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Disabilities – Constant Quest in Medical, Social and Political Records

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (21 December 2022) | Viewed by 26325

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Prof. Dr. Beata Karakiewicz

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Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University in Szczecin, Żołnierska Str. 48, 71-210 Szczecin, Poland
Interests: disability; public health; mental health; environmental medicine; health education; midvifery

Prof. Dr. Karolina Skonieczna-Żydecka

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Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, Broniewskiego Str. 24, 71-460 Szczecin, Poland
Interests: microbiome; metabolomics; gut brain axis; neuropsychiatric diseases; epidemiology; nutrition; gastroenterology hepatology

Dr. Paulina Zabielska

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Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University in Szczecin, Żołnierska Str. 48, 71-210 Szczecin, Poland
Interests: public health; environmental medicine; epidemiology; elderly; longevity

Special Issue Information

Dear Colleagues,

Physically and mentally disabled people constitute an increasing percentage of the population worldwide. Most of them are unable to fulfill normal social roles, and their everyday life is limited by numerous social barriers. Moreover, in people with disabilities, a high incidence of comorbidities—both somatic and mental—is observed, which is consequently associated with a lower level of well-being and a relatively low quality of life. Evaluating the association between health status and demographic, social, cognitive, and psychological factors in a global sample of persons with mild-to-severe disabilities of both types is of the greatest importance in every society.

This will make it possible to refine diagnostic strategies and implement procedures improving the health condition and, consequently, the quality of life of this group of people. It will also allow health-science-related authorities to select the disabled population with concurrent lower self-efficacy. We encourage authors to submit manuscripts to our Special Issue. They will have a great opportunity to share their knowledge on disabilities, in both children and adults, regarding medical, epidemiological, social, and political aspects.

Prof. Dr. Beata Karakiewicz
Prof. Dr. Karolina Skonieczna-Żydecka
Dr. Paulina Zabielska
Guest Editors

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Keywords

disability
social barrier
quality of life
epidemiology
policy

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Research

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12 pages, 365 KiB

Open AccessArticle

Health System’s Role in Facilitating Health Service Access among Persons with Spinal Cord Injury across 22 Countries

by Olena Bychkovska, Vegard Strøm, Piotr Tederko, Julia Patrick Engkasan, Alvydas Juocevičius, Linamara Rizzo Battistella, Mohit Arora, Christoph Egen and Armin Gemperli

Int. J. Environ. Res. Public Health 2023, 20(11), 6056; https://doi.org/10.3390/ijerph20116056 - 5 Jun 2023

Cited by 1 | Viewed by 1953

Abstract

(1) Background: Despite efforts to improve access to health services, between- and within-country access inequalities remain, especially for individuals with complex disabling conditions like spinal cord injury (SCI). Persons with SCI require regular multidisciplinary follow-up care yet experience more access barriers than the general population. This study examines health system characteristics associated with access among persons with SCI across 22 countries. (2) Methods: Study data are from the International Spinal Cord Injury Survey with 12,588 participants with SCI across 22 countries. Cluster analysis was used to identify service access clusters based on reported access restrictions. The association between service access and health system characteristics (health workforce, infrastructure density, health expenditure) was determined by means of classification and regression trees. (3) Results: Unmet needs were reported by 17% of participants: lowest (10%) in Japan, Spain, and Switzerland (cluster 1) and highest (62%) in Morocco (cluster 8). The country of residence was the most important factor in facilitating access. Those reporting access restrictions were more likely to live in Morocco, to be in the lowest income decile, with multiple comorbidities (Secondary Conditions Scale (SCI-SCS) score > 29) and low functioning status (Spinal Cord Independence Measure score < 53). Those less likely to report access restriction tended to reside in all other countries except Brazil, China, Malaysia, Morocco, Poland, South Africa, and South Korea and have fewer comorbidities (SCI-SCS < 23). (4) Conclusions: The country of residence was the most important factor in facilitating health service access. Following the country of residence, higher income and better health were the most important facilitators of service access. Health service availability and affordability were reported as the most frequent health access barriers. Full article

(This article belongs to the Special Issue Disabilities – Constant Quest in Medical, Social and Political Records)

11 pages, 884 KiB

Open AccessArticle

Existential and Spiritual Attitudes of Polish Medical and Nursing Staff towards Death

by Krzysztof Zdziarski, Paulina Zabielska, Sylwia Wieder-Huszla, Iwona Bąk, Katarzyna Cheba, Mariola Głowacka and Beata Karakiewicz

Int. J. Environ. Res. Public Health 2022, 19(15), 9461; https://doi.org/10.3390/ijerph19159461 - 2 Aug 2022

Viewed by 1544

Abstract

Issues related to death are difficult areas of human existence and are most often considered in terms of ethical or non-ethical behaviour. The aim of the research was to examine the attitudes of Polish medical and nursing personnel towards death. The research was conducted among medical (110 people) and nursing staff (110 people) working in Polish hospitals and representing 16 regions. The Questionnaire About Attitudes to Death (DAP-R-PL) was used. The attitude of medical staff, taking into account the holistic approach to the patient in his existential–spiritual dimension, is an extremely important element of professional care. The study outlines the attitudes of medical and nursing staff towards death. Medical personnel under examination demonstrate a mature attitude towards death. In light of this research, health care workers show great commitment to helping dying people with existential and spiritual needs. Full article

(This article belongs to the Special Issue Disabilities – Constant Quest in Medical, Social and Political Records)

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20 pages, 389 KiB

Open AccessArticle

Hepcidin (rs10421768), Transferrin (rs3811647, rs1049296) and Transferrin Receptor 2 (rs7385804) Gene Polymorphism Might Be Associated with the Origin of Multiple Sclerosis

by Laura Stachowska, Dorota Koziarska, Beata Karakiewicz, Artur Kotwas, Anna Knyszyńska, Marcin Folwarski, Karolina Dec, Ewa Stachowska, Viktoria Hawryłkowicz, Monika Kulaszyńska, Joanna Sołek-Pastuszka and Karolina Skonieczna-Żydecka

Int. J. Environ. Res. Public Health 2022, 19(11), 6875; https://doi.org/10.3390/ijerph19116875 - 4 Jun 2022

Cited by 5 | Viewed by 2491

Abstract

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system in which there is a multifocal damage to the nerve tissue. Additionally, the literature emphasizes the excessive accumulation of iron in the central nervous system of patients, which is negatively correlated with their psychophysical fitness. Iron metabolism genes polymorphisms may modulate iron deposition in the body and thus affect the clinical course of MS. We aimed to assess the frequency of HAMP, TFR2, and TF polymorphisms in MS patients and their impact on the clinical course of the disease. The studied polymorphisms were identified by the Real-Time PCR using TaqMan technology. Neurological assessment by means of EDSS scale was conducted. This cross-sectional study included 176 patients, with the mean age of onset of symptoms at 30.6 years. The frequency of alleles of the studied polymorphisms was as follows: (a) HAMP rs10421768: A 75.9% (n = 267), G 24.1% (n = 65), (b) TF rs1049296: C 89.2% (n = 314), T 10.8% (n = 38), (c) TF rs3811647: A 39.8% (n = 140), G 60.2% (n = 212), (d) TFR2 rs7385804: A 59.1% (n = 59.1%), C 40.9% (n = 144). In the codominant inheritance model of TF rs1049269, it was shown that people with the CT genotype scored statistically significantly lower points in the EDSS scale at the time of diagnosis than those with the CC genotype (CC Me = 1.5, CT Me = 1.0 p = 0.0236). In the recessive model of TF inheritance rs3811647, it was noticed that the primary relapses were significantly more frequent in patients with at least one G allele compared with those with the AA genotype (AG + GG = 81.2%, AA = 18.8%, p = 0.0354). In the overdominant model rs7385804 TFR2, it was shown that among patients with the AA genotype, multiple sclerosis occurs significantly more often in relatives in a straight line compared with people with the AC and CC genotypes (AA = 100.0%, AC + CC = 0.0%, p = 0.0437). We concluded that the studied polymorphisms might affect the clinical course of MS. Full article

(This article belongs to the Special Issue Disabilities – Constant Quest in Medical, Social and Political Records)

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11 pages, 2129 KiB

Open AccessArticle

Searching for the Relationship between the Concentration of Heavy Metals in the Blood and the Clinical Course of Multiple Sclerosis: A Cross-Sectional Study in Poland

by Anna Knyszyńska, Karolina Skonieczna-Żydecka, Dorota Koziarska, Laura Stachowska, Artur Kotwas, Monika Kulaszyńska, Anna Lubkowska and Beata Karakiewicz

Int. J. Environ. Res. Public Health 2022, 19(11), 6548; https://doi.org/10.3390/ijerph19116548 - 27 May 2022

Cited by 2 | Viewed by 2012

Abstract

(1) Background: Of all environmental pollutants, heavy metals have the most detrimental effect on public health because they remain in the ecosystem and are not biodegradable. The neurotoxicity of heavy metals, including cadmium and lead, has been well documented, and blood levels of heavy metals serve as a biomarker of exposure, reflecting their content in soft tissues. Multiple sclerosis (MS) is one of the most common chronic neurodegenerative diseases. The pathogenesis of MS is complex and relies on the interaction between genetic and environmental factors. The aim of this study was to search for the relationship between the values of cadmium and lead concentration in the blood and the health history and functional status of patients with MS. (2) Methods: The study group consisted of 151 patients with a clinical diagnosis of MS. Determination of the presence of tested elements in serum was performed using an ELAN DRC-e ICP mass spectrometer. (3) Results: Statistical analysis demonstrated that an increase in the level of cadmium was accompanied by an increase in the level of lead. There was no significant correlation between the blood lead concentration and the functional status assessed by EDSS among patients with MS in Poland. However, a tendency towards worse functional status of patients with higher blood lead concentration (p = 0.07) was demonstrated. Patients who experienced first MS symptoms at older age had higher blood levels of the tested metals. (4) Conclusions: The concentrations of cadmium and lead in the blood of MS patients in Poland were not factors differentiating their functional status and the course of the disease. Full article

(This article belongs to the Special Issue Disabilities – Constant Quest in Medical, Social and Political Records)

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17 pages, 1101 KiB

Open AccessArticle

Analysis of Medical Management in Geriatric Patients in the Hospital Emergency Department by Example of Selected Cities with County Status in Poland: A Retrospective Cohort Study

by Mariusz Celiński, Mateusz Cybulski, Joanna Fiłon, Marta Muszalik, Mariusz Goniewicz, Elżbieta Krajewska-Kułak and Anna Ślifirczyk

Int. J. Environ. Res. Public Health 2022, 19(1), 48; https://doi.org/10.3390/ijerph19010048 - 21 Dec 2021

Cited by 2 | Viewed by 2032

Abstract

The aim of this study was to analyse medical management in geriatric patients in the Hospital Emergency Departments in the Biała Podlaska County and Chełm County (Poland) between 2016 and 2018 in a group of patients ≥65 years of age. We analysed medical records of 829 patients transported to Hospital Emergency Departments by Medical Emergency Teams. The research was conducted in the period from June 2019 to March 2020. We analysed emergency medical procedure forms and medical records of patients transported to the hospitals. Cardiovascular diseases were diagnosed in 40% of patients. Mortality cases accounted for 3.1% of the 1200 interventions analysed. Ambulance dispatch resulted in the patient being transported to the Hospital Emergency Departments in more than ²/₃ of cases. The concordance between the diagnoses made by the Medical Emergency Teams and those made at the Hospital Emergency Departments was confirmed for 78% patients admitted to the department (n = 647), whereas the concordance of classification at the group level was estimated at 71.7% (n = 594). Further in-patient treatment was initiated in some of the patients admitted to the department (n = 385). The mean time of hospital stay was 10.1 days. In conclusion, differences between the initial diagnosis made by the heads of the Medical Emergency Teams and the diagnosis made by the doctor on duty in the Hospital Emergency Departments depended on the chapter of diseases in the ICD-10 classification, but they were acceptable. The majority of the patients were transported to Hospital Emergency Departments. The most common groups of diseases that require Hospital Emergency Departments admission include cardiovascular diseases, injuries due to external causes, and respiratory diseases. A moderate percentage of patients were qualified for further specialist treatment in hospital departments. Full article

(This article belongs to the Special Issue Disabilities – Constant Quest in Medical, Social and Political Records)

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8 pages, 309 KiB

Open AccessArticle

Educational and Psychological Support Combined with Minimally Invasive Surgical Technique Reduces Perioperative Depression and Anxiety in Patients with Bladder Cancer Undergoing Radical Cystectomy

by Artur Lemiński, Krystian Kaczmarek, Aleksandra Bańcarz, Alicja Zakrzewska, Bartosz Małkiewicz and Marcin Słojewski

Int. J. Environ. Res. Public Health 2021, 18(24), 13071; https://doi.org/10.3390/ijerph182413071 - 11 Dec 2021

Cited by 11 | Viewed by 2412

Abstract

Radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) is an extensive and morbid operation, often associated with permanent alteration of body image and disability. Combined with the aggressive malignant potential of MIBC and considerable risk of complications, it poses a serious threat to the psychological well-being of patients. Educational deficiencies causing uncertainty and confusion aggravate surgery-related anxiety and may lead to depression along with further social disability. We conceived a preoperative supportive program named “Cystocare” held by urologists, psychologists, stoma therapists and cancer survivors to facilitate patients’ adaptation and coping. We aimed to evaluate whether participation in Cystocare meetings would alleviate emotional distress in patients undergoing RC. We included 95 consecutive patients who filled Hospital Anxiety and Depression Score questionnaires before RC and on discharge. The intervention arm (A) comprised 32 Cystocare participants. The remaining 63 patients who received standard preparation constituted the control arm (B). Whilst there were no differences in median anxiety and depression scores preoperatively, in postoperative measurement, the intervention arm showed a lower median depression score than controls: 3 vs. 8 points, p = 0.015. On multivariate analysis we confirmed lower risk of postoperative depression in Cystocare participants: OR = 0.215 (95%CI: 0.066–0.699), p = 0.011, along with lower odds of preoperative anxiety in patients undergoing laparoscopic RC: OR = 0.365 (95%CI: 0.136–0.978), p = 0.045, and higher risk of prolonged hospital stay in patients experiencing postoperative anxiety OR = 17.114 (95%CI: 1.283–228.234) p = 0.032. Preoperative educational and supportive intervention complements laparoscopic RC in the alleviation of surgery-related anxiety and depression. The support group meetings provide an attractive and cost-effective opportunity to moderate emotional response in patients undergoing RC, and as such, deserve widespread adoption. Full article

(This article belongs to the Special Issue Disabilities – Constant Quest in Medical, Social and Political Records)

13 pages, 361 KiB

Open AccessArticle

Attitudes of Polish Medical and Health Sciences Students towards Persons with Physical Disabilities Using the MAS-PL Scale

by Iwona Radlińska, Marta Kożybska and Beata Karakiewicz

Int. J. Environ. Res. Public Health 2021, 18(15), 7787; https://doi.org/10.3390/ijerph18157787 - 22 Jul 2021

Cited by 8 | Viewed by 3538

Abstract

Discovering the role of negative attitudes in the social functioning of people with disabilities, tools were developed to measure these attitudes, of which the Multidimensional Attitude Scale of People with Disabilities (MAS) is a good one. It is particularly important to study the attitudes of people who are professionally involved in meeting the needs of people with disabilities. The aim of this study was to determine the attitudes towards people with physical disabilities among medical and health sciences students regarding gender, year of study, field of study, and place of residence. The study was conducted among 625 students in Poland with the use of the MAS-PL scale. The results obtained indicate that women display more positive attitudes towards people with disabilities than men in the cognition and behavioural domains. In the emotional domain, these attitudes were more negative than in the other domains and almost identical for both genders. The year of study, field of study, and place of residence did not differentiate students in terms of their MAS score. Since the sociodemographic variables studied do not determine a positive attitude, educational interventions to increase contact with people with disabilities should be undertaken in future research, and this factor should be investigated as an element of attitude modulation. Full article

(This article belongs to the Special Issue Disabilities – Constant Quest in Medical, Social and Political Records)

15 pages, 366 KiB

Open AccessArticle

Analysis of the Interventions of Medical Emergency Teams in Older Patients in Selected Polish Cities with County Status: A Retrospective Cohort Study

by Mariusz Celiński, Mateusz Cybulski, Joanna Fiłon, Marta Muszalik, Mariusz Goniewicz, Elżbieta Krajewska-Kułak and Anna Ślifirczyk

Int. J. Environ. Res. Public Health 2021, 18(14), 7664; https://doi.org/10.3390/ijerph18147664 - 19 Jul 2021

Cited by 2 | Viewed by 1998

Abstract

Introduction: Geriatric patients account for a large proportion of interventions of medical emergency teams (METs). The aim of this study was to analyse medical emergency interventions in the Biała Podlaska and Chełm (Poland) between 2016 and 2018 in a group of patients ≥ 65 years of age. Materials and Methods: We analysed medical records of 1200 older patients treated by METs in Biała Podlaska and Chełm (Lublin Province, Poland). The research was conducted from June 2019 to March 2020 at the Emergency Medical Service Station in Biała Podlaska and the Medical Rescue Station in Chełm (Independent Public Complex of Health Care Facilities). Results: A total of 92.5% of medical emergency service interventions took place at the patient’s home. The mean time of stay at the scene was 20 min. The highest number of interventions occurred between 8:00 p.m. and 8:59 p.m. There were no statistically significant differences in the type of ambulance used depending on the patient’s sex, while there was a statistically significant relationship between priority code and sex. Cardiovascular diseases were diagnosed in 40% of patients, and the symptoms were not precisely classified in almost the same percentage of patients. Mortality cases accounted for 3.1% of the 1200 interventions analysed. Ambulance dispatch resulted in the patient being transported to the hospital emergency department in 69.1% of cases. Conclusions: METs were called for a variety of diseases due to the fact that geriatric patients are not able to distinguish a life-threatening condition. Medical procedures performed by METs from Biała Podlaska and Chełm were closely related to the initial diagnoses made by these teams. It was irrelevant whether a specialist or non-specialist medical emergency service was used. Paramedics are very well trained to practice their profession and are able to provide treatment to older patients in a state of sudden life threat. Full article

(This article belongs to the Special Issue Disabilities – Constant Quest in Medical, Social and Political Records)

10 pages, 361 KiB

Open AccessArticle

Age Differences in Attitudes towards Older People in Poland

by Elżbieta Krajewska-Kułak, Mateusz Cybulski, Paulina Aniśko and Magda Popławska

Int. J. Environ. Res. Public Health 2021, 18(13), 6869; https://doi.org/10.3390/ijerph18136869 - 26 Jun 2021

Cited by 1 | Viewed by 2568

Abstract

Introduction: The attitudes towards older people is essential. Society’s perception of older adults is often unpleasant. Inappropriate treatment of older people in society causes a decrease in self-esteem, a sense of control over one’s own life, a decrease in the quality of life, an increase in anxiety, depression, anger, and sadness. The aim of this study was to compare the attitudes of young people and seniors towards older people in relation to their satisfaction with life and self-esteem. Materials and Methods: The study was conducted online in groups of young adults under 35 years of age (Group I) and over 65 years of age (group II), with 177 people each. Method: The study used the following questionnaires: Satisfaction with Life Scale (SWLS), Self-Assessment of Own Person (SOP), and Kogan’s Attitude Towards Old People Scale (KATOPS). Results: The satisfaction of life in both groups was average. The mean value of self-esteem was significantly (p < 0.001) lower in the group of seniors. Both groups of respondents had negative attitudes towards seniors in the KATOPS. There was a statistically significant correlation between life satisfaction and self-esteem in seniors. Gender, age, education, or place of residence of respondents had no impact on negative attitudes in both groups. Conclusions: Both groups showed negative attitudes towards seniors. No significant correlation was found between the groups and gender of the respondents, and the influence of the respondent’s age, education, marital status, or place of residence. There was a correlation between the respondents’ attitudes in the subscale of negative attitudes and their satisfaction with life. No correlation between self-esteem and age and marital status were found with no dependence on gender, education, or place of residence. Full article

(This article belongs to the Special Issue Disabilities – Constant Quest in Medical, Social and Political Records)

Review

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13 pages, 838 KiB

Open AccessReview

Environmental Factors in the Rehabilitation Framework: Role of the One Health Approach to Improve the Complex Management of Disability

by Lorenzo Lippi, Alessandro de Sire, Arianna Folli, Alessio Turco, Stefano Moalli, Antonio Ammendolia, Antonio Maconi and Marco Invernizzi

Int. J. Environ. Res. Public Health 2022, 19(22), 15186; https://doi.org/10.3390/ijerph192215186 - 17 Nov 2022

Cited by 6 | Viewed by 4129

Abstract

Environment factors play a crucial implication in human health, with strong evidence suggesting that several biological, chemical, physical and social factors could be possible targets to implement effective strategies for human health promotion. On the other hand, a large gap of knowledge still exists about the implications of environmental factors in terms of functional impairment and disability, while the integration of an environmental-based approach in the therapeutic care of patients affected by disabilities remains still challenging. In this scenario, the One Health approach has been recently introduced in clinical care and aims to optimize health outcomes by recognizing the interconnection between people and the environment. Concurrently, the “Rehabilitation 2030 Initiative” proposed in 2017 by the WHO emphasized the need to integrate environmental-based strategies to promote rehabilitation across different health systems and different nations. However, no previous study underlined the potential implications of the One Health approach in the rehabilitation setting, nor the role of a comprehensive rehabilitation approach focused on environmental factors. Therefore, the aim of this narrative review was to present a comprehensive overview of the data currently available assessing the close relationship between rehabilitation and the environment to provide a different perspective on the comprehensive care of patients affected by disability. Full article

(This article belongs to the Special Issue Disabilities – Constant Quest in Medical, Social and Political Records)

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