a lack of systematic assessment of functioning/functional ability, a predominance of disease-centred rehabilitation, and a scarcity of programmes addressing prevalent issues like pain, hearing/vision loss, fall prevention, incontinence, and sexual dysfunctions. Our research can facilitate evidence-based decision-making and inspire further research and innovation in rehabilitation and healthy ageing. Limitations of our study include reliance on published research to infer practice and not assessing model effectiveness. Future research in the field is needed to expand and validate our findings.
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Affiliation(s)
- Vanessa Seijas
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Roxanne Maritz
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Patricia Fernandes
- Department of Clinical Medicine, Federal University of Parana, Parana, Brazil
| | | | - Luz Helena Lugo
- Rehabilitation in Health Research Group, University of Antioquia, Medellin, Colombia
| | - Jerome Bickenbach
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Carla Sabariego
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
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Theotokatos G, Escorpizo R, Angelopoulos TJ, Chrysagis NK, Venieri A, Bickenbach J, Karteroliotis K, Grammatopoulou E, Skordilis E. The Sociodemographic Factors Related to Disability of Applicants of Welfare Benefits in Greece: A Cross-Sectional Survey Based on the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. Cureus 2024; 16:e55614. [PMID: 38586637 PMCID: PMC10995654 DOI: 10.7759/cureus.55614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION The aim of the present study was to report on the prevalence of disability and its association with sociodemographic factors among welfare benefit applicants in Greece. The study also compared the disability scores between different health conditions using the WHODAS 2.0 (12-item version), a biopsychosocial-model-based measure. METHODS The Greek WHODAS 2.0, 12-item version, was administered by interview. A three-member medical committee assessed the medical records of the applicants and assigned a disability percentage based on the biomedical measure of disability percentage determination (Barema scale). RESULTS The majority of the participants were female (56.65%). Certain health conditions were presented more frequently among welfare benefit applicants (mental health disorders and neoplasms). The domains with the highest rate of difficulty were the "participation" and "life activities" domains. Significant differences were found between WHODAS 2.0 and Barema scores for all eight different health condition categories. The factorial ANOVA (8x2) showed a significant interaction effect between health condition category and gender with respect to the WHODAS 2.0 score (F = 19.033, p <.001, η2 = 0.13). The WHODAS 2.0 score was negatively correlated to gender, years of studies, and marital status and positively correlated to age, working status, and the Barema score. The results revealed that male participants with a partner who were younger, had more studies, were actively working, and had a lower Barema score would have lower WHODAS scores. CONCLUSION Sociodemographic characteristics of welfare benefit applicants are associated with disability levels based on WHODAS 2.0. Certain health conditions, like mental health or neuromusculoskeletal conditions, are associated with higher disability scores. There are differences between the biopsychosocial and the biomedical approaches to disability assessment. The implementation of WHODAS 2.0 may contribute to a better understanding of the lived experience of patients and is a feasible and efficient tool. Combining biomedical and biopsychosocial approaches may enhance the procedures of disability assessment and help in the development of policies that support people with disabilities.
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Affiliation(s)
- Georgios Theotokatos
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, GRC
| | - Reuben Escorpizo
- Employment and Participation Unit, Swiss Paraplegic Research, Nottwil, CHE
- Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, USA
| | - Theodore J Angelopoulos
- Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, USA
| | - Nikolaos K Chrysagis
- Laboratory of Advanced Physiotherapy (LAdPhys) Physiotherapy, School of Health and Care Sciences, University of West Attica (UNIWA), Athens, GRC
| | - Aikaterini Venieri
- Sports Excellence, 1st Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Athens, GRC
| | - Jerome Bickenbach
- Schweizer Paraplegiker Forschung (SPF), Swiss Paraplegic Research, Nottwil, CHE
- University of Lucerne, Faculty of Health Sciences and Medicine, Lucerne, CHE
| | | | - Eirini Grammatopoulou
- Laboratory of Advanced Physiotherapy (LAdPhys) Physiotherapy, School of Health and Care Sciences, University of West Attica (UNIWA), Athens, GRC
| | - Emmanouil Skordilis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, GRC
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Seijas V, Maritz R, Mishra S, Bernard RM, Fernandes P, Lorenz V, Machado B, Posada AM, Lugo-Agudelo LH, Bickenbach J, Sabariego C. Correction: Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models. BMC Health Serv Res 2024; 24:193. [PMID: 38351034 PMCID: PMC10863206 DOI: 10.1186/s12913-024-10694-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024] Open
Affiliation(s)
- Vanessa Seijas
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland.
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland.
| | - Roxanne Maritz
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Satish Mishra
- Disability, Rehabilitation, Palliative and Long‑Term Care, Health Workforce and Service Delivery Unit, Division of Country Health Policies and Systems, WHO Regional Office for Europe, UN City, Marmorvej 51, Copenhagen, 2100, Denmark
| | - Renaldo M Bernard
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Patricia Fernandes
- Department of Clinical Medicine, Federal University of Parana, R. XV de Novembro, 1299-Centro, Curitiba, PR 80060-000, Brasil
| | - Viola Lorenz
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Barbara Machado
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Ana María Posada
- Rehabilitation in Health Research Group, Sede de Investigación Universitaria, University of Antioquia, Cl. 62 # 52-59, Medellín, Colombia
| | - Luz Helena Lugo-Agudelo
- Rehabilitation in Health Research Group, Sede de Investigación Universitaria, University of Antioquia, Cl. 62 # 52-59, Medellín, Colombia
| | - Jerome Bickenbach
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Carla Sabariego
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
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Seijas V, Maritz R, Mishra S, Bernard RM, Fernandes P, Lorenz V, Machado B, Posada AM, Lugo-Agudelo LH, Bickenbach J, Sabariego C. Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models. BMC Health Serv Res 2024; 24:123. [PMID: 38263183 PMCID: PMC10804573 DOI: 10.1186/s12913-023-10387-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/27/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The world population is ageing rapidly. Rehabilitation is one of the most effective health strategies for improving the health and functioning of older persons. An understanding of the current provision of rehabilitation services in primary care (PC) is needed to optimise access to rehabilitation for an ageing population. The objectives of this scoping review are a) to describe how rehabilitation services are currently offered in PC to older persons, and b) to explore age-related differences in the type of rehabilitation services provided. METHODS We conducted a secondary analysis of a scoping review examining rehabilitation models for older persons, with a focus on PC. Medline and Embase (2015-2022) were searched to identify studies published in English on rehabilitation services for people aged 50 + . Two authors independently screened records and extracted data using the World Health Organization (WHO)'s operational framework, the Primary Health Care Systems (PRIMASYS) approach and the WHO paper on rehabilitation in PC. Data synthesis included quantitative and qualitative analysis. RESULTS We synthesised data from 96 studies, 88.6% conducted in high-income countries (HICs), with 31,956 participants and identified five models for delivering rehabilitation to older persons in PC: community, home, telerehabilitation, outpatient and eldercare. Nurses, physiotherapists, and occupational therapists were the most common providers, with task-shifting reported in 15.6% of studies. The most common interventions were assessment of functioning, rehabilitation coordination, therapeutic exercise, psychological interventions, and self-management education. Environmental adaptations and assistive technology were rarely reported. CONCLUSIONS We described how rehabilitation services are currently provided in PC and explored age-related differences in the type of rehabilitation services received. PC can play a key role in assessing functioning and coordinating the rehabilitation process and is also well-placed to deliver rehabilitation interventions. By understanding models of rehabilitation service delivery in PC, stakeholders can work towards developing more comprehensive and accessible services that meet the diverse needs of an ageing population. Our findings, which highlight the role of rehabilitation in healthy ageing, are a valuable resource for informing policy, practice and future research in the context of the United Nations Decade of Healthy Ageing, the Rehab2030 initiative and the recently adopted WHA resolution on strengthening rehabilitation in health systems, but the conclusions can only be applied to HICs and more studies are needed that reflect the reality in low- and middle-income countries.
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Affiliation(s)
- Vanessa Seijas
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland.
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland.
| | - Roxanne Maritz
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Satish Mishra
- Disability, Rehabilitation, Palliative and Long-Term Care, Health Workforce and Service Delivery Unit, Division of Country Health Policies and Systems, WHO Regional Office for Europe, UN City, Marmorvej 51, Copenhagen, 2100, Denmark
| | - Renaldo M Bernard
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Patricia Fernandes
- Department of Clinical Medicine, Federal University of Parana, R. XV de Novembro, 1299 - Centro, Curitiba, PR, 80060-000, Brasil
| | - Viola Lorenz
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Barbara Machado
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Ana María Posada
- Rehabilitation in Health Research Group, Sede de Investigación Universitaria, University of Antioquia, Cl. 62 # 52-59, Medellín, Colombia
| | - Luz Helena Lugo-Agudelo
- Rehabilitation in Health Research Group, Sede de Investigación Universitaria, University of Antioquia, Cl. 62 # 52-59, Medellín, Colombia
| | - Jerome Bickenbach
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Carla Sabariego
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
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Ooms M, Schooß R, Puladi B, Steiner T, Hölzle F, Bickenbach J, Rieg A, Modabber A. Identification of risk factors for postoperative delirium in patients following intraoral reconstruction with microvascular free flaps: a matched-pair analysis. Int J Oral Maxillofac Surg 2023; 52:1127-1136. [PMID: 37045611 DOI: 10.1016/j.ijom.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 03/08/2023] [Accepted: 03/24/2023] [Indexed: 04/14/2023]
Abstract
Postoperative delirium (POD) following microvascular head and neck reconstruction negatively impacts patient outcomes, and only a few risk factors have been identified. The aim of this study was to identify additional risk factors for POD after intraoral reconstruction with microvascular free flaps. Data from 377 patients who underwent intraoral microvascular free flap reconstruction between 2011 and 2019 were analysed retrospectively. Preoperative, intraoperative, and postoperative variables were compared between 40 patients with POD and 40 patients without POD who were matched for previously identified risk factors (i.e., sex, age, American Society of Anesthesiologists class, preoperative arterial hypertension, tracheotomy, operation time, and blood transfusion). A multivariable regression analysis was then performed to identify risk factors associated with POD. POD occurred in 50 (13.3%) of the 377 cases studied; the median time of onset was postoperative day 2. Excessive preoperative alcohol consumption (odds ratio 9.22, 95% confidence interval 1.09-77.97; P = 0.041) and postoperative transplant revision (odds ratio 25.72, 95% confidence interval 1.26-525.43; P = 0.035) were identified as risk factors for POD. The identification of patients at high risk of POD based on these two risk factors may allow early adjustment of diagnostic and therapeutic modalities to improve outcomes and reduce healthcare costs.
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Affiliation(s)
- M Ooms
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.
| | - R Schooß
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - B Puladi
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - T Steiner
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - F Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - J Bickenbach
- Department of Intensive Care Medicine, Uniklinik RWTH Aachen, Aachen, Germany
| | - A Rieg
- Department of Anaesthesiology, Uniklinik RWTH Aachen, Aachen, Germany
| | - A Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
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Bickenbach J, Rubinelli S, Sabariego C, Stucki G. The Learning Rehabilitation System: Strengthening an intersectoral strategy to improve functioning of an ageing population. Health Policy 2023; 135:104866. [PMID: 37421891 DOI: 10.1016/j.healthpol.2023.104866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/12/2023] [Accepted: 06/26/2023] [Indexed: 07/10/2023]
Abstract
Rehabilitation uses a person-centred approach that relies on dynamic case management and works across sectors, including social protection, labour, and education to improve individual functioning. Global population ageing means that more people will live with impairment in functioning. Responding to this growth in impairment will require countries to strengthen rehabilitation at all levels of their health systems as highlighted by the 2023 WHO Resolution on Rehabilitation. Efforts to strengthen rehabilitation can benefit from the concept of the Learning Health System, which implies a cyclical process of identifying issues, developing and implementing responses, monitoring the consequences of systems' change, and revising the response. However, we argue that it is not enough to simply adopt the notion of the Learning Health System for strengthening rehabilitation. We should rather think of a Learning Rehabilitation System. This is because rehabilitation is an intrinsically inter-sectoral strategy given its focus on people's functioning in their daily lives. Therefore, we believe that introducing the notion of the Learning Rehabilitation System is more than a terminological change; it is a fundamental programmatic shift that can contribute towards the goal of strengthening rehabilitation as an intersectoral strategy to improve functioning of an ageing population.
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Affiliation(s)
- Jerome Bickenbach
- Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research (SPF), Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland
| | - Sara Rubinelli
- Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research (SPF), Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland
| | - Carla Sabariego
- Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research (SPF), Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland
| | - Gerold Stucki
- Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research (SPF), Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland.
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Sabariego C, Ehrmann C, Bickenbach J, Pacheco Barzallo D, Schedin Leiulfsrud A, Strøm V, Osterthun R, Tederko P, Seijas V, Eriks-Hoogland I, Le Fort M, Gonzalez Viejo MA, Bökel A, Popa D, Dionyssiotis Y, Baricich A, Juocevicius A, Amico P, Stucki G. Ageing, functioning patterns and their environmental determinants in the spinal cord injury (SCI) population: A comparative analysis across eleven European countries implementing the International Spinal Cord Injury Community Survey. PLoS One 2023; 18:e0284420. [PMID: 37079622 PMCID: PMC10118153 DOI: 10.1371/journal.pone.0284420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/30/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND As the European population with Spinal Cord Injury (SCI) is expected to become older, a better understanding of ageing with SCI using functioning, the health indicator used to model healthy ageing trajectories, is needed. We aimed to describe patterns of functioning in SCI by chronological age, age at injury and time since injury across eleven European countries using a common functioning metric, and to identify country-specific environmental determinants of functioning. METHODS Data from 6'635 participants of the International Spinal Cord Injury Community Survey was used. The hierarchical version of Generalized Partial Credit Model, casted in a Bayesian framework, was used to create a common functioning metric and overall scores. For each country, linear regression was used to investigate associations between functioning, chronological age, age at SCI or time since injury for persons with para- and tetraplegia. Multiple linear regression and the proportional marginal variance decomposition technique were used to identify environmental determinants. RESULTS In countries with representative samples older chronological age was consistently associated with a decline in functioning for paraplegia but not for tetraplegia. Age at injury and functioning level were associated, but patterns differed across countries. An association between time since injury and functioning was not observed in most countries, neither for paraplegia nor for tetraplegia. Problems with the accessibility of homes of friends and relatives, access to public places and long-distance transportation were consistently key determinants of functioning. CONCLUSIONS Functioning is a key health indicator and the fundament of ageing research. Enhancing methods traditionally used to develop metrics with Bayesian approach, we were able to create a common metric of functioning with cardinal properties and to estimate overall scores comparable across countries. Focusing on functioning, our study complements epidemiological evidence on SCI-specific mortality and morbidity in Europe and identify initial targets for evidence-informed policy-making.
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Affiliation(s)
- Carla Sabariego
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland
| | | | - Jerome Bickenbach
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland
| | - Diana Pacheco Barzallo
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland
| | - Annelie Schedin Leiulfsrud
- Department of Spinal Cord Injuries, St Olav University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vegard Strøm
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Rutger Osterthun
- Rijndam Rehabilitation, Rotterdam, the Netherlands
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Piotr Tederko
- Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland
| | - Vanessa Seijas
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland
| | - Inge Eriks-Hoogland
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Centre, Nottwil, Switzerland
| | - Marc Le Fort
- CHU Nantes-Hôpital Saint-Jacques, Nantes, France
| | | | - Andrea Bökel
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
| | - Daiana Popa
- Rehabilitation Hospital Felix-Spa, Bihor, Romania
| | - Yannis Dionyssiotis
- Spinal Cord Injury Rehabilitation Clinic, University of Patras, Rio Patras, Greece
| | - Alessio Baricich
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - Alvydas Juocevicius
- The Center of Rehabilitation, Physical and Sports Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | | | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland
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Barmpas P, Tasoulis S, Vrahatis AG, Georgakopoulos SV, Anagnostou P, Prina M, Ayuso-Mateos JL, Bickenbach J, Bayes I, Bobak M, Caballero FF, Chatterji S, Egea-Cortés L, García-Esquinas E, Leonardi M, Koskinen S, Koupil I, Paja̧k A, Prince M, Sanderson W, Scherbov S, Tamosiunas A, Galas A, Haro JM, Sanchez-Niubo A, Plagianakos VP, Panagiotakos D. A divisive hierarchical clustering methodology for enhancing the ensemble prediction power in large scale population studies: the ATHLOS project. Health Inf Sci Syst 2022; 10:6. [PMID: 35529251 PMCID: PMC9013733 DOI: 10.1007/s13755-022-00171-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/30/2022] [Indexed: 01/13/2023] Open
Abstract
The ATHLOS cohort is composed of several harmonized datasets of international groups related to health and aging. As a result, the Healthy Aging index has been constructed based on a selection of variables from 16 individual studies. In this paper, we consider additional variables found in ATHLOS and investigate their utilization for predicting the Healthy Aging index. For this purpose, motivated by the volume and diversity of the dataset, we focus our attention upon data clustering, where unsupervised learning is utilized to enhance prediction power. Thus we show the predictive utility of exploiting hidden data structures. In addition, we demonstrate that imposed computation bottlenecks can be surpassed when using appropriate hierarchical clustering, within a clustering for ensemble classification scheme, while retaining prediction benefits. We propose a complete methodology that is evaluated against baseline methods and the original concept. The results are very encouraging suggesting further developments in this direction along with applications in tasks with similar characteristics. A straightforward open source implementation for the R project is also provided (https://github.com/Petros-Barmpas/HCEP). Supplementary Information The online version contains supplementary material available at 10.1007/s13755-022-00171-1.
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Affiliation(s)
- Petros Barmpas
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | - Sotiris Tasoulis
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | - Aristidis G. Vrahatis
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | | | - Panagiotis Anagnostou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | - Matthew Prina
- Social Epidemiology Research Group. Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Global Health Institute, King’s College London, London, UK
| | - José Luis Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
| | - Jerome Bickenbach
- Swiss Paraplegic Research, Guido A. Zäch Institute (GZI), Nottwil, Switzerland
- Department of Health Sciences & Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Ivet Bayes
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Research, Innovation and Teaching Unit. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Francisco Félix Caballero
- Department Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Idipaz, Madrid, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Somnath Chatterji
- Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Laia Egea-Cortés
- Research, Innovation and Teaching Unit. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Esther García-Esquinas
- Department Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Idipaz, Madrid, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | | | - Seppo Koskinen
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ilona Koupil
- Centre for Health Equity Studies, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Andrzej Paja̧k
- Department of Epidemiology and Population Studies, Jagienllonian University, Krakow, Poland
| | - Martin Prince
- Global Health Institute, King’s College London, London, UK
- Centre for Global Mental Health. Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Warren Sanderson
- International Institute for Applied Systems Analysis, World Population Program, Wittgenstein Centre for Demography and Global Human Capital, Laxenburg, Austria
- Department of Economics, Stony Brook University, Stony Brook, NY USA
| | - Sergei Scherbov
- International Institute for Applied Systems Analysis, World Population Program, Wittgenstein Centre for Demography and Global Human Capital, Laxenburg, Austria
- Austrian Academy of Science, Vienna Institute of Demography, Vienna, Austria
- Russian Presidential Academy of National Economy and Public Administration (RANEPA), Moscow, Russian Federation
| | | | - Aleksander Galas
- Department of Epidemiology and Preventive Medicine, Jagiellonian University, Krakow, Poland
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Research, Innovation and Teaching Unit. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Albert Sanchez-Niubo
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Research, Innovation and Teaching Unit. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Vassilis P. Plagianakos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
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9
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Ooms M, Puladi B, Winnand P, Heitzer M, Steiner T, Bickenbach J, Hölzle F, Modabber A. Perfusion of microvascular free flaps in head and neck reconstruction after prior neck dissection and irradiation. Int J Oral Maxillofac Surg 2022; 52:640-647. [PMID: 36253245 DOI: 10.1016/j.ijom.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 12/24/2022]
Abstract
Microvascular free flaps are frequently used for head and neck reconstruction after prior neck dissection (ND) and neck irradiation (RTX). The aim of this study was to investigate the influence of ND and RTX on flap perfusion as a critical factor for flap success. Overall, 392 patients reconstructed with a microvascular fasciocutaneous flap (FF) or perforator flap (PF) in the head and neck region between 2011 and 2020 were analysed retrospectively. Flap perfusion measured intraoperatively and postoperatively with the O2C tissue oxygen analysis system was compared between patients who had received neither ND nor RTX (controls), patients who had received ND but no RTX (ND group), and patients who had received both ND and RTX (ND+RTX group). Intraoperative and postoperative flap blood flow was decreased in FFs in ND group patients compared to controls (median 66.3 AU vs 86.0 AU, P = 0.023; median 73.5 AU vs 93.8 AU, P = 0.045, respectively). In the multivariable analysis, these differences showed a tendency to persist (P = 0.052 and P = 0.056). Flap success rates were similar in control patients, ND patients, and ND+RTX patients (98.7%, 94.0%, and 97.6%, respectively). Flap perfusion is not reduced in FFs and PFs in patients who have undergone ND or ND and RTX. This indicates that neck dissection and neck irradiation should not be contraindications for microvascular free flap reconstruction.
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10
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Frontera WR, Stucki G, Engkasan JP, Francisco GE, Gutenbrunner C, Hasnan N, Lains J, Yusof YM, Negrini S, Omar Z, Battistella LR, Sowa G, Stam H, Bickenbach J. Advancing Academic Capacity in Physical and Rehabilitation Medicine to Strengthen Rehabilitation in Health Systems Worldwide: A Joint Effort by the European Academy of Rehabilitation Medicine, the Association of Academic Physiatrists, and the International Society of Physical and Rehabilitation Medicine. Am J Phys Med Rehabil 2022; 101:897-904. [PMID: 35777886 PMCID: PMC9377495 DOI: 10.1097/phm.0000000000002067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Frontera WR, Stucki G, Engkasan JP, Francisco GE, Gutenbrunner C, Hasnan N, Lains J, Yusof YM, Negrini S, Battistella LR, Sowa G, Stam H, Bickenbach J. Advancing Academic Capacity in Physical and Rehabilitation Medicine to Strengthen Rehabilitation in Health Systems Worldwide: A Joint Effort by the European Academy of Rehabilitation Medicine, the Association of Academic Physiatrists, and the International Society of Physical and Rehabilitation Medicine. J Rehabil Med 2022; 54:jrm00310. [PMID: 35796075 PMCID: PMC9272549 DOI: 10.2340/jrm.v54.3510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Not available.
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Affiliation(s)
- Walter R Frontera
- Department of Physical Medicine, Rehabilitation and Sports Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
| | - Gerold Stucki
- Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland; Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Julia P Engkasan
- Department of Rehabilitation Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Gerard E Francisco
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, University of Texas Health Science Center, Houston, Texas; NeuroRecovery Research Center, TIRR Memorial Hermann, Houston, Texas
| | | | - Nazirah Hasnan
- Department of Rehabilitation Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Jorge Lains
- Centro de Medicina de Reabilitação da Região Centro, Tocha, Portugal; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale," Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | - Gwen Sowa
- Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland; Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Henk Stam
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jerome Bickenbach
- Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland
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12
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Bickenbach J, Stucki G, van Ginneken E, Busse R. Editorial: Strengthening Rehabilitation in Europe. Health Policy 2022; 126:151. [PMID: 35227426 PMCID: PMC8880035 DOI: 10.1016/j.healthpol.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- J Bickenbach
- Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland
| | - G Stucki
- Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland
| | - E van Ginneken
- Department of Health Care Management, Berlin University of Technology, Berlin, Germany; European Observatory on Health Systems and Policies
| | - R Busse
- Department of Health Care Management, Berlin University of Technology, Berlin, Germany; European Observatory on Health Systems and Policies.
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13
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Sabariego C, Fellinghauer C, Lee L, Kamenov K, Posarac A, Bickenbach J, Kostanjsek N, Chatterji S, Cieza A. Generating comprehensive functioning and disability data worldwide: development process, data analyses strategy and reliability of the WHO and World Bank Model Disability Survey. Arch Public Health 2022; 80:6. [PMID: 34983659 PMCID: PMC8725367 DOI: 10.1186/s13690-021-00769-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 12/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background Data on functioning and disability collected at population level is essential to complement mortality and morbidity, to estimate rehabilitation needs of countries and regions and to monitor the Convention on the Rights of Persons with Disabilities (CRPD) and the Sustainable Development Goals (SDGs). The objective of this paper is to briefly report the development process of the WHO Model Disability Survey, its data analysis strategy as well as its reliability and ability to measure low to high levels of functioning and disability across countries. Methods The development process is described in detail, and a secondary analysis using Rasch methods is conducted to report reliability and targeting using data from eight national and two regional implementations of the survey. Results The currently available versions of the Model Disability Survey are presented. The survey has good to very good internal reliability and good targeting in all included countries. Conclusion The participatory and evidence-based development, consideration of the expertise of stakeholders, the availability of previously developed ICF-based surveys, and WHO tools targeting functioning and disability are reflected in its good to very good psychometric properties. The survey has been implemented to date in Afghanistan, Cameroon, Chile, Costa Rica, India, Laos, Pakistan, Philippines, Sri Lanka, and Tajikistan, and is used to inform policy-making, to monitor the CRPD and SDGs and to plan the delivery of rehabilitation services. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00769-z.
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Affiliation(s)
- Carla Sabariego
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
| | - Carolina Fellinghauer
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | - Lindsay Lee
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | - Kaloyan Kamenov
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland.
| | - Aleksandra Posarac
- East Africa Human Development. The World Bank, Washington, DC, 22304, USA
| | - Jerome Bickenbach
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
| | - Nenad Kostanjsek
- Department of Classifications and Terminologies, World Health Organization, Geneva, Switzerland
| | - Somnath Chatterji
- Department of Data and Analytics, World Health Organization, Geneva, Switzerland
| | - Alarcos Cieza
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
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14
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Frontera W, Stucki G, Engkasan J, Francisco G, Gutenbrunner C, Hasnan N, Lains J, Yusof Y, Negrini S, Omar Z, Battistella L, Sowa G, Stam H, Bickenbach J. Advancing academic capacity in physical and rehabilitation medicine to strengthen rehabilitation in health systems worldwide: A joint effort by the european academy of rehabilitation medicine, the association of academic physiatrists, and the international society of physical and rehabilitation medicine. J Int Soc Phys Rehabil Med 2022. [DOI: 10.4103/ijprm.jisprm-000168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Sabariego C, Bickenbach J, Stucki G. Supporting evidence-informed policy making in rehabilitation: A logic framework for continuous improvement of rehabilitation programs. Health Policy 2021; 126:152-157. [PMID: 34872725 DOI: 10.1016/j.healthpol.2021.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 10/25/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022]
Abstract
Because of important health and population trends, rehabilitation is a key health strategy of the 21st century, and efforts are being made towards a broader integration of rehabilitation into health systems worldwide. In the scope of the call for action Rehabilitation 2030, WHO recommends a logic model approach for monitoring and evaluating national efforts at the systems level. In this paper we argue that as strengthening rehabilitation in health systems will require countries to implement a range of new programs, sound logic models designed to monitor and evaluate rehabilitation programs at service level are needed as well. We therefore propose in this paper an overarching logic model for monitoring and evaluating rehabilitation programs, including feasible indicators, options for their operationalization and considerations about data analyses. Our overarching logic model for monitoring and evaluation at service level is suitable to structure national clinical quality management for continuous improvement, to inform policy making and programming at the national level, and to serve as a reference framework for research. The model will serve as a starting point for developing other logic models that fit specific features of rehabilitation programs in diverse settings and countries.
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Affiliation(s)
- Carla Sabariego
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Switzerland
| | - Jerome Bickenbach
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Switzerland
| | - Gerold Stucki
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Switzerland.
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16
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Boes S, Sabariego C, Bickenbach J, Stucki G. How to capture the individual and societal impacts of syndemics: the lived experience of COVID-19. BMJ Glob Health 2021; 6:bmjgh-2021-006735. [PMID: 34706878 PMCID: PMC8551741 DOI: 10.1136/bmjgh-2021-006735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/08/2021] [Indexed: 12/16/2022] Open
Affiliation(s)
- Stefan Boes
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
| | - Carla Sabariego
- Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Jerome Bickenbach
- Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Gerold Stucki
- Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland .,Swiss Paraplegic Research, Nottwil, Switzerland
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17
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Spiess AAF, Skempes D, Bickenbach J, Stucki G. Exploration of current challenges in rehabilitation from the perspective of healthcare professionals: Switzerland as a case in point. Health Policy 2021; 126:173-182. [PMID: 34625281 DOI: 10.1016/j.healthpol.2021.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 09/09/2021] [Accepted: 09/23/2021] [Indexed: 12/11/2022]
Abstract
Rehabilitation is a health strategy with the potential to mitigate the negative health consequences of population ageing and the rise of noncommunicable diseases. Literature indicates that even in high-income countries rehabilitation services can be improved. The purpose of this study is to engage rehabilitation professionals in Switzerland in identifying and prioritizing current challenges in the development and delivery of rehabilitation services. We conducted a qualitative study consisting of interviews with key informants and a stakeholder consultation. Thirteen interviews were conducted and analysed using inductive thematic analysis. Identified challenges were refined, extended, and prioritized through multi-voting in a workshop attended by a wide range of rehabilitation professional organizations. Final results were subject to further analysis and member checking. We identified nineteen challenges, of which eight were viewed as highly important. Results suggest the need to revise the financing system for rehabilitation services, highlighted a poor integration of rehabilitation in primary care, a lack of academic rehabilitation training, and insufficient funding for research. Finally, we identified a perceived lack of awareness for rehabilitation among policy-makers and the public. This study provides a unique perspective on challenges in rehabilitation practice and policy and offers an opportunity for professionals, policy-makers, and other stakeholders, to influence and guide the rehabilitation service agenda both in Switzerland and in terms of mutual learning also in other countries.
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Affiliation(s)
- Adrian Andrea Flavio Spiess
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland.
| | - Dimitrios Skempes
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research (SPF), Guido A. Zaech Strasse 4, 6207 Nottwil, Switzerland..
| | - Jerome Bickenbach
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research (SPF), Guido A. Zaech Strasse 4, 6207 Nottwil, Switzerland..
| | - Gerold Stucki
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research (SPF), Guido A. Zaech Strasse 4, 6207 Nottwil, Switzerland..
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18
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Sanchez-Niubo A, Forero CG, Wu YT, Giné-Vázquez I, Prina M, De La Fuente J, Daskalopoulou C, Critselis E, De La Torre-Luque A, Panagiotakos D, Arndt H, Ayuso-Mateos JL, Bayes-Marin I, Bickenbach J, Bobak M, Caballero FF, Chatterji S, Egea-Cortés L, García-Esquinas E, Leonardi M, Koskinen S, Koupil I, Mellor-Marsá B, Olaya B, Pająk A, Prince M, Raggi A, Rodríguez-Artalejo F, Sanderson W, Scherbov S, Tamosiunas A, Tobias-Adamczyk B, Tyrovolas S, Haro JM. Development of a common scale for measuring healthy ageing across the world: results from the ATHLOS consortium. Int J Epidemiol 2021; 50:880-892. [PMID: 33274372 PMCID: PMC8271194 DOI: 10.1093/ije/dyaa236] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Research efforts to measure the concept of healthy ageing have been diverse and limited to specific populations. This diversity limits the potential to compare healthy ageing across countries and/or populations. In this study, we developed a novel measurement scale of healthy ageing using worldwide cohorts. METHODS In the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) project, data from 16 international cohorts were harmonized. Using ATHLOS data, an item response theory (IRT) model was used to develop a scale with 41 items related to health and functioning. Measurement heterogeneity due to intra-dataset specificities was detected, applying differential item functioning via a logistic regression framework. The model accounted for specificities in model parameters by introducing cohort-specific parameters that rescaled scores to the main scale, using an equating procedure. Final scores were estimated for all individuals and converted to T-scores with a mean of 50 and a standard deviation of 10. RESULTS A common scale was created for 343 915 individuals above 18 years of age from 16 studies. The scale showed solid evidence of concurrent validity regarding various sociodemographic, life and health factors, and convergent validity with healthy life expectancy (r = 0.81) and gross domestic product (r = 0.58). Survival curves showed that the scale could also be predictive of mortality. CONCLUSIONS The ATHLOS scale, due to its reliability and global representativeness, has the potential to contribute to worldwide research on healthy ageing.
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Affiliation(s)
- Albert Sanchez-Niubo
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Carlos G Forero
- Department of Medicine, International University of Catalunya, Barcelona, Spain
| | - Yu-Tzu Wu
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Iago Giné-Vázquez
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Matthew Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Global Health Institute, King's College London, London, UK
| | - Javier De La Fuente
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria Princesa (IIS Princesa), Hospital Universitario de La Princesa, Madrid, Spain
| | - Christina Daskalopoulou
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Elena Critselis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Alejandro De La Torre-Luque
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria Princesa (IIS Princesa), Hospital Universitario de La Princesa, Madrid, Spain
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | | | - José Luis Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria Princesa (IIS Princesa), Hospital Universitario de La Princesa, Madrid, Spain
| | - Ivet Bayes-Marin
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Jerome Bickenbach
- Swiss Paraplegic Research, Guido A. Zäch Institute (GZI), Nottwil, Switzerland.,Department of Health Sciences & Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Somnath Chatterji
- Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Laia Egea-Cortés
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Seppo Koskinen
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ilona Koupil
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Blanca Mellor-Marsá
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,Sanitary Research Institute, Hospital Clínico San Carlos, Madrid, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Martin Prince
- Global Health Institute, King's College London, London, UK.,Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alberto Raggi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Warren Sanderson
- Wittgenstein Centre for Demography and Global Human Capital, International Institute for Applied Systems Analysis, Laxenburg, Austria.,Department of Economics, Stony Brook University, Stony Brook, NY, USA
| | - Sergei Scherbov
- Wittgenstein Centre for Demography and Global Human Capital, International Institute for Applied Systems Analysis, Laxenburg, Austria.,Austrian Academy of Science, Vienna Institute of Demography, Vienna, Austria.,International Laboratory of Demography and Human Capital, Russian Presidential Academy of National Economy and Public Administration, Moscow, Russian Federation
| | - Abdonas Tamosiunas
- Department of Population Studies Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Beata Tobias-Adamczyk
- Department of Medical Sociology, Jagiellonian University Medical College, Krakow, Poland.,Department of Epidemiology, Jagiellonian University Medical College, Krakow, Poland
| | - Stefanos Tyrovolas
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Sabariego C, Fellinghauer C, Lee L, Posarac A, Bickenbach J, Kostanjsek N, Chatterji S, Kamenov K, Cieza A. Measuring functioning and disability using household surveys: metric properties of the brief version of the WHO and World Bank model disability survey. ACTA ACUST UNITED AC 2021; 79:128. [PMID: 34253263 PMCID: PMC8273944 DOI: 10.1186/s13690-021-00654-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/06/2021] [Indexed: 12/01/2022]
Abstract
Background The Model Disability Survey (MDS) is the current standard recommended by WHO to collect functioning and disability data. Answering calls from countries requesting a version to be implemented as a module that could be integrated into existing surveys and be used for monitoring disability trends and for data disaggregation, WHO developed the brief MDS. The objectives of this paper are to evaluate the metric properties of the disability metrics generated with the Brief MDS and the precision of the Brief MDS in comparison with the full MDS. Results The partial credit model, a unidimensional model for polytomous data from the Rasch family, was applied to evaluate psychometric properties using data from national MDS implementations in Chile (N = 12,265) and in Sri Lanka (N = 3000). The Brief MDS generates valid metrics for measuring disability, from the perspectives of capacity and performance, thereby achieving good levels of measurement precision in comparison with its full counterpart. Conclusion Given the scarcity of valid functioning and disability modules for household surveys, the Brief MDS represents a milestone in disability measurement. The Brief MDS is currently used by countries to monitor disability trends over time, which is especially important to evaluate the impact of health policies and public health interventions, to disaggregate indicators of the Sustainable Development Goals, and to monitor the implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD). Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00654-9.
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Affiliation(s)
- Carla Sabariego
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
| | - Carolina Fellinghauer
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | - Lindsay Lee
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | | | - Jerome Bickenbach
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
| | - Nenad Kostanjsek
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Somnath Chatterji
- Department of Data and Analytics, World Health Organization, Geneva, Switzerland
| | - Kaloyan Kamenov
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland.
| | - Alarcos Cieza
- Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
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20
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Skempes D, Kiekens C, Malmivaara A, Michail X, Bickenbach J, Stucki G. Supporting government policies to embed and expand rehabilitation in health systems in Europe: A framework for action. Health Policy 2021; 126:158-172. [PMID: 34281701 DOI: 10.1016/j.healthpol.2021.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/25/2021] [Accepted: 06/28/2021] [Indexed: 11/28/2022]
Abstract
Investment in action is vital to confront the challenges associated with chronic diseases and disability facing European health systems. Although relevant policy responses are being increasingly developed, most of them fail to recognize the role of rehabilitation services in achieving public health and social goals. Comprehensive guidance is thus urgently needed to support rehabilitation policy development and expand access to rehabilitation care to meet population needs effectively. This paper describes a framework to guide policy action for rehabilitation in Europe. The framework was developed in collaboration with the European Academy of Rehabilitation Medicine based on a focused literature review and expert consultations. A review in PubMed and grey literature sources identified 458 references and resulted in 135 relevant documents published between 2006 and 2019. Thematic analysis of extracted information helped summarize the findings and develop the draft policy action framework. This was circulated to a wider group of experts and discussed in three workshops in 2018-2019. The framework was revised according to their feedback. The proposed framework contains 48 options for policy action organized in six domains and twelve subdomains that address several areas of health programming. The proposed framework provides a structure to understand the policy terrain related to rehabilitation in Europe and the measures required for translating aspirational political pronouncements into targeted programmatic action and tangible health and social outcomes.
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Affiliation(s)
- Dimitrios Skempes
- Swiss Paraplegic Research, Nottwil, Switzerland; Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Switzerland
| | - Carlotte Kiekens
- Spinal Unit, Montecatone Rehabilitation Institute, Imola (Bologna), Italy; Physical and Rehabilitation Medicine, University Hospitals Leuven - Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium
| | - Anti Malmivaara
- Centre for Health and Social Economics, National Institute for Health and Welfare and Orton Orthopedic Hospital and Orton Research Institute, Orton Foundation, Helsinki, Finland
| | - Xanthi Michail
- Department of Physiotherapy, University of West Attica, Athens, Greece
| | - Jerome Bickenbach
- Swiss Paraplegic Research, Nottwil, Switzerland; Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Switzerland
| | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland; Center for Rehabilitation in Global Health Systems, Department of Health Sciences and Medicine, University of Lucerne, Switzerland.
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21
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Affiliation(s)
- Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland. .,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland. .,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland.
| | - Jerome Bickenbach
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
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22
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Affiliation(s)
- Jerome Bickenbach
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland,*Correspondence: Jerome Bickenbach
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23
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Stucki G, Bickenbach J, Kiekens C, Negrini S, Stam HJ. Reflections of the European Academy of Rehabilitation Medicine on the first global estimates of the need for rehabilitation and the implications for physical and rehabilitation medicine. J Rehabil Med 2020; 52:jrm00131. [PMID: 33337501 DOI: 10.2340/16501977-2784] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Gerold Stucki
- Department of Health Sciences and Health Policy, Faculty of Humanities and Social Sciences, University of Lucerne, Frohburgstrasse 3, P.O. Box 4466, CH-6002 Lucerne, Switzerland. E-mail: ,
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24
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Post MW, Reinhardt JD, Avellanet M, Escorpizo R, Engkasan JP, Schwegler U, Leiulfsrud AS, Engkasan JP, Middleton JW, Stucki G, Brach M, Bickenbach J, Fekete C, Thyrian C, Battistella L, Li J, Perrouin-Verbe B, Gutenbrunner C, Rapidi CA, Wahyuni LK, Zampolini M, Saitoh E, Lee BS, Juocevicius A, Hasnan N, Hajjioui A, Post MW, Stanghelle JK, Tederko P, Popa D, Joseph C, Avellanet M, Baumberger M, Kovindha A, Escorpizo R. Employment Among People With Spinal Cord Injury in 22 Countries Across the World: Results From the International Spinal Cord Injury Community Survey. Arch Phys Med Rehabil 2020; 101:2157-2166. [DOI: 10.1016/j.apmr.2020.05.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/14/2020] [Accepted: 05/28/2020] [Indexed: 10/23/2022]
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25
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Pacheco Barzallo D, Gross-Hemmi M, Bickenbach J, Juocevičius A, Popa D, Wahyuni LK, Strøm V. Quality of Life and the Health System: A 22-Country Comparison of the Situation of People With Spinal Cord Injury. Arch Phys Med Rehabil 2020; 101:2167-2176. [DOI: 10.1016/j.apmr.2020.04.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/26/2020] [Accepted: 04/04/2020] [Indexed: 10/24/2022]
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26
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Bickenbach J, Batistella L, Gutenbrunner C, Middleton J, Post MW, Stucki G. The International Spinal Cord Injury Survey: The Way Forward. Arch Phys Med Rehabil 2020; 101:2227-2232. [PMID: 32663478 DOI: 10.1016/j.apmr.2020.06.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 11/19/2022]
Abstract
As a community survey of individuals living with spinal cord injury in 22 countries, representing all 6 of the World Health Organization regions, the International Spinal Cord Injury (InSCI) community survey is one of the few surveys that highlights not only basic medical issues, but also the impact of spinal cord injury (SCI) on the everyday lives of people. The InSCI survey is part of a much larger project known as the Learning Health System for SCI Initiative (LHS-SCI). The objective of this article is to highlight some of the ongoing and planned next steps at the national and international levels. The implementation phase of the LHS-SCI initiative, beginning with the publication of primary results and extending until 2023, will use the results of the InSCI survey as evidence for implementation of recommendations for improving the societal response to the needs of individuals with SCI at the national level. To illustrate the variety of implementation activities currently underway, we provide country examples from Australia, Morocco, Malaysia, and Germany to demonstrate the diversity of approaches to the implementation of InSCI data. The implementation phase of the LHS-SCI initiative promises to usher in a new era of SCI research that will be seamlessly linked to ongoing and effective implementation actions, at both international and national levels and across settings from clinical practice, health systems management, and national policy.
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Affiliation(s)
- Jerome Bickenbach
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
| | | | | | - James Middleton
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Marcel W Post
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, The Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center, Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Gerold Stucki
- Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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27
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Garg A, Skempes D, Bickenbach J. Legal and Regulatory Approaches to Rehabilitation Planning: A Concise Overview of Current Laws and Policies Addressing Access to Rehabilitation in Five European Countries. Int J Environ Res Public Health 2020; 17:E4363. [PMID: 32570746 PMCID: PMC7346088 DOI: 10.3390/ijerph17124363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The rising prevalence of disability due to noncommunicable diseases and the aging process in tandem with under-prioritization and underdevelopment of rehabilitation services remains a significant concern for European public health. Over recent years, health system responses to population health needs, including rehabilitation needs, have been increasingly acknowledging the power of law and formal written policies as strategic governance tools to improve population health outcomes. However, the contents and scope of enacted legislation and adopted policies concerning rehabilitation services in Europe has not been synthesized. This paper presents a concise overview of laws and policies addressing rehabilitation in five European countries. METHODS Publicly available laws, policies, and national action plans addressing rehabilitation issues of Sweden, Italy, Germany, the Netherlands and the United Kingdom were reviewed and descriptive documents analyzed. Actions found in national health policies were also evaluated for compliance with the key recommendations specified in the World Health Organization's Rehabilitation 2030: Call for Action. Results: Across countries, legal and policy approaches to rehabilitation planning varied in scope and reach. While all countries entitle citizens to rehabilitation services, comprehensiveness of coverage varied. Health legislation of Germany and Netherlands recognizes access to rehabilitation as a human right for persons with disabilities, while Sweden and the United Kingdom acknowledge its importance in disability laws for achieving substantive equality for persons with disabilities. Regarding policies, in all countries but Italy, targeted universalism remains the predominant strategy governing rehabilitation services, as demonstrated by the lack of comprehensive, national action plans for rehabilitation addressing the general population. Nevertheless, references found in disease specific policies indicate a solid consensus that rehabilitation remains an integral component of the care continuum for those experiencing disability. CONCLUSION Although a universal approach to rehabilitation coverage is institutionalized in national legislation of the countries examined, this approach is not expressed in formal policies. Targeted strategies aiming to ensure access to subpopulation groups with higher perceived needs for rehabilitation prevail, indicating a strong political will towards the reduction of health inequalities and the promotion of human rights of people experiencing disability. Results obtained from conducting this descriptive review provide the basis for future appraisals of the situation regarding rehabilitation service and policy development in Europe.
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Affiliation(s)
- Aditi Garg
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland; (D.S.); (J.B.)
| | - Dimitrios Skempes
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland; (D.S.); (J.B.)
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, 6207 Nottwil, Switzerland
| | - Jerome Bickenbach
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland; (D.S.); (J.B.)
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, 6207 Nottwil, Switzerland
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28
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Tyrovolas S, Panaretos D, Daskalopoulou C, Gine-Vazquez I, Niubo AS, Olaya B, Bobak M, Prince M, Prina M, Ayuso-Mateos JL, Caballero FF, Garcia-Esquinas E, Holger A, Scherbov S, Sanderson W, Gheno I, Koupil I, Bickenbach J, Chatterji S, Koskinen S, Raggi A, Pajak A, Tobiasz-Adamczyk B, Haro JM, Panagiotakos D. Alcohol Drinking and Health in Ageing: A Global Scale Analysis of Older Individual Data through the Harmonised Dataset of ATHLOS. Nutrients 2020; 12:E1746. [PMID: 32545243 PMCID: PMC7353331 DOI: 10.3390/nu12061746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/04/2020] [Accepted: 06/07/2020] [Indexed: 11/26/2022] Open
Abstract
We investigated the relation between alcohol drinking and healthy ageing by means of a validated health status metric, using individual data from the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project. For the purposes of this study, the ATHLOS harmonised dataset, which includes information from individuals aged 65+ in 38 countries, was analysed (n = 135,440). Alcohol drinking was reflected by means of three harmonised variables: alcohol drinking frequency, current and past alcohol drinker. A set of 41 self-reported health items and measured tests were used to generate a specific health metric. In the harmonised dataset, the prevalence of current drinking was 47.5% while of past drinking was 26.5%. In the pooled sample, current alcohol drinking was positively associated with better health status among older adults ((b-coef (95% CI): 1.32(0.45 to 2.19)) and past alcohol drinking was inversely related (b-coef (95% CI): -0.83 (-1.51 to -0.16)) with health status. Often alcohol consumption appeared to be beneficial only for females in all super-regions except Africa, both age group categories (65-80 years old and 80+), both age group categories, as well as among all the financial status categories (all p < 0.05). Regional analysis pictured diverse patterns in the association for current and past alcohol drinkers. Our results report the need for specific alcohol intake recommendations among older adults that will help them maintain a better health status throughout the ageing process.
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Affiliation(s)
- Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, 42, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (A.S.N.); (B.O.); (J.M.H.)
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5, Pabellón 11, 28029 Madrid, Spain;
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 Eleftheriou Venizelou Ave, Attica, 176 61 Athens, Greece; (D.P.); (D.P.)
| | - Dimitris Panaretos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 Eleftheriou Venizelou Ave, Attica, 176 61 Athens, Greece; (D.P.); (D.P.)
| | - Christina Daskalopoulou
- Psychology and Neuroscience, Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London WC1E 6BT, UK; (C.D.); (M.P.); (M.P.)
| | - Iago Gine-Vazquez
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, 42, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (A.S.N.); (B.O.); (J.M.H.)
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5, Pabellón 11, 28029 Madrid, Spain;
| | - Albert Sanchez Niubo
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, 42, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (A.S.N.); (B.O.); (J.M.H.)
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5, Pabellón 11, 28029 Madrid, Spain;
| | - Beatriz Olaya
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, 42, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (A.S.N.); (B.O.); (J.M.H.)
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5, Pabellón 11, 28029 Madrid, Spain;
| | - Martin Bobak
- Research Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 7HB, UK;
| | - Martin Prince
- Psychology and Neuroscience, Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London WC1E 6BT, UK; (C.D.); (M.P.); (M.P.)
| | - Matthew Prina
- Psychology and Neuroscience, Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London WC1E 6BT, UK; (C.D.); (M.P.); (M.P.)
| | - Jose Luis Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5, Pabellón 11, 28029 Madrid, Spain;
- Department of Psychiatry, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), 28006 Madrid, Spain
| | - Francisco Felix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (F.F.C.); (E.G.-E.)
- CIBER of Epidemiology and Public Health-CIBERESP, 28029 Madrid, Spain
| | - Esther Garcia-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (F.F.C.); (E.G.-E.)
- CIBER of Epidemiology and Public Health-CIBERESP, 28029 Madrid, Spain
| | - Arndt Holger
- SPRING TECHNO GMBH & Co. KG, 28199 Bremen, Germany;
| | - Sergei Scherbov
- World Population Program, International Institute for Applied Systems Analysis, Wittgenstein Centre for Demography and Global Human Capital, 2361 Laxenburg, Austria; (S.S.); (W.S.)
- Vienna Institute of Demography, Austrian Academy of Science, 1030 Vienna, Austria
- International Laboratory for Demography and Human Capital, Russian Presidential Academy of National Economy and Public Administration (RANEPA), 119571 Moscow, Russia
| | - Warren Sanderson
- World Population Program, International Institute for Applied Systems Analysis, Wittgenstein Centre for Demography and Global Human Capital, 2361 Laxenburg, Austria; (S.S.); (W.S.)
- Department of Economics, Stony Brook University, Stony Brook, NY 11794, USA
| | | | - Ilona Koupil
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University, 114 19 Stockholm, Sweden;
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, University of Lucerne, 6002 Lucerne, Switzerland;
- Swiss Paraplegic Research, 6207 Nottwil, Switzerland
| | - Somnath Chatterji
- Information, Evidence and Research, World Health Organization, 1202 Geneva, Switzerland;
| | - Seppo Koskinen
- Department of Public Health Solutions, Finnish Institute for Health and Welfare (THL), P.O. Box 30, FI-00271 Helsinki, Finland;
| | - Alberto Raggi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy;
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland;
| | - Beata Tobiasz-Adamczyk
- Department of Medical Sociology, Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland;
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, 42, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (A.S.N.); (B.O.); (J.M.H.)
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3–5, Pabellón 11, 28029 Madrid, Spain;
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 Eleftheriou Venizelou Ave, Attica, 176 61 Athens, Greece; (D.P.); (D.P.)
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Guido D, Leonardi M, Mellor-Marsá B, Moneta MV, Sanchez-Niubo A, Tyrovolas S, Giné-Vázquez I, Haro JM, Chatterji S, Bobak M, Ayuso-Mateos JL, Arndt H, Koupil I, Bickenbach J, Koskinen S, Tobiasz-Adamczyk B, Panagiotakos D, Raggi A. Pain rates in general population for the period 1991-2015 and 10-years prediction: results from a multi-continent age-period-cohort analysis. J Headache Pain 2020; 21:52. [PMID: 32404046 PMCID: PMC7218619 DOI: 10.1186/s10194-020-01108-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/13/2020] [Indexed: 12/04/2022] Open
Abstract
Background Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people. The aims of this study are to evaluate the temporal variations of pain rates among general populations for the period 1991–2015 and to project 10-year pain rates. Methods We used the harmonized dataset of ATHLOS project, which included 660,028 valid observations in the period 1990–2015 and we applied Bayesian age–period–cohort modeling to perform projections up to 2025. The harmonized Pain variable covers the content “self-reported pain experienced at the time of the interview”, with a dichotomous (yes or no) modality. Results Pain rates were higher among females, older subjects, in recent periods, and among observations referred to cohorts of subjects born between the 20s and the 60s. The 10-year projections indicate a noteworthy increase in pain rates in both genders and particularly among subjects aged 66 or over, for whom a 10–20% increase in pain rate is foreseen; among females only, a 10–15% increase in pain rates is foreseen for those aged 36–50. Conclusions Projected increase in pain rates will require specific interventions by health and welfare systems, as pain is responsible for limited quality of subjective well-being, reduced employment rates and hampered work performance. Worksite and lifestyle interventions will therefore be needed to limit the impact of projected higher pain rates.
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Affiliation(s)
- Davide Guido
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | - Blanca Mellor-Marsá
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Maria V Moneta
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Albert Sanchez-Niubo
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Iago Giné-Vázquez
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Josep M Haro
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Somnath Chatterji
- Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Martin Bobak
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Jose L Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, Spain
| | | | - Ilona Koupil
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden.,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Seppo Koskinen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Beata Tobiasz-Adamczyk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
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Raggi A, Leonardi M, Mellor-Marsá B, Moneta MV, Sanchez-Niubo A, Tyrovolas S, Giné-Vázquez I, Haro JM, Chatterji S, Bobak M, Ayuso-Mateos JL, Arndt H, Hossin MZ, Bickenbach J, Koskinen S, Tobiasz-Adamczyk B, Panagiotakos D, Corso B. Predictors of pain in general ageing populations: results from a multi-country analysis based on ATHLOS harmonized database. J Headache Pain 2020; 21:45. [PMID: 32375641 PMCID: PMC7201730 DOI: 10.1186/s10194-020-01116-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/24/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people, and with increasing trends in general populations. Different risk factors for pain have been identified, but generally from studies with limited samples and a limited number of candidate predictors. The aim of this study is to evaluate the predictors of pain from a large set of variables and respondents. METHODS We used part of the harmonized dataset of ATHLOS project, selecting studies and waves with a longitudinal course, and in which pain was absent at baseline and with no missing at follow-up. Predictors were selected based on missing distribution and univariable association with pain, and were selected from the following domains: Socio-demographic and economic characteristics, Lifestyle and health behaviours, Health status and functional limitations, Diseases, Physical measures, Cognition, personality and other psychological measures, and Social environment. Hierarchical logistic regression models were then applied to identify significant predictors. RESULTS A total of 13,545 subjects were included of whom 5348 (39.5%) developed pain between baseline and the average 5.2 years' follow-up. Baseline risk factors for pain were female gender (OR 1.34), engaging in vigorous exercise (OR 2.51), being obese (OR 1.36) and suffering from the loss of a close person (OR 1.88) whereas follow-up risk factors were low energy levels/fatigue (1.93), difficulties with walking (1.69), self-rated health referred as poor (OR 2.20) or average to moderate (OR 1.57) and presence of sleep problems (1.80). CONCLUSIONS Our results showed that 39.5% of respondents developed pain over a five-year follow-up period, that there are proximal and distal risk factors for pain, and that part of them are directly modifiable. Actions aimed at improving sleep, reducing weight among obese people and treating fatigue would positively impact on pain onset, and avoiding vigorous exercise should be advised to people aged 60 or over, in particular if female or obese.
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Affiliation(s)
- Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | - Blanca Mellor-Marsá
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Maria V Moneta
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
| | - Albert Sanchez-Niubo
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Iago Giné-Vázquez
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Josep M Haro
- Parc Sanitari Sant Joan de Déu, Fundacion Sant Joan de Deu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Somnath Chatterji
- Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Martin Bobak
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Jose L Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, Spain
| | | | - Muhammad Z Hossin
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Seppo Koskinen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Beata Tobiasz-Adamczyk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Barbara Corso
- National Research Council, Neuroscience Institute, Padova, Italy
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Devi N, Prodinger B, Pennycott A, Sooben R, Bickenbach J. Investigating Supported Decision‐Making for Persons With Mild to Moderate Intellectual Disability Using Institutional Ethnography. Journal of Policy and Practice in Intellectual Disabilities 2019. [DOI: 10.1111/jppi.12314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nandini Devi
- Department of Health Sciences and Health PolicyUniversity of Lucerne Lucerne Switzerland
- Swiss Paraplegic Research Nottwil Switzerland
| | - Birgit Prodinger
- Swiss Paraplegic Research Nottwil Switzerland
- Fakultät für Angewandte Gesundheits‐ und SozialwissenschaftenRosenheim University of Applied Sciences Rosenheim Germany
| | - Andrew Pennycott
- Department of Sciences and TechnologyETH Zurich Zurich Switzerland
| | - Roja Sooben
- Department of Nursing and Social WorkUniversity of Hertfordshire Hatfield, Hertfordshire, UK
| | - Jerome Bickenbach
- Department of Health Sciences and Health PolicyUniversity of Lucerne Lucerne Switzerland
- Swiss Paraplegic Research Nottwil Switzerland
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Stucki G, Bickenbach J. Health, Functioning, and Well-being: Individual and Societal. Arch Phys Med Rehabil 2019; 100:1788-1792. [DOI: 10.1016/j.apmr.2019.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/05/2019] [Accepted: 03/12/2019] [Indexed: 11/30/2022]
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McNamara A, Perrouin-Verbe B, Bickenbach J. European Academy of Rehabilitation Medicine: Commentary on "Two perspectives on the social response to disability". J Rehabil Med 2019; 51:147-148. [PMID: 30667511 DOI: 10.2340/16501977-2515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
Purpose: To evaluate the access to human rights of persons with disabilities who use prosthetic and orthotic assistive devices, and to compare groups of participants in terms of gender, residential area, income, and type and level of assistive device. The addressed areas were rights to: health, a standard of living adequate for health, education, marry and establish a family, vote, and work.Methods: Questionnaires were used to collect self-reported data from 139 lower-limb prosthetic and orthotic users in Sierra Leone.Results: About half of the participants considered their overall physical health good, while 37% said their mental health was bad. Most said they lacked access to medical care. About half of the participants had regular access to safe drinking water. Most had reasonable housing and 60% could read and write. Half of the participants were married and 70% had children. Almost all reported that they could vote if desired and about half were working.Conclusions: There is still a need for improved access to medical care when needed for persons with lower limb physical disability in Sierra Leone. Better access to food and clean water are also necessary to facilitate a standard of living adequate for health, to realize the health rights of persons with disabilities.Implications for rehabilitationIn Sierra Leone, persons with disabilities need a source of regular income to access basic needs, including clean water, access to food, medical care, and medications which should be considered in addition to providing rehabilitation services.To facilitate implementation of the Convention on the Rights of Persons with Disabilities, Sierra Leone's health system needs to be strengthened: an increased number of healthcare staff should be educated, knowledge of disability should be improved in the general public to reduce negative attitudes toward persons with disabilities, persons with disabilities should be included in mainstream health services, and national development policies should target sustainable development goals to a greater extent than during the millennium development goal era.
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Affiliation(s)
- Lina Magnusson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
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Stucki G, Bickenbach J. 1.2 Epidemiology of Disability. J Int Soc Phys Rehabil Med 2019. [DOI: 10.4103/jisprm.jisprm_6_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Affiliation(s)
- Gerold Stucki
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland
- ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland
| | - Sara Rubinelli
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland
- ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland
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Skempes D, Melvin J, von Groote P, Stucki G, Bickenbach J. Using concept mapping to develop a human rights based indicator framework to assess country efforts to strengthen rehabilitation provision and policy: the Rehabilitation System Diagnosis and Dialogue framework (RESYST). Global Health 2018; 14:96. [PMID: 30285888 PMCID: PMC6167891 DOI: 10.1186/s12992-018-0410-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 09/10/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Rehabilitation is crucial for the realization of the right to health and a proper concern of global health. Yet, reliable information to guide rehabilitation service planning is unavailable in many countries in part due to the lack of appropriate indicators. To ensure universal health coverage and meet the central imperative of "leaving no one behind" countries must be able to assess key aspects of rehabilitation policy and provision and monitor how they have discharged their human rights responsibilities towards those most disadvantaged, including people with disability. This article describes the process of developing an expert guided indicator framework to assess governments' efforts and progress in strengthening rehabilitation in line with the Convention on the Rights of Persons with Disabilities. METHODS A systems methodology - concept mapping - was used to capture, aggregate and confirm the knowledge of diverse stakeholders on measures thought to be useful for monitoring the implementation of the Convention with respect to health related rehabilitation. Fifty-six individuals generated a list of 107 indicators through online brainstorming which were subsequently sorted by 37 experts from the original panel into non overlapping categories. Forty-one participants rated the indicators for importance and feasibility. Multivariate statistical techniques where used to explore patterns and themes in the data and create the indicators' organizing framework which was verified and interpreted by a select number of participants. RESULTS A concept map of 11 clusters of indicators emerged from the analysis grouped into three broader themes: Governance and Leadership (3 clusters); Service Delivery, Financing and Oversight (6 clusters); and Human Resources (2 clusters). The indicator framework was comprehensive and well aligned with the Convention. On average, there was a moderately positive correlation between importance and feasibility of the indicators (r = .58) with experts prioritizing the indicators contained in the clusters of the Governance and Leadership domain. Two of the most important indicators arose from the Service Delivery, Financing and Oversight domain and reflect the need to monitor unmet needs and barriers in access to rehabilitation. In total, 59 indicators achieved above average score for importance and comprised the two-tiered priority set of indicators. CONCLUSION Concept mapping was successful in generating a shared model that enables a system's view of the most critical legal, policy and programmatic factors that must be addressed when assessing country efforts to reform, upscale and improve rehabilitation services. The Rehabilitation Systems Diagnosis and Dialogue framework provides a data driven basis for the development of standardized data collection tools to facilitate comparative analysis of rehabilitation systems. Despite agreement on the importance and feasibility of 59 indicators, further research is needed to appraise the applicability and utility of the indicators and secure a realistic assessment of rehabilitation systems.
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Affiliation(s)
- Dimitrios Skempes
- Department of Health Sciences and Health Policy, Center for Rehabilitation in Global Health Systems, University of Lucerne, Frohburgstrasse 3, P.O. Box 4466, CH-6002 Lucerne, Switzerland
- Swiss Paraplegic Research (SPF), Guido A. Zaech Institute, CH-6207 Nottwil, Switzerland
| | - John Melvin
- Department of Rehabilitation Medicine, Thomas Jefferson University, 25 S. Ninth Street, Philadelphia, PA 19107 USA
| | - Per von Groote
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, CH-3012 Bern, Switzerland
| | - Gerold Stucki
- Department of Health Sciences and Health Policy, Center for Rehabilitation in Global Health Systems, University of Lucerne, Frohburgstrasse 3, P.O. Box 4466, CH-6002 Lucerne, Switzerland
- Swiss Paraplegic Research (SPF), Guido A. Zaech Institute, CH-6207 Nottwil, Switzerland
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, Center for Rehabilitation in Global Health Systems, University of Lucerne, Frohburgstrasse 3, P.O. Box 4466, CH-6002 Lucerne, Switzerland
- Swiss Paraplegic Research (SPF), Guido A. Zaech Institute, CH-6207 Nottwil, Switzerland
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Boes S, Mantwill S, Kaufmann C, Brach M, Bickenbach J, Rubinelli S, Stucki G. Swiss Learning Health System: A national initiative to establish learning cycles for continuous health system improvement. Learn Health Syst 2018; 2:e10059. [PMID: 31245587 PMCID: PMC6508820 DOI: 10.1002/lrh2.10059] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/02/2018] [Accepted: 06/04/2018] [Indexed: 11/26/2022] Open
Abstract
The health system in Switzerland is considered as one of the best in the world. Nevertheless, to effectively and efficiently meet current and future challenges, an infrastructure and culture are needed where the best evidence is systematically made available and used, and the system evolves on the basis of a constant exchange between research, policy, and practice. The Swiss Learning Health System institutionalizes this idea as a multistakeholder national initiative to ensure continuous improvement through ongoing research and implementation. This article presents the objectives and mechanisms of the Swiss Learning Health System in the context of international initiatives to strengthen health systems and improve population health through learning cycles.
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Affiliation(s)
- Stefan Boes
- University of LucerneDepartment of Health Sciences and Health PolicyLucerneSwitzerland
| | - Sarah Mantwill
- University of LucerneDepartment of Health Sciences and Health PolicyLucerneSwitzerland
| | - Cornel Kaufmann
- University of LucerneDepartment of Health Sciences and Health PolicyLucerneSwitzerland
| | - Mirjam Brach
- University of LucerneDepartment of Health Sciences and Health PolicyLucerneSwitzerland
- Swiss Paraplegic ResearchNottwilSwitzerland
| | - Jerome Bickenbach
- University of LucerneDepartment of Health Sciences and Health PolicyLucerneSwitzerland
- Swiss Paraplegic ResearchNottwilSwitzerland
| | - Sara Rubinelli
- University of LucerneDepartment of Health Sciences and Health PolicyLucerneSwitzerland
- Swiss Paraplegic ResearchNottwilSwitzerland
| | - Gerold Stucki
- University of LucerneDepartment of Health Sciences and Health PolicyLucerneSwitzerland
- Swiss Paraplegic ResearchNottwilSwitzerland
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Abstract
There is strong evidence that population ageing and the epidemiological transition to a higher incidence of chronic, non-communicable diseases will continue to profoundly impact societies worldwide, putting more pressure on healthcare systems to respond to the needs of the people they serve. These trends argue for the need to address what matters to people about their health: limitations in their functioning that affect their day-to-day actions and goals in life. From its inception, rehabilitation, 1 of the 4 health strategies identified in the Declaration of Alma Ata in 1978, has had functioning as its outcome of interest. Its practitioners are from fields that include physical and rehabilitation medicine, occupational therapy, physiotherapy, speech and language therapy, orthotics and prosthetics, psychology, and evaluators of functioning interventions, including assistive technologies. Demographic and epidemiological trends suggest that the key indicators of the health of populations will be not merely mortality and morbidity, but functioning as well. This, in turn, suggests that the primary focus of healthcare will need to respond to actual healthcare demands generated by the need for long-term management of chronic conditions, including, in particular, the scaling up and strengthening of rehabilitation. This is the case for thinking that rehabilitation will become the key health strategy of the 21st century.
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Affiliation(s)
- Gerold Stucki
- Department of Health Sciences and Health Policy, Faculty of Humanities and Social Sciences, University of Lucerne, Frohburgstrasse 3, P.O. Box 4466, CH-6002 Lucerne, Switzerland.
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Bickenbach J, Marx G, Marx N, Lemmen S, Dreher M. Der Einfluss multiresistenter Pneumonieerreger auf das Outcome bei Patienten im prolongierten Weaning. Pneumologie 2018. [DOI: 10.1055/s-0037-1619141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- J Bickenbach
- Klinik für Operative Intensivmedizin und Intermediate Care, Medizinische Fakultät der RWTH Aachen
| | - G Marx
- Klinik für Operative Intensivmedizin und Intermediate Care, Medizinische Fakultät der RWTH Aachen
| | - N Marx
- Sektion Pneumologie, Medizinische Klinik I, Medizinische Fakultät der RWTH Aachen
| | - S Lemmen
- Zentralbereich für Krankenhaushygiene und Infektiologie, Medizinische Fakultät der RWTH Aachen
| | - M Dreher
- Sektion Pneumologie, Medizinische Klinik I, Medizinische Fakultät der RWTH Aachen
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Abstract
Disability as a health outcome deserves more attention than it has so far received. With people living longer and the epidemiological transition from infectious to noncommunicable diseases as the major cause of health burden, we need to focus attention on disability - the non-fatal impact of heath conditions - over and above our concern for causes of mortality.With the first Global Burden of Disease study, WHO provided a metric that enabled the comparison of the impact of diseases, drawing on a model of disability that focused on decrements of health. This model has since been elaborated in the International Classification of Functioning, Disability and Health as being either a feature of the individual or arising out of the interaction between the individual's health condition and contextual factors. The basis of WHO's ongoing work is a set of principles: that disability is a universal human experience; that disability is not determined solely by the underlying health condition or predicated merely on the presence of specific health conditions; and finally, that disability lies on a continuum from no to complete disability. To determine whether interventions at individual or population levels are effective, an approach to disability measurement that allows for an appropriate and fair comparison across health conditions is needed. WHO has designed the Model Disability Survey (MDS) to collect information relevant to understand the lived experience of disability, including the person's capacity to perform tasks actions in daily life, their actual performance, the barriers and facilitators in the environment they experience, and their health conditions. As disability gains prominence within the development agenda in the United Nations Sustainable Development Goals, and the implementation of the United Nations Convention on the Rights of Persons with Disabilities, the MDS will provide the data to monitor the progress of countries on meeting their obligations.The lesson learned from WHO's activities is that disability is a universal human experience, in the sense that everyone can be placed on a continuum of functioning and either currently experiences or is vulnerable to experiencing disability over the course of their lives. This understanding of disability is the key to mainstreaming disability within the public discourse.
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Affiliation(s)
- Alarcos Cieza
- Department of Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland.
| | - Carla Sabariego
- Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, University of Lucerne and Swiss Paraplegic Research (SPF), Nottwil, Switzerland
| | - Somnath Chatterji
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
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Gutenbrunner C, Bickenbach J, Melvin J, Lains J, Nugraha B. Strengthening health-related rehabilitation services at national levels. J Rehabil Med 2018; 50:317-325. [DOI: 10.2340/16501977-2217] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gutenbrunner C, Bickenbach J, Borg K, Nugraha B, Melvin J, Stucki G. Scaling up rehabilitation - Towards an international policy agenda. J Rehabil Med 2018; 50:307-308. [DOI: 10.2340/16501977-2317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Affiliation(s)
- Evelyne Durocher
- Department of Occupational Science and Occupational Therapy, University of Toronto
| | - Rosalie H. Wang
- Department of Occupational Science and Occupational Therapy, University of Toronto
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, University of Lucerne Swiss Paraplegic Research, Nottwil
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Kamenov K, Cabello M, Ballert CS, Cieza A, Chatterji S, Rojas D, Cerón G, Bickenbach J, Ayuso-Mateos JL, Sabariego C. What makes the difference in people's lives when they have a mental disorder? Int J Public Health 2017; 63:57-67. [PMID: 29177711 DOI: 10.1007/s00038-017-1047-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 07/17/2017] [Accepted: 10/14/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The objective of this study was to identify which environmental factors are the most responsible for the disability experienced by persons with mental disorders and whether they differ (1) from those in cardiovascular diseases, chronic respiratory conditions, diabetes, and cancer, and (2) depending on the capacity level-a proxy for the impact of health conditions on the health state of individuals. METHODS Nationally representative data from 12,265 adults in Chile collected in 2015 with the WHO Model Disability Survey was analyzed. RESULTS The availability of personal assistance, frequency of receiving personal assistance, and assistive devices for mobility were the most important environmental factors across mental and other non-communicable diseases. Perception of discrimination and use of health services were also prominent factors. There was a huge overlap between the factors found relevant for mental and other non-communicable diseases, but a substantial variability depending on the intensity of difficulties in capacity. CONCLUSIONS This study challenges the appropriateness of disease-specific approaches and suggests that considering intrinsic capacity levels is more informative than focusing on diagnosis alone when comparing needs and barriers that affect the performance in daily life of specific groups of individuals.
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Affiliation(s)
- Kaloyan Kamenov
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red, CIBER, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Cabello
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red, CIBER, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Alarcos Cieza
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.,Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität München, Munich, Germany.,Blindness and Deafness Prevention, Disability and Rehabilitation (BDD), World Health Organization, Geneva, Switzerland
| | - Somnath Chatterji
- Department for Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Diego Rojas
- Department of Studies, Servicio Nacional de Discapacidad (Senadis), Ministerio de Desarrollo Social, Santiago, Chile
| | - Gloria Cerón
- Department of Studies, Servicio Nacional de Discapacidad (Senadis), Ministerio de Desarrollo Social, Santiago, Chile
| | | | - José Luis Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red, CIBER, Madrid, Spain. .,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain. .,Instituto de investigación de la Princesa, (IIS-IP), Hospital Universitario de la Princesa, C/Diego de León 62, 28006, Madrid, Spain.
| | - Carla Sabariego
- Department of Medical Informatics, Biometry and Epidemiology-IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-Universität München, Munich, Germany
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48
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Ehrmann C, Bickenbach J, Stucki G. Graphical modelling: a tool for describing and understanding the functioning of people living with a health condition. Eur J Phys Rehabil Med 2017; 55:131-135. [PMID: 29144108 DOI: 10.23736/s1973-9087.17.04970-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Rehabilitation aims to optimize people's lived experience of health or functioning. A comprehensive understanding of people's functioning is thus fundamental for rehabilitation clinicians and scientists. Over the past ten years it has been shown that graphical modelling is a promising technique for modelling data on people's functioning. It can contribute to our understanding of the complex associations between domains of functioning and the identification of potential targets for rehabilitation interventions both at the level of the person and the environment. The objective of this methodological note is to demonstrate how graphical modelling can be used by rehabilitation clinicians and scientists in the description, understanding and influencing of people's functioning. The application of graphical modelling and the interpretation of results is illustrated using the Spinal Cord Injury Independence Measure - Self Report used in the Swiss Spinal Cord Injury Cohort Study. Finally, we discuss the potential of graphical modelling for the planning of studies that expand our understanding of functioning and for rehabilitation interventions.
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Affiliation(s)
- Cristina Ehrmann
- Department of Health Sciences and Health Policy, Faculty of Humanities and Social Sciences, University of Lucerne, Lucerne, Switzerland - .,Swiss Paraplegic Research (SPF), Nottwil, Switzerland -
| | - Jerome Bickenbach
- Department of Health Sciences and Health Policy, Faculty of Humanities and Social Sciences, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research (SPF), Nottwil, Switzerland.,ICF Research Branch, a cooperation partner within the WHO Collaborating Center for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland
| | - Gerold Stucki
- Department of Health Sciences and Health Policy, Faculty of Humanities and Social Sciences, University of Lucerne, Lucerne, Switzerland.,Swiss Paraplegic Research (SPF), Nottwil, Switzerland.,ICF Research Branch, a cooperation partner within the WHO Collaborating Center for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland
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49
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Bickenbach J, Prina M, Huisman M. HEALTHY AGEING: FROM EPIDEMIOLOGY TO POLICY. CHALLENGES AND UPDATES FROM THE ATHLOS PROJECT. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - M. Prina
- King’s College London, United Kingdom
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50
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Bobak M, Bickenbach J, Gheno I, Zaidi A, Chatterji S, Prina M, Haro J. POLICY AND KNOWLEDGE TRANSLATION IN THE ATHLOS PROJECT. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M. Bobak
- Epidemiology and Public Health, University College London, London, United Kingdom,
| | | | - I. Gheno
- Age Platform Europe, Brussels, Belgium,
| | - A. Zaidi
- University of Southampton, Southampton, United Kingdom
| | | | - M. Prina
- Kings College London, London, United Kingdom,
| | - J. Haro
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain,
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