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Delivering trauma and rehabilitation interventions to women and children in conflict settings: a systematic review

JAIN, Reena P
METEKE, Sarah
GAFFEY, Michelle F
et al
May 2020

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In recent years, more than 120 million people each year have needed urgent humanitarian assistance and protection. Armed conflict has profoundly negative consequences in communities. Destruction of civilian infrastructure impacts access to basic health services and complicates widespread emergency responses. The number of conflicts occurring is increasing, lasting longer and affecting more people today than a decade ago. The number of children living in conflict zones has been steadily increasing since the year 2000, increasing the need for health services and resources. This review systematically synthesised the indexed and grey literature reporting on the delivery of trauma and rehabilitation interventions for conflict-affected populations.

A systematic search of literature published from 1 January 1990 to 31 March 2018 was conducted across several databases. Eligible publications reported on women and children in low and middle-income countries. Included publications provided information on the delivery of interventions for trauma, sustained injuries or rehabilitation in conflict-affected populations. A total of 81 publications met the inclusion criteria, and were included in the review.

 

BMJ Global Health 2020;5:e001980

http://dx.doi.org/10.1136/bmjgh-2019-001980

Patient and caregiver experiences on care transitions for adults with a hip fracture: a scoping review

ASIF, Maliha
CADEL, Lauren
KULUSKI, Kerry
EVERALL, Amanda C
GUILCHER, Sara J T
May 2019

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Purpose: The purpose of this scoping review was to explore the literature on experiences and perspectives of patients with hip fractures and their caregivers during transitions in care.

 

Methods: Seven databases were searched for studies published between 1 January 2000 and 3 July 2018. Grey literature was also searched.

 

Results: Eleven articles met the inclusion criteria. The scoping review found that patients and caregivers encounter several challenges during care transitions including the following: lack of information sharing, role confusion and disorganized discharge planning. Common suggestions reported in the literature for improving care transitions were: increasing written communication, offering a patient representative role, using technology for knowledge dissemination and increasing geriatrician involvement.

 

Conclusions: The results of this scoping review provide a useful foundation from which to build strategies to address challenges such as lack of information sharing, role confusion and disorganized discharge planning experienced by patients and caregivers during care transitions. Further research needs to explore the development of strategies to promote patient-centered care especially during discharge from an acute care facility.

Impact of parenting a child with cerebral palsy on the quality of life of parents: A systematic review of literature

RAMANANDI, Vivek H
PARMAR, Trupti Rudra
PANCHAL, Juhi Kalpesh
PRABHAKAR, M M
et al
2019

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Purpose: The implications of parenting a child with cerebral palsy (CP) are multifaceted, as parents have to cope with their child’s functional limitations and specific needs, and prepare for the possibility of long-term dependence. There has been significant research on the consequences of managing these parenting tasks. This article reviews the literature on the effects of parenting children with CP, and summarises the related factors.

 

Methods: A systematic search of online databases was conducted and, based on the reference lists of selected articles, further studies were identified. Thirty-six articles that met the inclusion criteria were analysed.

 

Conclusion & Implication: Parents of children with CP were found to have lower quality of life, associated with high levels of stress and depression, due to factors such as child behaviour and cognitive problems, low caregiver self-efficacy and low social support. The implications of these findings in relation to the planning and development of interventions addressing the family as a whole are discussed. The aim is to enhance parents’ competence and resources so that they are better able to cope with the demands of parenting their children.

 

 

Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)

Psychosocial disability in the Middle East

BOLTON. Laura
May 2018

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A K4 helpdesk report, commissioned by DFID (UK), provides a rapid review of literature to provide best estimates of psychosocial disability in specific countries in the Middle East.

Topics discussed include:

Prevalence and different forms of mental health conditions and psychosocial disability

Factors influencing prevalence

Differences across demographics

Provision for those with psychosocial disabilities

Inclusion of marginalised Aboriginal and Torres Strait Islander peoples with neurocognitive disability in the National Disability Insurance Scheme (NDIS)

TOWNSEND, Clare
McINTYRE, Michelle
LAKHANI, Ali
WRIGHT, Courtney
WHITE, Paul
BISHARA, Jason
CULLEN, Jennifer
2018

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Given the ambiguity surrounding the extent and experience of neurocognitive disability (NCD) among marginalised Aboriginal and/or Torres Strait Islander peoples in Australia, evidence regarding the level and nature of NCD is crucial to ensure equitable access and inclusion into the National Disability Insurance Scheme (NDIS). This paper reports the results of the implementation of The Guddi Protocol (a culturally informed and appropriate screening protocol for Aboriginal and/or Torres Strait Islander peoples) at two locations in Queensland. Results indicated high levels of NCD, and additional qualitative data revealed a number of factors associated with the complex disablement of study participants, namely: i) intergenerational trauma; ii) a social context of disadvantage, marginalisation and exclusion; and iii) the nonidentification of disability. The results are linked to implications for NDIS inclusion for this population, and recommendations are made. Unless the extent and nature of complex disability and the issues surrounding culturally safe policy, and service design and engagement are addressed with and by Aboriginal and Torres Strait Islander peoples, including those who experience complex disablement, marginalised people will continue to be effectively excluded from the NDIS.

 

Disability and the Global South, 2018, Vol.5, No. 2

Road traffic injuries and rehabiliation. Factsheet.

HANDICAP INTERNATIONAL
March 2017

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The rate of road accidents is increasing globally and the resulting deaths, injuries, physical disabilities and psychological distress are creating a tremendous negative economic impact on victims, their families and society in general, especially in low and middle income countries. Common impairments and activity limitations from road traffic injuries are musculo-skeletal injuries, spinal cord injuries (SCI), traumatic brain injury and psychological distress and depression. Different examples of rehabilitation across the care cycle are provided. A case study of brain injury in Laos is provided. 

Mental health and trauma in asylum seekers landing in Sicily in 2015: a descriptive study of neglected invisible wounds

CREPET, Anna
RITA, Francesco
REID, Anthony
et al
January 2017

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While the medical conditions of newly migrated asylum seekers to Sicily were being addressed, the mental health of those who may have experienced trauma before, during, or after their migration was not addressed. "Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily. This study documents mental health conditions, potentially traumatic events and post-migratory living difficulties experienced by asylum seekers in the MSF programme in 2014–15." 

The 2015 Nepal earthquake(s): Lessons learned from the disability and rehabilitation sector's preparation for, and response to, natural disasters

LANDRY, Michel
SHEPHARD, Phillip
LEUNG, Kit
RETIS, Chiara
SALVADOR, Edwin
RAMAN, Sudha
November 2016

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This article outlines lessons learned from 2015 Nepal earthquake that can be applied to future disasters to reduce overall disability-related outcomes and more fully integrate rehabilitation in preparation and planning. Information is presented on disasters in general, and then specficially on the earthquake(s) in Nepal. Field experience in Nepal before, during, and after the earthquake is described, and actions that can and should be adopted prior to disasters as part of disability preparedness planning are examined. Emerging roles of rehabilitation providers such as physical therapists during the immediate and postdisaster recovery phases are discussed. Finally, approaches are suggested that can be adopted to “build back better” for, and with, people with disabilities in postdisaster settings such as Nepal.

 

Physical Therapy, Volume 96, Issue 11, 1 November 2016, Pages 1714–1723

https://doi.org/10.2522/ptj.20150677

 

Physiotherapy care for adults with paraplegia due to traumatic cause: A review

GUPTA, Nalina
RAJA, Kavitha
2016

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Purpose: This review aimed to identify the practice guidelines/ recommendations for physiotherapy management in acute /post-acute/ chronic/long-term phase of rehabilitation of clients with paraplegia due to traumatic causes.

 

Methods: Of the 120 articles retrieved, 26 met the inclusion criteria. After quality appraisal, 16 articles were included in the study. Data were extracted under the sub-headings: physiotherapy care in acute, chronic and long-term community stage; expected outcomes; effect of physical interventions; morbidities; wheelchair characteristics and standing.

 

Results: There is strong evidence in support of strength and fitness training, and gait training. Parameters of strength training (frequency, duration and intensity) vary. There is lack of evidence on passive movements, stretching, bed mobility, transfers and wheelchair propulsion. Preservation of upper limb functions is an important consideration in caring for clients with paraplegia.

 

Conclusion: Many areas of rehabilitation interventions remain inadequately explored and there is a need for high quality studies on rehabilitation protocols. Client preferences and feasibility are other areas that should be explored.

 

Limitations: The search criteria of articles in the English language or articles translated in English is a reason for this limitation. Articles related to advanced therapeutic interventions such as robot-assisted training, and transcranial electrical and magnetic stimulation were excluded from the study.

Injuries, death, and disability associated with 11 years of conflict in Baghdad, Iraq : a randomized household cluster survey

LAFTA, Riyadh
et al
August 2015

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“The objective of this study was to characterize injuries, deaths, and disabilities arising during 11 years of conflict in Baghdad.” The quantitative study shows the methodology used in the collection of data, the findings discovered through evaluation of the data gathered, and interpretation of how to best use those findings to serve specific populations”

 

 PLOS ONE, 10(8)

Early Care following Traumatic Spinal Cord Injury (TSCI) in a Rehabilitation Centre in Bangladesh - An Analysis

RAZZAK, A T M A
2013

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Purpose: The study aimed to explore the outcome of current practices in the treatment of persons with traumatic spinal cord injuries (TSCI) in Bangladesh, through the stages of rescue and first contact with physician, transportation to the tertiary hospital and intermediate admission.

 

Method: This observational study was conducted between June and August 2011, at the Centre for the Rehabilitation of the Paralysed (CRP), in Dhaka, Bangladesh. From the 113 persons with SCI admitted at CRP during this period, 56 persons with TSCI were selected. With the help of a questionnaire, data were collected from these persons or their attendants by trained staff, and also taken from hospital records. Data were processed and analysed by SPSS software version 16.

 

Results: The male-female ratio among the study participants was 5.25: 1, with a mean age of 33.02 years. 55.3% of them were paraplegic, while 44.7% were tetraplegic. About 70% of the injuries were complete according to ASIA impairment scale (AIS) during admission at CRP.

 

The most common causes of injury were falls (50%), followed by road traffic accidents (RTA) and carrying loads on the head. 74.8% of the injured persons had been rescued from the accident site by local people but only 16.1% had been transported by ambulance. The spine board had never been used. More than half of the injured received initial treatment only at a sub-district or district hospital where none of the requisite facilities were available.

 

While being transported from one hospital to the other, 10.7% experienced neurological deterioration of some sort. Significant statistical correlation was found between mode of transfer (P <0.03) and intermediate admission (P<0.001)with neurological deterioration.

 

Conclusions: There is an urgent need to implement pre-hospital trauma care in Bangladesh. Since resources and places for the rehabilitation of persons with TSCI are scarce, regional and national spinal injury centres should be established without delay.

 

Limitations: The study focussed only on a small sample of persons with TSCI undergoing treatment at a single centre.

Disability associated with exposure to traumatic events: results from a cross-sectional community survey in South Sudan

AYAZI, Touraj
LIEN, Lars
EIDE, Arne Henning
JENKINS, Rachel
ALBINO, Rita Amok
HAUFF , Edvard
May 2013

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"There is a general lack of knowledge regarding disability and especially factors that are associated with disability in low-income countries. We aimed to study the overall and gender-specific prevalence of disability, and the association between exposure to traumatic events and disability in a post-conflict setting. We conducted a cross-sectional community based study of four Greater Bahr el Ghazal States, South Sudan (n = 1200). The Harvard Trauma Questionnaire (HTQ) was applied to investigate exposure to trauma events. Disability was measured using the Washington Group Short Measurement Set on Disability, which is an activity based scale derived from the WHO’s International Classification of Disability, Functioning and Health. The estimated prevalence of disability (with severe difficulty) was 3.6% and 13.4% for disability with moderate difficulties. No gender differences were found in disability prevalence. Almost all participants reported exposure to at least one war-related traumatic event. The result of a hierarchical regression analysis showed that, for both men and women, exposure to traumatic events, older age and living in a polygamous marriage increased the likelihood of having a disability. The finding of association between traumatic experience and disability underlines the precariousness of the human rights situation for individuals with disability in low-income countries. It also has possible implications for the construction of disability services and for the provision of health services to individuals exposed to traumatic events"

 

BMC Public Health, 13:469

Disability and health related rehabilitation in international disaster relief

REINHARDT, Jan
LI, Jianan
GOSNEY, James
et al
August 2011

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Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention. The objective was to examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability. A qualitative literature review and secondary data analysis were carried out. 

 

Global Health Action

http://dx.doi.org/10.3402/gha.v4i0.7191 

Including disabled children in psychosocial programmes in areas affected by armed conflict

VON DER ASSEN, Nina
EUWEMA, Mathijs
CORNIELJE, Huib
2010

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"Children with disabilities are more vulnerable to violence, as well as more likely to experience psychosocial problems in situations of armed conflict than children with no disabilities. All children who live in conflict affected areas have the same rights to psychosocial support, as enshrined in the Convention on the Rights of the Child and in the case of disabled children, additionally the Convention on the Rights of Persons with Disabilities. However, children with disabilities are often overlooked in psychosocial programmes. In this article, the authors examine the reasons behind this observed exclusion and suggest ways to increase the participation of children with disabilities"
Intervention, Vol 8, No 1

Psychosocial counselling and social work with clients and their families in the Somali context : a facilitator’s guide

OFFICE OF THE HIGH COMMISSIONER FOR HUMAN RIGHTS (UNHCR)
November 2009

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This handbook is "designed to be used as training support handbook for helping professionals in the Somali context. The focus is on psychosocial needs for the rehabilitation of persons with trauma, mental health related forms of distress and those who have experienced gender based violence and gender related abuses. The guidelines, developed within a UNHCR funded programme in Somalia, are intended to assist staffs, who are concerned with providing protection and assistance to refugees and IDP"

A handbook for network support agents and other community workers supporting HIV prevention, care, support and treatment

March 2009

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This manual is intended to help network support agents and other community workers be more effective in disseminating standardised information about HIV and AIDS. It "...emphasises the importance of the acquisition of knowledge, skills and the right attitude needed to identify the psychosocial needs of people of people infected and affected by HIV/AIDS and address these needs by giving information, counselling and appropriate referrals. Knowledge of counselling and psychosocial care, is combined as much as possible with prevention activities such as adopting HIV basic care positive prevention and adherence to treatment"

Future sight loss UK (2) : an epidemiological and economic model for sight loss in the decade 2010 to 2020

MINASSIAN, Darwin
REIDY, Angela
2009

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This report provides estimates of the numbers of persons that were likely to have age-related macular disease, cataract, diabetic retinopathy and glaucoma at two points in time 2010 and 2020. Estimates of the baseline and cumulative costs to society of the prevailing health and social care provision and support in that time frame are provided using a cost of illness approach from the societal perspective. Useful figures and tables are provided to present the results

Introduction to child protection in emergencies : an interagency modular training package|Child protection in emergencies training and resource CD : psychosocial module

CHILD PROTECTION WORKING GROUP (CPWG)
2009

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This document is the psychosocial module of the Introduction to Child Protection in Emergencies and Interagency Modular Training Package. This module is divided into the following sections:
Part 1 presents a background to psychosocial issues including the overall impact of emergencies on psychosocial well-being, psychosocial effects of emergencies on children, and legal framework and advocacy activities.
Part 2 intervention planning presents psychosocial programming principles and priority activities, and co-ordination and sector support.
Part 3 psychosocial programming presents addressing basic services and security developing community and family supports, focused supports, and referrals to specialised services
This comprehensive document will be of particular interest to NGOs, DPOs, international and national bodies and anyone else interested in child protection and psychosocial work with children and their families
Note: The core resources for this module are the Inter-Agency Standing Committee (IASC) Guidance on Mental Health and Psychosocial Support in Emergency Settings and the key interventions of the Sphere Handbook (2004) Standard for Mental and Social Aspects of Health

Disability among clients attending Taif Rehabilitation Centre, Saudi Arabia

AL-SHEHRI, Abdul-Salam A
ABDEL-FATTAH, Moataz M
2008

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This is a cross-sectional study of hospital records of people who were admitted to Rehab Armed Forces Rehabilitation Center, Taif, Saudi Arabia from 1999- 2005. Eight hundred and fifty records were reviewed. Data were collected on age, sex, nationality, data of admission and discharge and type of disability. Univariate and multivariate logistic regression analysis were performed to determine predictors of long stay at the hospital. Trauma as an etiology of disability was more common than non-traumatic incidents among male and middle aged clients (16-45 years). Traumatic accidents mostly result in quadriplegia (72.8%). Male, single, less than 45 years old, people with traumatic accidents and people with paralytic types of disability were significantly more likely to stay longer at the hospital. Home care programme should be expanded to minimize duration of stay at the rehabilitation centres. Health education of the public would help in encouraging disabled people to adapt to daily life activities.

The medical peace work textbook

ROWSON, M
MELF, K
Eds
2008

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This textbook provides an introduction to medical peace work and includes chapters relating to human rights; the causes and health effects of war and violent conflict; how health workers can promote peace-building and reconstruction; and the health and well-being needs of refugees and immigrants. The book is aimed at doctors, nurses, public health workers and other health professionals, and students. This e-textbook is part of an online course on Medical Peace Work. The book can be consulted, downloaded, or printed for free without registering for the course

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