95 research outputs found

    PUBH 595.52: Public Health and Disability

    Get PDF

    Psychosocial Impacts of the COVID-19 Pandemic on Women with Spinal Cord Injury

    Get PDF
    This study represents the first known research addressing the impact of the COVID-19 pandemic on women with spinal cord injury (SCI) in the United States. Women in this population face unique barriers that put them at elevated risk for compromised quality of life, risk that was magnified by physical and social restrictions imposed during the pandemic. This qualitative study examined the perceptions of women with SCI and the effect of the pandemic on their lives. The predominantly White and relatively well-educated sample of 105 women with traumatic SCI was diverse in age, injury characteristics, and geographic representation. Recruited across the USA, participants in an online psychological health intervention trial were asked to respond to the item, Please tell us how COVID-19 has affected you and your life , administered May-October, 2020. An overall sentiment rating of impact was coded as well as the impact of COVID-19 on eight individual themes: Physical Health, Mental Health, Social Health, Activities of Daily Living, Exercise, Work, Activities Outside the Home, and Activities at Home. Sentiment responses were rated as positive, negative, a mixture of positive and negative impacts, or neutral impact. Participants described the overall impact of COVID-19 as negative (54%), positive (10%), mixed (21%) or neutral (15%). Sentiment ratings to individual themes were also described. Our findings highlight the importance of providing access to disability-sensitive and affordable support, resources, and interventions for women with SCI, especially during a public health crisis

    Interpersonal Violence Against Women With Spinal Cord Injury: Adding Insult to Injury

    Get PDF
    BACKGROUND: Mounting empirical evidence suggests that, compared to women without disabilities, women with disabilities are more likely to experience interpersonal violence (IPV). However, there is extremely limited research attention on IPV against women with spinal cord injury (SCI), a particularly understudied and underserved population. OBJECTIVES: To conduct the first known examination of lifetime IPV experience in women with SCI, to explore demographic and disability-related correlates of IPV, and to examine the health impacts of IPV. METHODS: The sample included 175 women with traumatic SCI from across the United States who enrolled in a randomized controlled trial of an online psychological health promotion intervention. The data, which included a brief measure of lifetime abuse, were collected as part of the baseline survey administered prior to randomization to the intervention or control conditions. RESULTS: The majority (55%) of the women described experiencing some abuse in their lifetime, with 43% reporting physical abuse, 32% reporting sexual abuse, and 23% reporting disability-related abuse. Sixteen percent of the women indicated that they had experienced all three (physical, sexual, disability) types of abuse. Few demographic and disability characteristics were related to overall lifetime IPV experience; however, disability characteristics were associated with disability-related IPV victimization. In addition, those with a history of IPV had poorer self-reported health and greater depression. CONCLUSION: This study suggests that IPV is common among women with SCI. More research is needed to understand the prevalence, risk factors, and consequences of IPV against women with SCI to help inform policy and practice

    Adapting Participatory Action Research to Include Individuals with Intellectual and Developmental Disabilities during the COVID-19 Global Pandemic

    Get PDF
    Participatory action research (PAR), or the inclusion of those affected by the issues being studied, is a growing area of emphasis in disability research. The principles of PAR align with those of the disability rights movement, such that full inclusion and β€œnothing about us without us” extends as much to research as it does to any other area of life. Moreover, PAR allows for meaningful input from people with intellectual and developmental disabilities (I/DD), which enhances the likelihood that research results are relevant and important to the disability community. As research activity resumes and is adapted to the context of a global pandemic, it is crucial that a balance is struck to optimize the safety of individuals with I/DD without taking steps backwards from the progress towards more meaningful inclusion in research. Lessons learned from past participatory research projects have demonstrated that accommodations to enable equitable participation of individuals with IDD in the research process are crucial. COVID-19 has significantly affected the lives of individuals with I/DD directly; however, COVID-19 has also affected those with I/DD indirectly through the disruption to critical intervention and other clinical research. As research processes are adapted to align with COVID-19 guidelines, the inclusion of individuals with I/DD via PAR needs to be adapted as well. Recommendations for the continuation of PAR in the context of COVID-19 will be discussed as well as ways in which accommodations can be modified to this new context

    Self-Esteem in Second Life: An inWorld Group Intervention for Women with Disabilities

    Get PDF
    We are developing and investigating the feasibility of a self-esteem enhancement intervention in Second Life for women with physical disabilities. We adapted the curriculum of a previously tested workshop intervention to include features unique to this environment. Results of the beta test were very positive. Everyone involved showed considerable enthusiasm for exploring the new world of SL. The group leaders were challenged to resolve technical problems on every occasion, but these diminished and were perceived as manageable as the intervention progressed. Beta testers gave positive ratings to the information presented, organization, and usefulness of the intervention and found it very enjoyable although fatigue and stress limited the participation of some. They appreciated the use of Internet technology as an accommodation to their disability, in place of requiring transportation and additional energy expenditure to attend face-to-face meetings. Research issues related to engagement, measurement, and participant safety, as well as future research directions, are discussed. We conclude that SL has great potential for delivering health promotion interventions to women with physical disabilities

    Abuse Assessment Screen–Disability (AAS-D): Measuring Frequency, Type, and Perpetrator of Abuse toward Women with Physical Disabilities

    Get PDF
    An interview questionnaire was presented to a multiethnic sample of 511 women, age 18–64 years, at public and private specialty clinics to determine the frequency, type, and perpetrator of abuse toward women with physical disabilities. The four-question Abuse Assessment Screen–Disability (AAS-D) instrument detected a 9.8% prevalence (50 of 511) of abuse during the previous 12 months. Using two standard physical and sexual assault questions, 7.8% of the women (40 of 511) reported abuse. The two disability-related questions detected an additional 2.0% of the women (10 of 511) as abused. Women defining themselves as other than black, white, or Hispanic (i.e., Asian, mixed ethnic background) were more likely to report physical or sexual abuse or both, whereas disability-related abuse was reported almost exclusively by white women. The perpetrator of physical or sexual abuse was most likely to be an intimate partner. Disability-related abuse was attributed equally to an intimate partner, a care provider, or a health professional. This study concludes that both traditional abuse-focused questions and disability-specific questions are required to detect abuse toward women with physical disabilities

    Using the Theoretical Domains Framework (TDF) to understand adherence to multiple evidence-based indicators in primary care : a qualitative study

    Get PDF
    BACKGROUND: There are recognised gaps between evidence and practice in general practice, a setting posing particular implementation challenges. We earlier screened clinical guideline recommendations to derive a set of 'high-impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. Here, we explore health professionals' perceived determinants of adherence to these indicators, examining the degree to which determinants were indicator-specific or potentially generalisable across indicators. METHODS: We interviewed 60 general practitioners, practice nurses and practice managers in West Yorkshire, the UK, about adherence to four indicators: avoidance of risky prescribing; treatment targets in type 2 diabetes; blood pressure targets in treated hypertension; and anticoagulation in atrial fibrillation. Interview questions drew upon the Theoretical Domains Framework (TDF). Data were analysed using framework analysis. RESULTS: Professional role and identity and environmental context and resources featured prominently across all indicators whilst the importance of other domains, for example, beliefs about consequences, social influences and knowledge varied across indicators. We identified five meta-themes representing more general organisational and contextual factors common to all indicators. CONCLUSIONS: The TDF helped elicit a wide range of reported determinants of adherence to 'high-impact' indicators in primary care. It was more difficult to pinpoint which determinants, if targeted by an implementation strategy, would maximise change. The meta-themes broadly underline the need to align the design of interventions targeting general practices with higher level supports and broader contextual considerations. However, our findings suggest that it is feasible to develop interventions to promote the uptake of different evidence-based indicators which share common features whilst also including content-specific adaptations

    Intrinsic genetic characteristics determine tumor-modifying capacity of fibroblasts: matrix metalloproteinase-3 5A/5A genotype enhances breast cancer cell invasion

    Get PDF
    Background Stromal fibroblasts can contribute to tumor invasion through the release of matrix metalloproteinases (MMPs). Population studies have suggested that single nucleotide polymorphisms (SNPs) in MMP genes influence levels of expression and may be associated with breast cancer risk and with disease progression. This study directly examined the impact of MMP SNP genotype on the ability of host fibroblasts to promote tumor cell invasion. Methods Primary breast fibroblasts were isolated from patients with (n = 13) or without (n = 19) breast cancer, and their ability to promote breast cancer cell invasion was measured in in vitro invasion assays. Fibroblast invasion-promoting capacity (IPC) was analyzed in relation to donor type (tumor or non-tumor patient), MMP-1, MMP-3, and MMP-9 SNP genotype and MMP activity using independent samples t test and analysis of variance. All statistical tests were two-sided. Results Tumor-derived fibroblasts promoted higher levels of invasion than normal fibroblasts (p = 0.041). When IPC was related to genotype, higher levels of IPC were generated by tumor fibroblasts with the high-expressing MMP-3 5A/5A genotype compared with the 5A/6A and 6A/6A genotypes (p = 0.05 and 0.07, respectively), and this was associated with enhanced MMP-3 release. The functional importance of MMP-3 was demonstrated by enhanced invasion in the presence of recombinant MMP-3, whereas reduction occurred in the presence of a specific MMP-3 inhibitor. An inverse relationship was demonstrated between fibroblast IPC and the high-expressing MMP-1 genotype (p = 0.031), but no relationship was seen with MMP-9 SNP status. In contrast, normal fibroblasts showed no variation in IPC in relation to MMP genotype, with MMP-3 5A/5A fibroblasts exhibiting significantly lower levels of IPC than their tumor-derived counterparts (p = 0.04). Conclusion This study has shown that tumor-derived fibroblasts exhibit higher levels of IPC than normal fibroblasts and that the MMP-3 5A/5A genotype contributes to this through enhanced MMP-3 release. Despite a high-expressing genotype, normal fibroblasts do not exhibit higher IPC or enhanced MMP release. This suggests that more complex changes occur in tumor-derived fibroblasts, enabling full expression of the MMP SNP genotype and these possibly are epigenetic in nature. The results do suggest that, in women with breast cancer, a high-expressing MMP-3 genotype may promote tumor progression more effectively

    LTR Retrotransposons in Fungi

    Get PDF
    Transposable elements with long terminal direct repeats (LTR TEs) are one of the best studied groups of mobile elements. They are ubiquitous elements present in almost all eukaryotic genomes. Their number and state of conservation can be a highlight of genome dynamics. We searched all published fungal genomes for LTR-containing retrotransposons, including both complete, functional elements and remnant copies. We identified a total of over 66,000 elements, all of which belong to the Ty1/Copia or Ty3/Gypsy superfamilies. Most of the detected Gypsy elements represent Chromoviridae, i.e. they carry a chromodomain in the pol ORF. We analyzed our data from a genome-ecology perspective, looking at the abundance of various types of LTR TEs in individual genomes and at the highest-copy element from each genome. The TE content is very variable among the analyzed genomes. Some genomes are very scarce in LTR TEs (<50 elements), others demonstrate huge expansions (>8000 elements). The data shows that transposon expansions in fungi usually involve an increase both in the copy number of individual elements and in the number of element types. The majority of the highest-copy TEs from all genomes are Ty3/Gypsy transposons. Phylogenetic analysis of these elements suggests that TE expansions have appeared independently of each other, in distant genomes and at different taxonomical levels. We also analyzed the evolutionary relationships between protein domains encoded by the transposon pol ORF and we found that the protease is the fastest evolving domain whereas reverse transcriptase and RNase H evolve much slower and in correlation with each other
    • …
    corecore