Types and factors affecting and impact of ableism among Asian children and youth with disabilities and their caregivers: a systematic review of quantitative studies

PURPOSE

Asian children and youth with disabilities often experience multiple barriers and discrimination in education, healthcare, and social settings, which influence their well-being, especially the transition to adulthood. This review aims to explore the types, factors affecting and impact of ableism on Asian children and youth with disabilities and their caregivers.

METHODS

We conducted a systematic review and a narrative synthesis whereby we searched the literature from six international databases, including Healthstar, Ovid Medline, Embase, PsycInfo, Scopus, and Web of Science.

RESULTS

Twenty-nine studies were included in the review, and three themes were identified that related to ableism: (1) types and rates of ableism (i.e., stigma, bullying and victimization, and discrimination and inequalities); (2) factors affecting ableism (i.e. sociodemographic factors, familial factors, and societal factors); and (3) impacts of ableism (i.e. mental health, family impacts, and societal impacts).

CONCLUSIONS

Our review highlights that ableism has various types and can be influenced by multiple factors, influencing social and health outcomes of Asian families with children and youth with disabilities. This review also emphasizes the importance of increasing the public's awareness regarding disabilities to reduce ableism among Asian families with children with disabilities.

Accessible independent housing for people with disabilities: A scoping review of promising practices, policies and interventions

BACKGROUND

Accessible housing is imperative to enabling independent living for many people with disabilities; yet, research consistently shows how people with disabilities often lack appropriate accessible housing and are more likely to experience unaffordable, insecure, and/or poor quality housing. Therefore, the aim of this study was to understand promising practices, policies and interventions regarding accessible independent housing for people with disabilities.

METHODS

We conducted a scoping review that involved searching seven international literature databases that identified 4831 studies, 60 of which met our inclusion criteria.

RESULTS

The reviewed studies involved 18 countries over a 20-year period. Our review highlighted the following key trends: (1) removing barriers to obtaining accessible housing (e.g., advocacy, builders enhancing housing supply, subsidies and financial incentives); (2) policies influencing accessible housing; (3) interventions to enhance accessible housing (i.e., home modifications, smart homes, mobile applications and other experimental devices); and (4) the impact of accessible independent housing on health and wellbeing.

CONCLUSIONS

Our findings emphasize the importance of accessible housing for people with disabilities and the urgent need to advance accessible housing options.

The impact of climate change related extreme weather events on people with pre-existing disabilities and chronic conditions: a scoping review

PURPOSE

People with disabilities experience a disproportionate impact of extreme weather events and there is a critical need to better understand the impact that climate change has for them. Most previous reviews focus on the risk of acquiring a new disability or injury after a climate-related event and not the impact on people with pre-existing disabilities or chronic conditions, which is the purpose of this study.

METHODS

We conducted a scoping review while searching seven international databases that identified 45 studies meeting our inclusion criteria.

RESULTS

The studies included in our review involved 2 337 199 participants with pre-existing disabilities and chronic conditions across 13 countries over a 20-year period. The findings demonstrated the following trends: (1) the impact on physical and mental health; (2) the impact on education and work; (3) barriers to accessing health and community services (i.e., lack of access to services, lack of knowledge about people with disabilities, communication challenges, lack of adequate housing); and (4) coping strategies (i.e., social supports and connecting to resources) and resilience.

CONCLUSIONS

Our findings highlight the critical need for rehabilitation clinicians and other service providers to explore opportunities to support their clients in preparing for climate-related emergencies.

Exploring the experiences of ableism among Asian children and youth with disabilities and their families: a systematic review of qualitative studies

PURPOSE

Asian children and youth with disabilities often experience multiple barriers, stigmas and discrimination within and outside their families; yet less is understood about their lived experiences. This systematic review explored the experiences of ableism among Asian children and youth with disabilities and their families.

METHODS

We conducted a systematic review of qualitative studies and a qualitative meta-synthesis. We searched six databases including Ovid Medline, Embase, PsychInfo, Healthstar, Web of Science, and Scopus.

RESULTS

Forty-two articles met our inclusion criteria involving 17 countries and regions over a 22-year period. The findings were synthesized into four themes: (1) individual- and family-level ableism (i.e., stigma, fears, concerns, stress and anxieties, physical abuse, bullying, reduced engagement in community activities); (2) institutional-level ableism (i.e., barriers to accessing and navigating supports, ableist attitudes among service providers, unavailable services); (3) societal-level ableism (i.e., cultural and religious stigma, social rejection, discrimination, environmental and policy barriers); and (4) coping strategies (i.e., self-care activities, supports from family, friends and people with similar conditions, religious beliefs).

CONCLUSIONS

Our results highlight the ableist experiences that Asian children and youth with disabilities and their caregivers often encounter and the strong need for further supports to address ableism using culturally responsive strategies.

Barriers and facilitators to obtaining accessible housing among children, youth and young adults with disabilities and their families: a scoping review

PURPOSE

Accessible housing is a fundamental human right and yet many children and youth with disabilities live in inaccessible, insecure, unaffordable and poor quality housing. The aim of our study was to understand the barriers and facilitators to obtaining accessible housing among children, youth and young adults with disabilities and their families.

METHODS

We conducted a scoping review involving seven international literature databases from 2000 to 2022 that identified 38 studies meeting our inclusion criteria.

RESULTS

The reviewed studies involved 10 countries over a 22-year period. Our review emphasized the following key trends: (1) barriers to obtaining accessible homes (i.e. common types of accessibility barriers, rates of inaccessible housing, factors affecting home accessibility), and negative impacts of inaccessible housing; and (2) rates and facilitators to obtaining accessible housing (i.e., common types of home modifications, enablers of home modifications) and positive impacts of accessible housing.

CONCLUSIONS

Our findings highlight the barriers and enablers of obtaining accessible housing among children, youth and young adults with disabilities and their families and the critical need to support them in securing appropriate housing.

Understanding the benefits and challenges of outpatient virtual care during the COVID-19 pandemic in a Canadian pediatric rehabilitation hospital

PURPOSE

The evolving virtual health care experience highlights the potential of technology to serve as a way to enhance care. Having virtual options for assessment, consultation and intervention were essential during the coronavirus (COVID-19) pandemic, especially for children with disabilities and their families. The purpose of our study was to describe the benefits and challenges of outpatient virtual care during the pandemic within pediatric rehabilitation.

METHODS

This qualitative study, part of a larger mixed methods project, involved in-depth interviews with 17 participants (10 parents, 2 youth, 5 clinicians) from a Canadian pediatric rehabilitation hospital. We analyzed the data using a thematic approach.

RESULTS

Our findings demonstrated three main themes: (1) benefits of virtual care (e.g., continuity of care, convenience, stress reduction and flexibility, and comfort within the home environment and enhanced rapport); (2) challenges related to virtual care (e.g., technical difficulties and lack of technology, environmental distractions and constraints, communication difficulty, and health impacts); and (3) advice for the future of virtual care (i.e., offering choice to families, enhanced communication and addressing health equity issues).

CONCLUSIONS

Clinicians and hospital leaders should consider addressing the modifiable barriers in accessing and delivering virtual care to optimize its effectiveness.

Ableism among children and youth with acquired brain injury and their caregivers: a systematic review

PURPOSE

Children and youth with acquired brain injury (ABI) experience persistent discrimination and ableism. The purpose of this systematic review was to understand the experiences and impact of ableism among children and youth with ABI.

METHOD

Six international databases were systematically searched for articles from 2002-2022. Studies were screened independently by four researchers who performed the data extraction. Study quality was appraised using the Standard quality assessment criteria for evaluating primary research.

RESULTS

Of the 2085 studies identified in the search, 15 met the inclusion criteria, which involved 1442 children and youth with brain injuries or caregivers representing them. Studies in the review showed the following key trends: (1) incidence of ableism among children and youth with ABI; (2) experiences of ableism at the individual and institutional levels, (3) impact of ableism (i.e., mental health, social relationships, quality of life) and (4) coping strategies (i.e., resources, supports).

CONCLUSIONS

Our findings reveal the alarming incidence of ableism among youth with ABI. Therefore, there is a critical need for more research to explore youth's lived experiences of ableism, especially from their perspectives along with the co-development of solutions to help enhance their social inclusion and well-being.

Varieties of 'new normal': Employment experiences among youth with and without disabilities during the reopening stages of the COVID-19 pandemic

BACKGROUND

Working and volunteering in the reopening stages of the COVID-19 pandemic has looked different depending on the location, employment sector and nature of the job. Although researchers have begun exploring the impacts on adults, little is known about what the transition to a 'new normal' in the reopening stages has been like for youth, especially those with disabilities.

OBJECTIVE

To explore and compare the experiences and perspectives of youth with and without disabilities who were working, volunteering or seeking work during the re-opening stages of the COVID-19 pandemic in Canada.

METHODS

We used a qualitative design involving semi-structured interviews with 16 youth (seven with a disability, nine without), aged 15-29 (mean 22 years). Thematic analysis was used to analyze the data.

RESULTS

Five main themes were identified: (1) Mixed views on being onsite in the reopening stages; (2) Mixed views on remaining remote; (3) Hybrid model as the best of both worlds; (4) Mixed views on COVID-19 workplace safety in the reopening stages; and (5) Hopes, dreams and advice for the future. Apart from the first main theme, there were more similarities than differences between youth with and without disabilities.

CONCLUSION

Our study highlights that youth encountered various work and volunteer arrangements during the reopening stages of the pandemic, and the personal preferences for particular models depend largely on their employment sector. The areas of agreement among youth highlight some longer-term impacts of the pandemic shutdowns and point to the need for greater mental health and career supports.

Ableism within health care professions: a systematic review of the experiences and impact of discrimination against health care providers with disabilities

PURPOSE

People with disabilities experience concerning rates of ableism and are significantly under-represented within healthcare education and professions. Focusing on healthcare professions is important for enhancing the diversity and inclusion of equity-deserving groups within the workforce. The objective of this review was to explore the experiences and impact of workplace discrimination and ableism among healthcare providers and trainees with disabilities.

METHODS

Systematic searches of seven databases from 2000 to January 2022 were conducted. Five reviewers independently applied the inclusion criteria, extracted the data and rated the study quality.

RESULTS

48 studies met our inclusion criteria, representing 13,815 participants across six countries over a 21-year period. The findings highlighted rates and types of workplace ableism, which occurred at the institutional (i.e., inaccessible environments, physical barriers and unsupportive work environments) and individual level (i.e., negative attitudes, bullying, harassment). The impact of ableism on healthcare providers included difficulty disclosing due to fear of stigma, and effects on well-being and career development.

CONCLUSIONS

Our findings revealed a critical need for more research on the experiences of ableism amongst healthcare providers and the impact it has on their well-being. Further efforts should explore mechanisms for including and welcoming people with disabilities in healthcare professions.Implications for rehabilitationWorkplace ableism is prevalent in health care professions and could be discouraging people with disabilities from entering or completing health care education and training, leading to an under-representation of this equity-deserving group within health care.More efforts are needed to recruit, retain and support people with disabilities in the health care workforce.Health care providers who have a disability often experience workplace discrimination and inaccessible physical environments which can impact their health and well-being.Managers, senior leadership and health care organizations should advocate for improved social inclusion of employees with disabilities.

Purification and characterization of the NAD-preferring glucose 6-phosphate dehydrogenase from Acetobacter hansenii (Acetobacter xylinum)

An NAD-preferring glucose 6-phosphate dehydrogenase of Acetobacter hansenii (formerly known as Acetobacter xylinum) has been purified to apparent homogeneity and kinetically characterized. The purified enzyme was stabilized by the use of glycerol, MgSO4, and 2-mercaptoethanol at pH 5.4. The molecular weight of the enzyme, determined by nondenaturing gel filtration, is 243,000. The subunit molecular weight is 60,140 as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, suggesting that the native enzyme is a tetramer. At pH 5.4 the enzyme has Kms of 0.104 and 0.34 mM for NAD+ and NADP+, respectively; the Kms for glucose 6-phosphate are 0.071 and 0.089 mM, using NAD+ and NADP+, respectively; and the kcat values are 128,000 and 77,300 min-1 with NAD+ and NADP+, respectively. The Kms for NADP+ and glucose 6-phosphate are approximately 10 times higher than the corresponding Kms for the NADP-specific glucose 6-phosphate dehydrogenase in the same organism, but the kcat is also approximately 10-fold higher, so that the kcat/Km values for these two activities are nearly identical at pH 5.4. Both the NAD- and NADP-linked activities of the NAD-preferring enzyme are inhibited by ATP. The NADP-specific glucose 6-phosphate dehydrogenase is insensitive to ATP at pH 6.7 and 9.5, but at pH 5.4 ATP inhibits this enzyme. The possible roles of these two glucose 6-phosphate dehydrogenases in the metabolism of A. hansenii are discussed.