The Role of Healthcare Professionals in Providing Sexuality Education to Young People with Disabilities: A Scoping Review on Barriers and Challenges

Abstract

While sexuality education is vital in supporting their sexual development, young people with disabilities experience specific barriers to accessing information related to sexuality. There are also indications that young people with disabilities have more unplanned pregnancies and STIs (sexually transmitted infections) and are more often victim of sexual violence. Further, sexuality education is often insufficiently adapted to their disability and/or level of development. In this review, we first investigate whether young people with disabilities are receiving sexuality education from healthcare professionals. Subsequently, we explore the barriers for young people with disabilities to receive sexuality education in healthcare settings and the challenges that healthcare professionals experience in discussing sexuality with young people with disabilities. In order to answer these questions, we conducted a scoping literature review following the PRISMA guidelines. A substantial amount of young people with disabilities never received any form of sexuality education by healthcare professionals, and when they did get information, it often did not meet their expectations. Four main barriers were described for young people with disabilities related to receiving sexuality education from healthcare professionals. From the healthcare professional's perspective, seven challenges were identified. In order to meet those challenges, it is necessary to gain a further picture through a larger sample. More insight in which interventions could support healthcare professionals, can be gained by performing further research within this matter.

Appendix

See Table

Table 1 Overview of selected studies and study characteristics

1 and Fig. 1.

Search Syntax

PubMed

((infant[TIAB]) OR (infants[TIAB]) OR (toddler[TIAB]) OR (toddlers[TIAB]) OR (minors[TIAB]) OR (boy[TIAB]) OR (boys[TIAB]) OR (boyfriend[TIAB]) OR (boyhood[TIAB]) OR (girl[TIAB]) OR (girls[TIAB]) OR (kid[TIAB]) OR (kids[TIAB]) OR (child[TIAB]) OR (children[TIAB]) OR (schoolchildren[TIAB]) OR (“school child”[TIAB]) OR (“school children”[TIAB]) OR (adolescent[TIAB]) OR (adolescence[TIAB]) OR (adolescents[TIAB]) OR (juvenile[TIAB]) OR (youth[TIAB]) OR (youths[TIAB]) OR (”young people”[TIAB]) OR (”young persons”[TIAB]) OR (teenager[TIAB]) OR (teenagers[TIAB]) OR (under aged[TIAB]) OR (pubescent[TIAB]) OR (pubescence[TIAB]) OR (school[TIAB]) OR (schools[TIAB]) OR (“18 years”[TIAB])).

AND

((“Sex education”[TIAB]) OR (“sexuality education”[TIAB]) OR (“sexual education”[TIAB]) OR (“hiv education”[TIAB]) OR (“hiv prevention”[TIAB]) OR (“sti education”[TIAB]) OR (“sti prevention”[TIAB]) OR (“relationship education”[TIAB]) OR (“life skills education”[TIAB]) OR (contraception promotion[TIAB]) OR (”contraception education”[TIAB]) OR (”contraceptive promotion”[TIAB]) OR (”contraceptive education”[TIAB]) OR (“contraceptive method education”[TIAB]) OR (”contraceptive method promotion”[TIAB]) OR (“condom promotion”[TIAB]) OR (“condom use”[TIAB]) OR (“sexual health education”[TIAB]) OR (”sexual health promotion”[TIAB]) OR (“reproductive health education”[TIAB]) OR (”reproductive health promotion”[TIAB]) OR (“sex and relationship education”[TIAB]) OR (“healthy lifestyle education”[TIAB]) OR OR (“sexual rights”[TIAB])).

AND

(("health care"[tiab]) OR (hospital[tiab]) OR (doctor[tiab]) OR ("general practicioner"[tiab]) OR (medical[tiab]) OR (medicine[tiab]) OR (physician[tiab]) OR (nurse[tiab]) OR (dermatologist[tiab]) OR (dietitian[tiab]) OR (endocrinologist[tiab]) OR (gynaecologist[tiab]) OR (gastroenterologist[tiab]) OR (cardiologist[tiab]) OR (surgeon[tiab]) OR (hepatologist[tiab]) OR (hematologist[tiab]) OR (internist[tiab]) OR (infectiologist[tiab]) OR (infectiologist[tiab]) OR (pediatrician[tiab]) OR (ent[tiab]) OR (geneticist[tiab]) OR (geneticist[tiab]) OR (pulmonologist[tiab]) OR (revalidation[tiab]) OR (rehabilitation[tiab]) OR (physiotherapist[tiab]) OR ("speech therapist"[tiab]) OR ("emergency doctor"[tiab]) OR (neurologist[tiab]) OR (neonatologist[tiab]) OR (ophtalmologist[tiab]) OR (psychiatrist[tiab]) OR ("plastic surgeon"[tiab]) OR (rheumatologist[tiab]) OR (nephrologist[tiab]) OR ("rehabilitation doctor"[tiab]) OR ("school doctor"[tiab]) OR (urologist[tiab]) OR (audiologist[tiab]) OR ("health care worker"[tiab]) OR ("health care workers"[tiab]) OR ("healthcare worker"[tiab]) OR ("healthcare workers"[tiab]) OR ("health care professional"[tiab]) OR ("health care professionals"[tiab]) OR ("healthcare professional"[tiab]) OR ("healthcare professionals"[tiab]) OR (“healthcare provider”[tiab]) OR (“health care provider”[tiab]) OR (clinician[tiab]) OR (clinicians[tiab]) OR (“primary health care”[tiab]) OR (“health personnel”[tiab]) OR (“health care worker”[tiab])).

AND

((Disabilities[TIAB]) OR (Disability[TIAB]) OR (“chronic disability”[TIAB]) OR (disablement[TIAB]) OR (handicap[TIAB]) OR (handicapped[TIAB]) OR (“disabled person”[TIAB]) OR (disabled[TIAB]) OR (“disabled patient”[TIAB]) OR (“disabled persons”[TIAB]) OR (“handicapped patient”[TIAB]) OR (“handicapped subject”[TIAB]) OR (impairment[TIAB]) OR (“impaired person”[TIAB]) OR (“acquired disability”[TIAB]) OR (“congenital disability”[TIAB]) OR (“Physical disability”[TIAB]) OR (“Physical impairment physiological disability”[TIAB]) OR (“physiological impairment functional disability”[TIAB]) OR (“functional impairment”[TIAB]) OR (“mobility disability”[TIAB]) OR (“mobility impairment multiple sclerosis”[TIAB]) OR (“chariot disease”[TIAB]) OR (“disseminated sclerosis”[TIAB]) OR (“insular sclerosis”[TIAB]) OR (MS[TIAB]) OR (“multiple sclerosis”[TIAB]) OR (“chronic progressive”[TIAB]) OR (“multiple sclerosis”[TIAB]) OR (“relapsing–remitting”[TIAB]) OR (“primary progressive multiple sclerosis”[TIAB]) OR (“relapsing remitting multiple sclerosis”[TIAB]) OR (“relapsing–remitting multiple sclerosis”[TIAB]) OR (“sclerosis multiplex”[TIAB]) OR (sclerosis[TIAB]) OR (insular[TIAB]) OR (“secondary progressive multiple sclerosis muscular dystrophy”[TIAB]) OR (“congenital atonic sclerotic muscular dystrophy”[TIAB]) OR (“congenital muscle dystrophy”[TIAB]) OR (“congenital muscular dystrophy”[TIAB]) OR (dystrophy[TIAB]) OR (“muscle dystrophia”[TIAB]) OR (“muscle dystrophy”[TIAB]) OR (“muscular dystrophia”[TIAB]) OR (“muscular dystrophies”[TIAB]) OR (“muscular dystrophy”[TIAB]) OR (myodystrophia[TIAB]) OR (“myodystrophy chronic arthritis”[TIAB]) OR (“chronic inflammatory joint disease”[TIAB]) OR (“polyarthritis chronica progressiva”[TIAB]) OR (polyarthritis[TIAB]) OR (“secondary chronic”[TIAB]) OR (“secondary chronic polyarthritis cerebal palsy”[TIAB]) OR (“muscle palsy”[TIAB]) OR (“muscle paralysis”[TIAB]) OR (“muscular palsy”[TIAB]) OR (“muscular paralysis”[TIAB]) OR (myoparalysis[TIAB]) OR (myoplegia[TIAB]) OR (“neuromuscular paralysis”[TIAB]) OR (neuroparalysis[TIAB]) OR (palsy[TIAB]) OR (paralysis[TIAB]) OR (“paralytic disease”[TIAB]) OR (“tardy apoplexy spina bifida”[TIAB]) OR (myelodysplasia[TIAB]) OR (“spinal dysraphism”[TIAB]) OR (neuroschisis[TIAB]) OR (“spina bifida”[TIAB]) OR (“spina bifida anterior”[TIAB]) OR (“spina bifida cystica”[TIAB]) OR (“spina bifida posterior”[TIAB]) OR (“spinal dysraphia”[TIAB]) OR (“spinal dysraphic state”[TIAB]) OR (“spinal dysraphic states”[TIAB]) OR (“spine dysgraphia spinal cord injury”[TIAB]) OR (injury[TIAB]) OR (“spinal cord”[TIAB]) OR (“spinal cord injuries”[TIAB]) OR (“spinal cord trauma”[TIAB]) OR (fibromyalgia[TIAB]) OR (“fibrositic nodule”[TIAB]) OR (fibrositis[TIAB]) OR (“fibrositis syndrome”[TIAB]) OR (myalgia[TIAB]) OR (“fibro chronic fatigue syndrome”[TIAB]) OR (encephalomyelitis[TIAB]) OR (myalgic[TIAB]) OR (“epidemic neuromyasthenia”[TIAB]) OR (“fatigue syndrome”[TIAB]) OR (chronic[TIAB]) OR (“Iceland disease”[TIAB]) OR (“myalgic encephalomyelitis”[TIAB]) OR (“chronic fatigue”[TIAB]) OR (“systemic exertion intolerance disease”[TIAB]) OR (“cystic fibrosis”[TIAB]) OR (“cystic fibrosis”[TIAB]) OR (“cystic pancreas fibrosis”[TIAB]) OR (“cystic pancreatic fibrosis”[TIAB]) OR (“fibrocystic disease”[TIAB]) OR (pancreas[TIAB]) OR (“mckusick 21,970″[TIAB]) OR (mucoviscidosis[TIAB]) OR (mucoviscoidosis[TIAB]) OR (“pancreas cystic disease”[TIAB]) OR (“pancreas cystic fibrosis”[TIAB]) OR (“pancreas fibrocystic disease”[TIAB]) OR (“pancreas fibrosis”[TIAB]) OR (“pancreatic cystic disease”[TIAB]) OR (“pancreatic cystic fibrosis”[TIAB]) OR (“pancreatic fibrosis Epilepsy”[TIAB]) OR (“acute epilepsy”[TIAB]) OR (“chronic epilepsy”[TIAB]) OR (“comitial disease”[TIAB]) OR (epilepsia[TIAB]) OR (epileptic[TIAB]) OR (“epileptic disorder”[TIAB]) OR (“epileptic syndrome”[TIAB]) OR (“epileptic syndromes”[TIAB]) OR (“falling sickness”[TIAB]) OR (sickness[TIAB]) OR (“tardy epilepsy”[TIAB]) OR (“Tourette syndrome”[TIAB]) OR (“de la tourette disease”[TIAB]) OR (“Gilles de la Tourette disease”[TIAB]) OR (“Gilles de la Tourette's syndrome”[TIAB]) OR (“Gilles de la Tourettes syndrome”[TIAB]) OR (“Gilles de Tourette syndrome”[TIAB]) OR (“Tourette disease”[TIAB]) OR (”Tourette's syndrome”[TIAB]) OR (“Tourettes syndrome”[TIAB]) OR (Dwarfism[TIAB]) OR (dwarf[TIAB]) OR (midget[TIAB]) OR (nanism[TIAB]) OR (“sensory disability”[TIAB]) OR (“sensory impairment”[TIAB]) OR (Blindness[TIAB]) OR (amaurosis[TIAB]) OR (blind[TIAB]) OR (blinding[TIAB]) OR (“Hearing impairment”[TIAB]) OR (“auditory defect”[TIAB]) OR (“bilateral deafness”[TIAB]) OR (deafness[TIAB]) OR (deaf[TIAB]) OR (“hearing damage”[TIAB]) OR (“hearing defect”[TIAB]) OR (“hearing difficulty”[TIAB]) OR (“hearing loss”[TIAB]) OR (hypacusia[TIAB]) OR (hypacusis[TIAB]) OR (hypoacousia[TIAB]) OR (hypoacusis[TIAB]) OR (“impaired hearing”[TIAB]) OR (deafness[TIAB]) OR (“Sensory processing disorder mental disability”[TIAB]) OR (“mental impairment”[TIAB]) OR (“mental health disability”[TIAB]) OR (“mental health impairment”[TIAB]) OR (Schizophrenia[TIAB]) OR (“childhood schizophrenia”[TIAB]) OR (“chronic schizophrenia”[TIAB]) OR (“dementia praecox”[TIAB]) OR (“dementia precox”[TIAB]) OR (schizophrenia[TIAB]) OR (childhood[TIAB]) OR (schizophrenic[TIAB]) OR (“schizophrenic syndrome”[TIAB]) OR (Depression[TIAB]) OR (”central depression”[TIAB]) OR (“clinical depression”[TIAB]) OR (“depressive disease”[TIAB]) OR (“depressive disorder”[TIAB]) OR (“depressive episode”[TIAB]) OR (“depressive illness”[TIAB]) OR (“depressive personality disorder”[TIAB]) OR (“depressive state”[TIAB]) OR (“depressive symptom”[TIAB]) OR (“depressive syndrome”[TIAB]) OR (“mental depression”[TIAB]) OR (“parental depression”[TIAB]) OR (“Post-traumatic stress disorder”[TIAB]) OR (“post-traumatic spectrum disorder”[TIAB]) OR (“combat disorders”[TIAB]) OR (“combat fatigue”[TIAB]) OR (“combat stress”[TIAB]) OR (“post-traumatic stress”[TIAB]) OR (“post-traumatic stress disorder”[TIAB]) OR (“posttraumatic neurosis”[TIAB]) OR (“posttraumatic psychic syndrome”[TIAB]) OR (“posttraumatic psychosis”[TIAB]) OR (“posttraumatic stress”[TIAB]) OR (“posttraumatic syndrome”[TIAB]) OR (psychosis[TIAB]) OR (posttraumatic[TIAB]) OR (PTSD[TIAB]) OR (“stress disorders”[TIAB]) OR (“post-traumatic”[TIAB]) OR (“stress disorders”[TIAB]) OR (posttraumatic[TIAB]) OR (“trauma and stressor related disorders”[TIAB]) OR (“traumatic stress”[TIAB]) OR (“traumatic stress disorder”[TIAB]) OR (“war neurosis”[TIAB]) OR (”Mood disorder”[TIAB]) OR (“affective disorder”[TIAB]) OR (“affective disorders”[TIAB]) OR (“affective disturbance”[TIAB]) OR (“affective illness”[TIAB]) OR (“mood disorders”[TIAB]) OR (“mood disturbance”[TIAB]) OR (“mood disturbances”[TIAB]) OR (“Anxiety disorder”[TIAB]) OR (“Dissociative disorders”[TIAB]) OR ( “dissociative disorder”[TIAB]) OR (depersonalization[TIAB]) OR (“dissociative amnesia”[TIAB]) OR (“dissociative fugue”[TIAB]) OR (“multiple personality”[TIAB]) OR (”Affective disorder”[TIAB]) OR (“affective disorders”[TIAB]) OR (“affective disturbance”[TIAB]) OR (“affective illness”[TIAB]) OR (“mood disorders”[TIAB]) OR (“mood disturbance”[TIAB]) OR (“mood disturbances eating disorders”[TIAB]) OR (EDNOS[TIAB]) OR (“feeding and eating disorders”[TIAB]) OR (anorexia[TIAB]) OR (“anorexia nervosa”[TIAB]) OR (“boulemia personality change”[TIAB]) OR (“personality disorders”[TIAB]) OR (“personality disturbance”[TIAB]) OR (“organic brain disorders”[TIAB]) OR (“body dysmorphic disorders”[TIAB]) OR (“body dysmorphic”[TIAB]) OR (dysmorphophobia[TIAB]) OR (phobia[TIAB]) OR (“dysmorpho intellectual disability”[TIAB]) OR (“intellectual impairment”[TIAB]) OR (“abnormal development”[TIAB]) OR (“child development disorder”[TIAB]) OR (“development disorder”[TIAB]) OR (“developmental disabilities”[TIAB]) OR (“Fragile X syndrome”[TIAB]) OR (“Down syndrome”[TIAB]) OR (“down disease”[TIAB]) OR (“Down's syndrome”[TIAB]) OR (“Downs syndrome”[TIAB]) OR (mongolian[TIAB]) OR (“langdon down disease”[TIAB]) OR (“langdon down syndrome”[TIAB]) OR (“mongolian idiocy”[TIAB]) OR (mongolism[TIAB]) OR (“mongoloid idiocy”[TIAB]) OR (mongoloidism[TIAB]) OR (“translocation 15 21 22″[TIAB]) OR (“trisomy 21 syndrome”[TIAB]) OR (“developmental delay”[TIAB]) OR (“development delay”[TIAB]) OR (“global developmental delay”[TIAB]) OR (“hhho syndrome”[TIAB]) OR (“labhart willi prader syndrome”[TIAB]) OR (“prader labhart willi syndrome”[TIAB]) OR (“Prader Willi”[TIAB]) OR (“prader willi labhart syndrome”[TIAB]) OR (“Prader-Willi syndrome”[TIAB]) OR (“willi prader labhart syndrome”[TIAB]) OR (“willi prader lalhart syndrome”[TIAB]) OR (“Fetal alcohol sprectrum disorder”[TIAB]) OR (“intellectual disability”[TIAB]) OR (“intellectual dysfunction”[TIAB]) OR (“mental deficiency”[TIAB]) OR (“cognitive retard”[TIAB]) OR (“cognitive retardation”[TIAB]) OR (“deficiency, mental”[TIAB]) OR (“disability, mental”[TIAB]) OR (“incapacity, mental”[TIAB]) OR (“intellectual retardation”[TIAB]) OR (“mental deficit”[TIAB]) OR (“mental disability”[TIAB]) OR (“mental disability assessment”[TIAB]) OR (“mental disability evaluation”[TIAB]) OR (“mental handicap”[TIAB]) OR (“mental incapacity”[TIAB]) OR (“mental retard”[TIAB]) OR (“mental retardation”[TIAB]) OR (“mental retardation, psychosocial”[TIAB]) OR (”mentally handicapped”[TIAB]) OR (“mentally retarded”[TIAB]) OR (”retardation, mental”[TIAB]) OR (“severe mental retardation”[TIAB]) OR (”Alpers disease”[TIAB]) OR (“beta mannosidosis”[TIAB]) OR (“Coffin Lowry syndrome”[TIAB]) OR (”COFS syndrome”[TIAB]) OR (“Danon disease”[TIAB]) OR (“Dubowitz syndrome”[TIAB]) OR (“Ellis van Creveld syndrome”[TIAB]) OR (“Hunter syndrome”[TIAB]) OR (“Hurler syndrome”[TIAB]) OR (“Kabuki makeup syndrome”[TIAB]) OR (“Leigh disease”[TIAB]) OR (leprechaunism[TIAB]) OR (mannosidosis[TIAB]) OR (“maple syrup urine disease”[TIAB]) OR (“Marinesco Sjogren syndrome”[TIAB]) OR (“Maroteaux Lamy syndrome”[TIAB]) OR (“mental retardation malformation syndrome”[TIAB]) OR (“prolidase deficiency”[TIAB]) OR (“Sandhoff disease”[TIAB]) OR (“Sanfilippo syndrome”[TIAB]) OR (“WAGR syndrome”[TIAB]) OR (“Weismann Netter syndrome26 Records”[TIAB]) OR (“X linked mental retardation”[TIAB]) OR (“learning disability”[TIAB]) OR (“learning impairment disorder”[TIAB]) OR (“impaired learning”[TIAB]) OR (“learning deficit”[TIAB]) OR (“learning difficulty”[TIAB]) OR (“learning disabilities”[TIAB]) OR (“learning disability”[TIAB]) OR (“learning disorders”[TIAB]) OR (“learning disturbance”[TIAB]) OR (“learning impairment”[TIAB]) OR (“learning problem”[TIAB]) OR (“specific learning disorder”[TIAB]) OR (“Functional cognitive disability”[TIAB]) OR (“Functional cognitive disability”[TIAB]) OR (Autism[TIAB]) OR (“autism spectrum disorder”[TIAB]) OR (“autism, early infantile”[TIAB]) OR (“autism, infantile”[TIAB]) OR (“autistic child”[TIAB]) OR (“autistic children”[TIAB]) OR (“autistic disorder”[TIAB]) OR (“autistic spectrum disorder”[TIAB]) OR (“child development disorders, pervasive”[TIAB]) OR (“childhood autism”[TIAB]) OR (“classical autism”[TIAB]) OR (“early infantile autism”[TIAB]) OR (“infantile autism”[TIAB]) OR (“infantile autism, early”[TIAB]) OR (“Kanner syndrome”[TIAB]) OR (“pervasive developmental disorder”[TIAB]) OR (“pervasive developmental disorder”[TIAB]) OR (“pervasive developmental disorders”[TIAB]) OR (“typical autism Dementia”[TIAB]) OR (amentia[TIAB]) OR (demention[TIAB]) OR (“brain injuries”[TIAB]) OR (“brain lesion”[TIAB]) OR (“brain system trauma”[TIAB]) OR (“brain trauma”[TIAB]) OR (“cerebral trauma”[TIAB]) OR (“cerebrovascular trauma”[TIAB]) OR (“encephalopathy, traumatic”[TIAB]) OR (“mild traumatic brain injury”[TIAB]) OR (“organic cerebral trauma”[TIAB]) OR (“posttraumatic encephalopathy”[TIAB]) OR (“traumatic brain injuries”[TIAB]) OR (“traumatic brain lesion”[TIAB]) OR (“traumatic cerebral lesion”[TIAB]) OR (“traumatic encephalopathy”[TIAB]) OR (“Attention deficit disorder”[TIAB]) OR (ADHD[TIAB]) OR (“attention deficit”[TIAB]) OR (“attention deficit and disruptive behavior disorders”[TIAB]) OR (“attention deficit and disruptive behaviour disorders”[TIAB]) OR (“attention deficit disorder with hyperactivity”[TIAB]) OR (“attention deficit hyperactivity disorder disability”[TIAB]) OR (“dyslectic child”[TIAB]) OR (“reading difficulty”[TIAB]) OR (“reading disability”[TIAB]) OR (“reading disorder”[TIAB]) OR (“reading disturbance”[TIAB]) OR (“reading error”[TIAB]) OR (“reading problem”[TIAB]) OR (strephosymbolia[TIAB]) OR (Dyscalculia[TIAB])).

Embase

(infant:ti,ab,kw) OR (infants:ti,ab,kw) OR (toddler:ti,ab,kw) OR (toddlers:ti,ab,kw) OR (minors:ti,ab,kw) OR (boy:ti,ab,kw) OR (boys:ti,ab,kw) OR (boyfriend:ti,ab,kw) OR (boyhood:ti,ab,kw) OR (girl:ti,ab,kw) OR (girls:ti,ab,kw) OR (kid:ti,ab,kw) OR (kids:ti,ab,kw) OR (child:ti,ab,kw) OR (children:ti,ab,kw) OR (schoolchildren:ti,ab,kw) OR (“school child”:ti,ab,kw) OR (“school children”:ti,ab,kw) OR (adolescent:ti,ab,kw) OR (adolescence:ti,ab,kw) OR (adolescents:ti,ab,kw) OR (juvenile:ti,ab,kw) OR (youth:ti,ab,kw) OR (youths:ti,ab,kw) OR (”young people”:ti,ab,kw) OR (”young persons”:ti,ab,kw) OR (teenager:ti,ab,kw) OR (teenagers:ti,ab,kw) OR (under aged:ti,ab,kw) OR (pubescent:ti,ab,kw) OR (pubescence:ti,ab,kw) OR (school:ti,ab,kw) OR (schools:ti,ab,kw) OR (18 years:ti,ab,kw).

AND

(“Sex education”:ti,ab,kw) OR (“sexuality education”:ti,ab,kw) OR (“sexual education”:ti,ab,kw) OR (“hiv education”:ti,ab,kw) OR (“hiv prevention”:ti,ab,kw) OR (“sti education”:ti,ab,kw) OR (“sti prevention”:ti,ab,kw) OR (“relationship education”:ti,ab,kw) OR (“life skills education”:ti,ab,kw) OR (contraception promotion:ti,ab,kw) OR (”contraception education”:ti,ab,kw) OR (”contraceptive promotion”:ti,ab,kw) OR (”contraceptive education”:ti,ab,kw) OR (“contraceptive method education”:ti,ab,kw) OR (”contraceptive method promotion”:ti,ab,kw) OR (“condom promotion”:ti,ab,kw) OR (“condom use”:ti,ab,kw) OR (“sexual health education”:ti,ab,kw) OR (”sexual health promotion”:ti,ab,kw) OR (“reproductive health education”:ti,ab,kw) OR (”reproductive health promotion”:ti,ab,kw) OR (“sex and relationship education”:ti,ab,kw) OR (“healthy lifestyle education”:ti,ab,kw) OR (“sexual rights”:ti,ab,kw).

AND

(Disabilities:ti,ab,kw) OR (Disability:ti,ab,kw) OR (“chronic disability”:ti,ab,kw) OR (disablement:ti,ab,kw) OR (handicap:ti,ab,kw) OR (handicapped:ti,ab,kw) OR (“disabled person”:ti,ab,kw) OR (disabled:ti,ab,kw) OR (“disabled patient”:ti,ab,kw) OR (“disabled persons”:ti,ab,kw) OR (“handicapped patient”:ti,ab,kw) OR (“handicapped subject”:ti,ab,kw) OR (impairment:ti,ab,kw) OR (“impaired person”:ti,ab,kw) OR (“acquired disability”:ti,ab,kw) OR (“congenital disability”:ti,ab,kw) OR (“Physical disability”:ti,ab,kw) OR (“Physical impairment physiological disability”:ti,ab,kw) OR (“physiological impairment functional disability”:ti,ab,kw) OR (“functional impairment”:ti,ab,kw) OR (“mobility disability”:ti,ab,kw) OR (“mobility impairment multiple sclerosis”:ti,ab,kw) OR (“chariot disease”:ti,ab,kw) OR (“disseminated sclerosis”:ti,ab,kw) OR (“insular sclerosis”:ti,ab,kw) OR (MS:ti,ab,kw) OR (“multiple sclerosis”:ti,ab,kw) OR (“chronic progressive”:ti,ab,kw) OR (“multiple sclerosis”:ti,ab,kw) OR (“relapsing–remitting”:ti,ab,kw) OR (“primary progressive multiple sclerosis”:ti,ab,kw) OR (“relapsing remitting multiple sclerosis”:ti,ab,kw) OR (“relapsing–remitting multiple sclerosis”:ti,ab,kw) OR (“sclerosis multiplex”:ti,ab,kw) OR (sclerosis:ti,ab,kw) OR (insular:ti,ab,kw) OR (“secondary progressive multiple sclerosis muscular dystrophy”:ti,ab,kw) OR (“congenital atonic sclerotic muscular dystrophy”:ti,ab,kw) OR (“congenital muscle dystrophy”:ti,ab,kw) OR (“congenital muscular dystrophy”:ti,ab,kw) OR (dystrophy:ti,ab,kw) OR (“muscle dystrophia”:ti,ab,kw) OR (“muscle dystrophy”:ti,ab,kw) OR (“muscular dystrophia”:ti,ab,kw) OR (“muscular dystrophies”:ti,ab,kw) OR (“muscular dystrophy”:ti,ab,kw) OR (myodystrophia:ti,ab,kw) OR (“myodystrophy chronic arthritis”:ti,ab,kw) OR (“chronic inflammatory joint disease”:ti,ab,kw) OR (“polyarthritis chronica progressiva”:ti,ab,kw) OR (polyarthritis:ti,ab,kw) OR (“secondary chronic”:ti,ab,kw) OR (“secondary chronic polyarthritis cerebal palsy”:ti,ab,kw) OR (“muscle palsy”:ti,ab,kw) OR (“muscle paralysis”:ti,ab,kw) OR (“muscular palsy”:ti,ab,kw) OR (“muscular paralysis”:ti,ab,kw) OR (myoparalysis:ti,ab,kw) OR (myoplegia:ti,ab,kw) OR (“neuromuscular paralysis”:ti,ab,kw) OR (neuroparalysis:ti,ab,kw) OR (palsy:ti,ab,kw) OR (paralysis:ti,ab,kw) OR (“paralytic disease”:ti,ab,kw) OR (“tardy apoplexy spina bifida”:ti,ab,kw) OR (myelodysplasia:ti,ab,kw) OR (“spinal dysraphism”:ti,ab,kw) OR (neuroschisis:ti,ab,kw) OR (“spina bifida”:ti,ab,kw) OR (“spina bifida anterior”:ti,ab,kw) OR (“spina bifida cystica”:ti,ab,kw) OR (“spina bifida posterior”:ti,ab,kw) OR (“spinal dysraphia”:ti,ab,kw) OR (“spinal dysraphic state”:ti,ab,kw) OR (“spinal dysraphic states”:ti,ab,kw) OR (“spine dysgraphia spinal cord injury”:ti,ab,kw) OR (injury:ti,ab,kw) OR (“spinal cord”:ti,ab,kw) OR (“spinal cord injuries”:ti,ab,kw) OR (“spinal cord trauma”:ti,ab,kw) OR (fibromyalgia:ti,ab,kw) OR (“fibrositic nodule”:ti,ab,kw) OR (fibrositis:ti,ab,kw) OR (“fibrositis syndrome”:ti,ab,kw) OR (myalgia:ti,ab,kw) OR (“fibro chronic fatigue syndrome”:ti,ab,kw) OR (encephalomyelitis:ti,ab,kw) OR (myalgic:ti,ab,kw) OR (“epidemic neuromyasthenia”:ti,ab,kw) OR (“fatigue syndrome”:ti,ab,kw) OR (chronic:ti,ab,kw) OR (“Iceland disease”:ti,ab,kw) OR (“myalgic encephalomyelitis”:ti,ab,kw) OR (“chronic fatigue”:ti,ab,kw) OR (“systemic exertion intolerance disease”:ti,ab,kw) OR (“cystic fibrosis”:ti,ab,kw) OR (“cystic fibrosis”:ti,ab,kw) OR (“cystic pancreas fibrosis”:ti,ab,kw) OR (“cystic pancreatic fibrosis”:ti,ab,kw) OR (“fibrocystic disease”:ti,ab,kw) OR (pancreas:ti,ab,kw) OR (“mckusick 21,970″:ti,ab,kw) OR (mucoviscidosis:ti,ab,kw) OR (mucoviscoidosis:ti,ab,kw) OR (“pancreas cystic disease”:ti,ab,kw) OR (“pancreas cystic fibrosis”:ti,ab,kw) OR (“pancreas fibrocystic disease”:ti,ab,kw) OR (“pancreas fibrosis”:ti,ab,kw) OR (“pancreatic cystic disease”:ti,ab,kw) OR (“pancreatic cystic fibrosis”:ti,ab,kw) OR (“pancreatic fibrosis Epilepsy”:ti,ab,kw) OR (“acute epilepsy”:ti,ab,kw) OR (“chronic epilepsy”:ti,ab,kw) OR (“comitial disease”:ti,ab,kw) OR (epilepsia:ti,ab,kw) OR (epileptic:ti,ab,kw) OR (“epileptic disorder”:ti,ab,kw) OR (“epileptic syndrome”:ti,ab,kw) OR (“epileptic syndromes”:ti,ab,kw) OR (“falling sickness”:ti,ab,kw) OR (sickness:ti,ab,kw) OR (“tardy epilepsy”:ti,ab,kw) OR (“Tourette syndrome”:ti,ab,kw) OR (“de la tourette disease”:ti,ab,kw) OR (“Gilles de la Tourette disease”:ti,ab,kw) OR (“Gilles de la Tourette syndrome”:ti,ab,kw) OR (“Gilles de la Tourettes syndrome”:ti,ab,kw) OR (“Gilles de Tourette syndrome”:ti,ab,kw) OR (“Tourette disease”:ti,ab,kw) OR (”Tourette syndrome”:ti,ab,kw) OR (“Tourettes syndrome”:ti,ab,kw) OR (Dwarfism:ti,ab,kw) OR (dwarf:ti,ab,kw) OR (midget:ti,ab,kw) OR (nanism:ti,ab,kw) OR (“sensory disability”:ti,ab,kw) OR (“sensory impairment”:ti,ab,kw) OR (Blindness:ti,ab,kw) OR (amaurosis:ti,ab,kw) OR (blind:ti,ab,kw) OR (blinding:ti,ab,kw) OR (“Hearing impairment”:ti,ab,kw) OR (“auditory defect”:ti,ab,kw) OR (“bilateral deafness”:ti,ab,kw) OR (deafness:ti,ab,kw) OR (deaf:ti,ab,kw) OR (“hearing damage”:ti,ab,kw) OR (“hearing defect”:ti,ab,kw) OR (“hearing difficulty”:ti,ab,kw) OR (“hearing loss”:ti,ab,kw) OR (hypacusia:ti,ab,kw) OR (hypacusis:ti,ab,kw) OR (hypoacousia:ti,ab,kw) OR (hypoacusis:ti,ab,kw) OR (“impaired hearing”:ti,ab,kw) OR (deafness:ti,ab,kw) OR (“Sensory processing disorder mental disability”:ti,ab,kw) OR (“mental impairment”:ti,ab,kw) OR (“mental health disability”:ti,ab,kw) OR (“mental health impairment”:ti,ab,kw) OR (Schizophrenia:ti,ab,kw) OR (“childhood schizophrenia”:ti,ab,kw) OR (“chronic schizophrenia”:ti,ab,kw) OR (“dementia praecox”:ti,ab,kw) OR (“dementia precox”:ti,ab,kw) OR (schizophrenia:ti,ab,kw) OR (childhood:ti,ab,kw) OR (schizophrenic:ti,ab,kw) OR (“schizophrenic syndrome”:ti,ab,kw) OR (Depression:ti,ab,kw) OR (”central depression”:ti,ab,kw) OR (“clinical depression”:ti,ab,kw) OR (“depressive disease”:ti,ab,kw) OR (“depressive disorder”:ti,ab,kw) OR (“depressive episode”:ti,ab,kw) OR (“depressive illness”:ti,ab,kw) OR (“depressive personality disorder”:ti,ab,kw) OR (“depressive state”:ti,ab,kw) OR (“depressive symptom”:ti,ab,kw) OR (“depressive syndrome”:ti,ab,kw) OR (“mental depression”:ti,ab,kw) OR (“parental depression”:ti,ab,kw) OR (“Post-traumatic stress disorder”:ti,ab,kw) OR (“post-traumatic spectrum disorder”:ti,ab,kw) OR (“combat disorders”:ti,ab,kw) OR (“combat fatigue”:ti,ab,kw) OR (“combat stress”:ti,ab,kw) OR (“post-traumatic stress”:ti,ab,kw) OR (“post-traumatic stress disorder”:ti,ab,kw) OR (“posttraumatic neurosis”:ti,ab,kw) OR (“posttraumatic psychic syndrome”:ti,ab,kw) OR (“posttraumatic psychosis”:ti,ab,kw) OR (“posttraumatic stress”:ti,ab,kw) OR (“posttraumatic syndrome”:ti,ab,kw) OR (psychosis:ti,ab,kw) OR (posttraumatic:ti,ab,kw) OR (PTSD:ti,ab,kw) OR (“stress disorders”:ti,ab,kw) OR (“post-traumatic”:ti,ab,kw) OR (“stress disorders”:ti,ab,kw) OR (posttraumatic:ti,ab,kw) OR (“trauma and stressor related disorders”:ti,ab,kw) OR (“traumatic stress”:ti,ab,kw) OR (“traumatic stress disorder”:ti,ab,kw) OR (“war neurosis”:ti,ab,kw) OR (”Mood disorder”:ti,ab,kw) OR (“affective disorder”:ti,ab,kw) OR (“affective disorders”:ti,ab,kw) OR (“affective disturbance”:ti,ab,kw) OR (“affective illness”:ti,ab,kw) OR (“mood disorders”:ti,ab,kw) OR (“mood disturbance”:ti,ab,kw) OR (“mood disturbances”:ti,ab,kw) OR (“Anxiety disorder”:ti,ab,kw) OR (“Dissociative disorders”:ti,ab,kw) OR ( “dissociative disorder”:ti,ab,kw) OR (depersonalization:ti,ab,kw) OR (“dissociative amnesia”:ti,ab,kw) OR (“dissociative fugue”:ti,ab,kw) OR (“multiple personality”:ti,ab,kw) OR (”Affective disorder”:ti,ab,kw) OR (“affective disorders”:ti,ab,kw) OR (“affective disturbance”:ti,ab,kw) OR (“affective illness”:ti,ab,kw) OR (“mood disorders”:ti,ab,kw) OR (“mood disturbance”:ti,ab,kw) OR (“mood disturbances eating disorders”:ti,ab,kw) OR (EDNOS:ti,ab,kw) OR (“feeding and eating disorders”:ti,ab,kw) OR (anorexia:ti,ab,kw) OR (“anorexia nervosa”:ti,ab,kw) OR (“boulemia personality change”:ti,ab,kw) OR (“personality disorders”:ti,ab,kw) OR (“personality disturbance”:ti,ab,kw) OR (“organic brain disorders”:ti,ab,kw) OR (“body dysmorphic disorders”:ti,ab,kw) OR (“body dysmorphic”:ti,ab,kw) OR (dysmorphophobia:ti,ab,kw) OR (phobia:ti,ab,kw) OR (“dysmorpho intellectual disability”:ti,ab,kw) OR (“intellectual impairment”:ti,ab,kw) OR (“abnormal development”:ti,ab,kw) OR (“child development disorder”:ti,ab,kw) OR (“development disorder”:ti,ab,kw) OR (“developmental disabilities”:ti,ab,kw) OR (“Fragile X syndrome”:ti,ab,kw) OR (“Down syndrome”:ti,ab,kw) OR (“down disease”:ti,ab,kw) OR (“Downs syndrome”:ti,ab,kw) OR (mongolian:ti,ab,kw) OR (“langdon down disease”:ti,ab,kw) OR (“langdon down syndrome”:ti,ab,kw) OR (“mongolian idiocy”:ti,ab,kw) OR (mongolism:ti,ab,kw) OR (“mongoloid idiocy”:ti,ab,kw) OR (mongoloidism:ti,ab,kw) OR (“translocation 15 21 22″:ti,ab,kw) OR (“trisomy 21 syndrome”:ti,ab,kw) OR (“developmental delay”:ti,ab,kw) OR (“development delay”:ti,ab,kw) OR (“global developmental delay”:ti,ab,kw) OR (“hhho syndrome”:ti,ab,kw) OR (“labhart willi prader syndrome”:ti,ab,kw) OR (“prader labhart willi syndrome”:ti,ab,kw) OR (“Prader Willi”:ti,ab,kw) OR (“prader willi labhart syndrome”:ti,ab,kw) OR (“Prader-Willi syndrome”:ti,ab,kw) OR (“willi prader labhart syndrome”:ti,ab,kw) OR (“willi prader lalhart syndrome”:ti,ab,kw) OR (“Fetal alcohol sprectrum disorder”:ti,ab,kw) OR (“intellectual disability”:ti,ab,kw) OR (“intellectual dysfunction”:ti,ab,kw) OR (“mental deficiency”:ti,ab,kw) OR (“cognitive retard”:ti,ab,kw) OR (“cognitive retardation”:ti,ab,kw) OR (“deficiency, mental”:ti,ab,kw) OR (“disability, mental”:ti,ab,kw) OR (“incapacity, mental”:ti,ab,kw) OR (“intellectual retardation”:ti,ab,kw) OR (“mental deficit”:ti,ab,kw) OR (“mental disability”:ti,ab,kw) OR (“mental disability assessment”:ti,ab,kw) OR (“mental disability evaluation”:ti,ab,kw) OR (“mental handicap”:ti,ab,kw) OR (“mental incapacity”:ti,ab,kw) OR (“mental retard”:ti,ab,kw) OR (“mental retardation”:ti,ab,kw) OR (“mental retardation, psychosocial”:ti,ab,kw) OR (”mentally handicapped”:ti,ab,kw) OR (“mentally retarded”:ti,ab,kw) OR (”retardation, mental”:ti,ab,kw) OR (“severe mental retardation”:ti,ab,kw) OR (”Alpers disease”:ti,ab,kw) OR (“beta mannosidosis”:ti,ab,kw) OR (“Coffin Lowry syndrome”:ti,ab,kw) OR (”COFS syndrome”:ti,ab,kw) OR (“Danon disease”:ti,ab,kw) OR (“Dubowitz syndrome”:ti,ab,kw) OR (“Ellis van Creveld syndrome”:ti,ab,kw) OR (“Hunter syndrome”:ti,ab,kw) OR (“Hurler syndrome”:ti,ab,kw) OR (“Kabuki makeup syndrome”:ti,ab,kw) OR (“Leigh disease”:ti,ab,kw) OR (leprechaunism:ti,ab,kw) OR (mannosidosis:ti,ab,kw) OR (“maple syrup urine disease”:ti,ab,kw) OR (“Marinesco Sjogren syndrome”:ti,ab,kw) OR (“Maroteaux Lamy syndrome”:ti,ab,kw) OR (“mental retardation malformation syndrome”:ti,ab,kw) OR (“prolidase deficiency”:ti,ab,kw) OR (“Sandhoff disease”:ti,ab,kw) OR (“Sanfilippo syndrome”:ti,ab,kw) OR (“WAGR syndrome”:ti,ab,kw) OR (“Weismann Netter syndrome26 Records”:ti,ab,kw) OR (“X linked mental retardation”:ti,ab,kw) OR (“learning disability”:ti,ab,kw) OR (“learning impairment disorder”:ti,ab,kw) OR (“impaired learning”:ti,ab,kw) OR (“learning deficit”:ti,ab,kw) OR (“learning difficulty”:ti,ab,kw) OR (“learning disabilities”:ti,ab,kw) OR (“learning disability”:ti,ab,kw) OR (“learning disorders”:ti,ab,kw) OR (“learning disturbance”:ti,ab,kw) OR (“learning impairment”:ti,ab,kw) OR (“learning problem”:ti,ab,kw) OR (“specific learning disorder”:ti,ab,kw) OR (“Functional cognitive disability”:ti,ab,kw) OR (“Functional cognitive disability”:ti,ab,kw) OR (Autism:ti,ab,kw) OR (“autism spectrum disorder”:ti,ab,kw) OR (“autism, early infantile”:ti,ab,kw) OR (“autism, infantile”:ti,ab,kw) OR (“autistic child”:ti,ab,kw) OR (“autistic children”:ti,ab,kw) OR (“autistic disorder”:ti,ab,kw) OR (“autistic spectrum disorder”:ti,ab,kw) OR (“child development disorders, pervasive”:ti,ab,kw) OR (“childhood autism”:ti,ab,kw) OR (“classical autism”:ti,ab,kw) OR (“early infantile autism”:ti,ab,kw) OR (“infantile autism”:ti,ab,kw) OR (“infantile autism, early”:ti,ab,kw) OR (“Kanner syndrome”:ti,ab,kw) OR (“pervasive developmental disorder”:ti,ab,kw) OR (“pervasive developmental disorder”:ti,ab,kw) OR (“pervasive developmental disorders”:ti,ab,kw) OR (“typical autism Dementia”:ti,ab,kw) OR (amentia:ti,ab,kw) OR (demention:ti,ab,kw) OR (“brain injuries”:ti,ab,kw) OR (“brain lesion”:ti,ab,kw) OR (“brain system trauma”:ti,ab,kw) OR (“brain trauma”:ti,ab,kw) OR (“cerebral trauma”:ti,ab,kw) OR (“cerebrovascular trauma”:ti,ab,kw) OR (“encephalopathy, traumatic”:ti,ab,kw) OR (“mild traumatic brain injury”:ti,ab,kw) OR (“organic cerebral trauma”:ti,ab,kw) OR (“posttraumatic encephalopathy”:ti,ab,kw) OR (“traumatic brain injuries”:ti,ab,kw) OR (“traumatic brain lesion”:ti,ab,kw) OR (“traumatic cerebral lesion”:ti,ab,kw) OR (“traumatic encephalopathy”:ti,ab,kw) OR (“Attention deficit disorder”:ti,ab,kw) OR (ADHD:ti,ab,kw) OR (“attention deficit”:ti,ab,kw) OR (“attention deficit and disruptive behavior disorders”:ti,ab,kw) OR (“attention deficit and disruptive behaviour disorders”:ti,ab,kw) OR (“attention deficit disorder with hyperactivity”:ti,ab,kw) OR (“attention deficit hyperactivity disorder disability”:ti,ab,kw) OR (“dyslectic child”:ti,ab,kw) OR (“reading difficulty”:ti,ab,kw) OR (“reading disability”:ti,ab,kw) OR (“reading disorder”:ti,ab,kw) OR (“reading disturbance”:ti,ab,kw) OR (“reading error”:ti,ab,kw) OR (“reading problem”:ti,ab,kw) OR (strephosymbolia:ti,ab,kw) OR (Dyscalculia:ti,ab,kw).

AND

(healthcare:ti,ab,kw) OR (hospital:ti,ab,kw) OR (doctor:ti,ab,kw) OR ("general practicioner":ti,ab,kw) OR ("family physician":ti,ab,kw) OR (medical:ti,ab,kw) OR (physician:ti,ab,kw) OR (nurse:ti,ab,kw) OR (pediatric:ti,ab,kw) OR (dermatologist:ti,ab,kw) OR (gynaecologist:ti,ab,kw) OR (gastroenterologist:ti,ab,kw) OR (cardiologist:ti,ab,kw) OR (surgeon:ti,ab,kw) OR (hematologist:ti,ab,kw) OR (internist:ti,ab,kw) OR (pediatrician:ti,ab,kw) OR (geneticist:ti,ab,kw) OR (rehabilitation:ti,ab,kw) OR ("rehabilitation doctor":ti,ab,kw) OR (physiotherapist:ti,ab,kw) OR ("emergency doctor":ti,ab,kw) OR (neurologist:ti,ab,kw) OR ("medical specialist":ti,ab,kw) OR ("school doctor":ti,ab,kw) OR (urologist:ti,ab,kw) OR ("health care worker":ti,ab,kw) OR ("healthcare worker":ti,ab,kw) OR ("health care professional":ti,ab,kw) OR ("health care professionals":ti,ab,kw) OR ("healthcare professional":ti,ab,kw) OR ("health care professionals":ti,ab,kw) OR (“health care providers”:ti,ab,kw) OR (clinican:ti,ab,kw) OR ("health care provider":ti,ab,kw) OR (clinician:ti,ab,kw) OR ("primary health care":ti,ab,kw) OR ("health care worker":ti,ab,kw).

AND

([adolescent]/lim OR [child]/lim OR [infant]/lim OR [newborn]/lim OR [preschool]/lim OR [school]/lim).

Web of Science

(TS = infant) OR (TS = infants) OR (TS = toddler) OR (TS = toddlers) OR (TS = minors) OR (TS = boy) OR (TS = boys) OR (TS = boyfriend) OR (TS = boyhood) OR (TS = girl) OR (TS = girls) OR (TS = kid) OR (TS = kids) OR (TS = child) OR (TS = children) OR (TS = schoolchildren) OR (TS = “school child”) OR (TS = “school children”) OR (TS = adolescent) OR (TS = adolescence) OR (TS = adolescents) OR (TS = juvenile) OR (TS = youth) OR (TS = youths) OR (TS = ”young people”) OR (TS = ”young persons”) OR (TS = teenager) OR (TS = teenagers) OR (TS = under aged) OR (TS = pubescent) OR (TS = pubescence) OR (TS = school) OR (TS = schools) OR (TS = ”18 years”).

AND

(TS = “Sex education”) OR (TS = “sexuality education”) OR (TS = “sexual education”) OR (TS = “hiv education”) OR (TS = “hiv prevention”) OR (TS = “sti education”) OR (TS = “sti prevention”) OR (TS = “relationship education”) OR (TS = “life skills education”) OR (TS = contraception promotion) OR (TS = ”contraception education”) OR (TS = ”contraceptive promotion”) OR (TS = ”contraceptive education”) OR (TS = “contraceptive method education”) OR (TS = ”contraceptive method promotion”) OR (TS = “condom promotion”) OR (TS = “condom use”) OR (TS = “sexual health education”) OR (TS = ”sexual health promotion”) OR (TS = “reproductive health education”) OR (TS = ”reproductive health promotion”) OR (TS = “sex and relationship education”) OR (TS = “healthy lifestyle education”) OR (TS = “sexual rights”).

AND

(TS = Disabilities) OR (TS = Disability) OR (TS = “chronic disability”) OR (TS = disablement) OR (TS = handicap) OR (TS = handicapped) OR (TS = “disabled person”) OR (TS = disabled) OR (TS = “disabled patient”) OR (TS = “disabled persons”) OR (TS = “handicapped patient”) OR (TS = “handicapped subject”) OR (TS = impairment) OR (TS = “impaired person”) OR (TS = “acquired disability”) OR (TS = “congenital disability”) OR (TS = “Physical disability”) OR (TS = “Physical impairment physiological disability”) OR (TS = “physiological impairment functional disability”) OR (TS = “functional impairment”) OR (TS = “mobility disability”) OR (TS = “mobility impairment multiple sclerosis”) OR (TS = “chariot disease”) OR (TS = “disseminated sclerosis”) OR (TS = “insular sclerosis”) OR (TS = MS) OR (TS = “multiple sclerosis”) OR (TS = “chronic progressive”) OR (TS = “multiple sclerosis”) OR (TS = “relapsing–remitting”) OR (TS = “primary progressive multiple sclerosis”) OR (TS = “relapsing remitting multiple sclerosis”) OR (TS = “relapsing–remitting multiple sclerosis”) OR (TS = “sclerosis multiplex”) OR (TS = sclerosis) OR (TS = insular) OR (TS = “secondary progressive multiple sclerosis muscular dystrophy”) OR (TS = “congenital atonic sclerotic muscular dystrophy”) OR (TS = “congenital muscle dystrophy”) OR (TS = “congenital muscular dystrophy”) OR (TS = dystrophy) OR (TS = “muscle dystrophia”) OR (TS = “muscle dystrophy”) OR (TS = “muscular dystrophia”) OR (TS = “muscular dystrophies”) OR (TS = “muscular dystrophy”) OR (TS = myodystrophia) OR (TS = “myodystrophy chronic arthritis”) OR (TS = “chronic inflammatory joint disease”) OR (TS = “polyarthritis chronica progressiva”) OR (TS = polyarthritis) OR (TS = “secondary chronic”) OR (TS = “secondary chronic polyarthritis cerebal palsy”) OR (TS = “muscle palsy”) OR (TS = “muscle paralysis”) OR (TS = “muscular palsy”) OR (TS = “muscular paralysis”) OR (TS = myoparalysis) OR (TS = myoplegia) OR (TS = “neuromuscular paralysis”) OR (TS = neuroparalysis) OR (TS = palsy) OR (TS = paralysis) OR (TS = “paralytic disease”) OR (TS = “tardy apoplexy spina bifida”) OR (TS = myelodysplasia) OR (TS = “spinal dysraphism”) OR (TS = neuroschisis) OR (TS = “spina bifida”) OR (TS = “spina bifida anterior”) OR (TS = “spina bifida cystica”) OR (TS = “spina bifida posterior”) OR (TS = “spinal dysraphia”) OR (TS = “spinal dysraphic state”) OR (TS = “spinal dysraphic states”) OR (TS = “spine dysgraphia spinal cord injury”) OR (TS = injury) OR (TS = “spinal cord”) OR (TS = “spinal cord injuries”) OR (TS = “spinal cord trauma”) OR (TS = fibromyalgia) OR (TS = “fibrositic nodule”) OR (TS = fibrositis) OR (TS = “fibrositis syndrome”) OR (TS = myalgia) OR (TS = “fibro chronic fatigue syndrome”) OR (TS = encephalomyelitis) OR (TS = myalgic) OR (TS = “epidemic neuromyasthenia”) OR (TS = “fatigue syndrome”) OR (TS = chronic) OR (TS = “Iceland disease”) OR (TS = “myalgic encephalomyelitis”) OR (TS = “chronic fatigue”) OR (TS = “systemic exertion intolerance disease”) OR (TS = “cystic fibrosis”) OR (TS = “cystic fibrosis”) OR (TS = “cystic pancreas fibrosis”) OR (TS = “cystic pancreatic fibrosis”) OR (TS = “fibrocystic disease”) OR (TS = pancreas) OR (TS = “mckusick 21,970″) OR (TS = mucoviscidosis) OR (TS = mucoviscoidosis) OR (TS = “pancreas cystic disease”) OR (TS = “pancreas cystic fibrosis”) OR (TS = “pancreas fibrocystic disease”) OR (TS = “pancreas fibrosis”) OR (TS = “pancreatic cystic disease”) OR (TS = “pancreatic cystic fibrosis”) OR (TS = “pancreatic fibrosis Epilepsy”) OR (TS = “acute epilepsy”) OR (TS = “chronic epilepsy”) OR (TS = “comitial disease”) OR (TS = epilepsia) OR (TS = epileptic) OR (TS = “epileptic disorder”) OR (TS = “epileptic syndrome”) OR (TS = “epileptic syndromes”) OR (TS = “falling sickness”) OR (TS = sickness) OR (TS = “tardy epilepsy”) OR (TS = “Tourette syndrome”) OR (TS = “de la tourette disease”) OR (TS = “Gilles de la Tourette disease”) OR (TS = “Gilles de la Tourette's syndrome”) OR (TS = “Gilles de la Tourettes syndrome”) OR (TS = “Gilles de Tourette syndrome”) OR (TS = “Tourette disease”) OR (TS = ”Tourette's syndrome”) OR (TS = “Tourettes syndrome”) OR (TS = Dwarfism) OR (TS = dwarf) OR (TS = midget) OR (TS = nanism) OR (TS = “sensory disability”) OR (TS = “sensory impairment”) OR (TS = Blindness) OR (TS = amaurosis) OR (TS = blind) OR (TS = blinding) OR (TS = “Hearing impairment”) OR (TS = “auditory defect”) OR (TS = “bilateral deafness”) OR (TS = deafness) OR (TS = deaf) OR (TS = “hearing damage”) OR (TS = “hearing defect”) OR (TS = “hearing difficulty”) OR (TS = “hearing loss”) OR (TS = hypacusia) OR (TS = hypacusis) OR (TS = hypoacousia) OR (TS = hypoacusis) OR (TS = “impaired hearing”) OR (TS = deafness) OR (TS = “Sensory processing disorder mental disability”) OR (TS = “mental impairment”) OR (TS = “mental health disability”) OR (TS = “mental health impairment”) OR (TS = Schizophrenia) OR (TS = “childhood schizophrenia”) OR (TS = “chronic schizophrenia”) OR (TS = “dementia praecox”) OR (TS = “dementia precox”) OR (TS = schizophrenia) OR (TS = childhood) OR (TS = schizophrenic) OR (TS = “schizophrenic syndrome”) OR (TS = Depression) OR (TS = ”central depression”) OR (TS = “clinical depression”) OR (TS = “depressive disease”) OR (TS = “depressive disorder”) OR (TS = “depressive episode”) OR (TS = “depressive illness”) OR (TS = “depressive personality disorder”) OR (TS = “depressive state”) OR (TS = “depressive symptom”) OR (TS = “depressive syndrome”) OR (TS = “mental depression”) OR (TS = “parental depression”) OR (TS = “Post-traumatic stress disorder”) OR (TS = “post-traumatic spectrum disorder”) OR (TS = “combat disorders”) OR (TS = “combat fatigue”) OR (TS = “combat stress”) OR (TS = “post-traumatic stress”) OR (TS = “post-traumatic stress disorder”) OR (TS = “posttraumatic neurosis”) OR (TS = “posttraumatic psychic syndrome”) OR (TS = “posttraumatic psychosis”) OR (TS = “posttraumatic stress”) OR (TS = “posttraumatic syndrome”) OR (TS = psychosis) OR (TS = posttraumatic) OR (TS = PTSD) OR (TS = “stress disorders”) OR (TS = “post-traumatic”) OR (TS = “stress disorders”) OR (TS = posttraumatic) OR (TS = “trauma and stressor related disorders”) OR (TS = “traumatic stress”) OR (TS = “traumatic stress disorder”) OR (TS = “war neurosis”) OR (TS = ”Mood disorder”) OR (TS = “affective disorder”) OR (TS = “affective disorders”) OR (TS = “affective disturbance”) OR (TS = “affective illness”) OR (TS = “mood disorders”) OR (TS = “mood disturbance”) OR (TS = “mood disturbances”) OR (TS = “Anxiety disorder”) OR (TS = “Dissociative disorders”) OR (TS = “dissociative disorder”) OR (TS = depersonalization) OR (TS = “dissociative amnesia”) OR (TS = “dissociative fugue”) OR (TS = “multiple personality”) OR (TS = ”Affective disorder”) OR (TS = “affective disorders”) OR (TS = “affective disturbance”) OR (TS = “affective illness”) OR (TS = “mood disorders”) OR (TS = “mood disturbance”) OR (TS = “mood disturbances eating disorders”) OR (TS = EDNOS) OR (TS = “feeding and eating disorders”) OR (TS = anorexia) OR (TS = “anorexia nervosa”) OR (TS = “boulemia personality change”) OR (TS = “personality disorders”) OR (TS = “personality disturbance”) OR (TS = “organic brain disorders”) OR (TS = “body dysmorphic disorders”) OR (TS = “body dysmorphic”) OR (TS = dysmorphophobia) OR (TS = phobia) OR (TS = “dysmorpho intellectual disability”) OR (TS = “intellectual impairment”) OR (TS = “abnormal development”) OR (TS = “child development disorder”) OR (TS = “development disorder”) OR (TS = “developmental disabilities”) OR (TS = “Fragile X syndrome”) OR (TS = “Down syndrome”) OR (TS = “down disease”) OR (TS = “Downs syndrome”) OR (TS = “Downs syndrome”) OR (TS = mongolian) OR (TS = “langdon down disease”) OR (TS = “langdon down syndrome”) OR (TS = “mongolian idiocy”) OR (TS = mongolism) OR (TS = “mongoloid idiocy”) OR (TS = mongoloidism) OR (TS = “translocation 15 21 22″) OR (TS = “trisomy 21 syndrome”) OR (TS = “developmental delay”) OR (TS = “development delay”) OR (TS = “global developmental delay”) OR (TS = “hhho syndrome”) OR (TS = “labhart willi prader syndrome”) OR (TS = “prader labhart willi syndrome”) OR (TS = “Prader Willi”) OR (TS = “prader willi labhart syndrome”) OR (TS = “Prader-Willi syndrome”) OR (TS = “willi prader labhart syndrome”) OR (TS = “willi prader lalhart syndrome”) OR (TS = “Fetal alcohol sprectrum disorder”) OR (TS = “intellectual disability”) OR (TS = “intellectual dysfunction”) OR (TS = “mental deficiency”) OR (TS = “cognitive retard”) OR (TS = “cognitive retardation”) OR (TS = “deficiency, mental”) OR (TS = “disability, mental”) OR (TS = “incapacity, mental”) OR (TS = “intellectual retardation”) OR (TS = “mental deficit”) OR (TS = “mental disability”) OR (TS = “mental disability assessment”) OR (TS = “mental disability evaluation”) OR (TS = “mental handicap”) OR (TS = “mental incapacity”) OR (TS = “mental retard”) OR (TS = “mental retardation”) OR (TS = “mental retardation, psychosocial”) OR (TS = ”mentally handicapped”) OR (TS = “mentally retarded”) OR (TS = ”retardation, mental”) OR (TS = “severe mental retardation”) OR (TS = ”Alpers disease”) OR (TS = “beta mannosidosis”) OR (TS = “Coffin Lowry syndrome”) OR (TS = ”COFS syndrome”) OR (TS = “Danon disease”) OR (TS = “Dubowitz syndrome”) OR (TS = “Ellis van Creveld syndrome”) OR (TS = “Hunter syndrome”) OR (TS = “Hurler syndrome”) OR (TS = “Kabuki makeup syndrome”) OR (TS = “Leigh disease”) OR (TS = leprechaunism) OR (TS = mannosidosis) OR (TS = “maple syrup urine disease”) OR (TS = “Marinesco Sjogren syndrome”) OR (TS = “Maroteaux Lamy syndrome”) OR (TS = “mental retardation malformation syndrome”) OR (TS = “prolidase deficiency”) OR (TS = “Sandhoff disease”) OR (TS = “Sanfilippo syndrome”) OR (TS = “WAGR syndrome”) OR (TS = “Weismann Netter syndrome26 Records”) OR (TS = “X linked mental retardation”) OR (TS = “learning disability”) OR (TS = “learning impairment disorder”) OR (TS = “impaired learning”) OR (TS = “learning deficit”) OR (TS = “learning difficulty”) OR (TS = “learning disabilities”) OR (TS = “learning disability”) OR (TS = “learning disorders”) OR (TS = “learning disturbance”) OR (TS = “learning impairment”) OR (TS = “learning problem”) OR (TS = “specific learning disorder”) OR (TS = “Functional cognitive disability”) OR (TS = “Functional cognitive disability”) OR (TS = Autism) OR (TS = “autism spectrum disorder”) OR (TS = “autism, early infantile”) OR (TS = “autism, infantile”) OR (TS = “autistic child”) OR (TS = “autistic children”) OR (TS = “autistic disorder”) OR (TS = “autistic spectrum disorder”) OR (TS = “child development disorders, pervasive”) OR (TS = “childhood autism”) OR (TS = “classical autism”) OR (TS = “early infantile autism”) OR (TS = “infantile autism”) OR (TS = “infantile autism, early”) OR (TS = “Kanner syndrome”) OR (TS = “pervasive developmental disorder”) OR (TS = “pervasive developmental disorder”) OR (TS = “pervasive developmental disorders”) OR (TS = “typical autism Dementia”) OR (TS = amentia) OR (TS = demention) OR (TS = “brain injuries”) OR (TS = “brain lesion”) OR (TS = “brain system trauma”) OR (TS = “brain trauma”) OR (TS = “cerebral trauma”) OR (TS = “cerebrovascular trauma”) OR (TS = “encephalopathy, traumatic”) OR (TS = “mild traumatic brain injury”) OR (TS = “organic cerebral trauma”) OR (TS = “posttraumatic encephalopathy”) OR (TS = “traumatic brain injuries”) OR (TS = “traumatic brain lesion”) OR (TS = “traumatic cerebral lesion”) OR (TS = “traumatic encephalopathy”) OR (TS = “Attention deficit disorder”) OR (TS = ADHD) OR (TS = “attention deficit”) OR (TS = “attention deficit and disruptive behavior disorders”) OR (TS = “attention deficit and disruptive behaviour disorders”) OR (TS = “attention deficit disorder with hyperactivity”) OR (TS = “attention deficit hyperactivity disorder disability”) OR (TS = “dyslectic child”) OR (TS = “reading difficulty”) OR (TS = “reading disability”) OR (TS = “reading disorder”) OR (TS = “reading disturbance”) OR (TS = “reading error”) OR (TS = “reading problem”) OR (TS = strephosymbolia) OR (TS = Dyscalculia).

AND

(TS = healthcare) OR (TS = hospital) OR (TS = doctor) OR (TS = "general practicioner") OR (TS = "family physician") OR (TS = medical) OR (TS = physician) OR (TS = nurse) OR (TS = dermatologist) OR (TS = endocrinologist) OR (TS = gynecologist) OR (TS = gastroenterologist) OR (TS = cardiologist) OR (TS = surgeon) OR (TS = hepatologist) OR (TS = hematologist) OR (TS = internist) OR (TS = pediatrician) OR (TS = geneticist) OR (TS = rehabilitation) OR (TS = physiotherapist) OR (TS = neonatologist) OR (TS = neurologist) OR (TS = "medical specialist") OR (TS = psychiatrist) OR (TS = "school doctor") OR (TS = urologist) OR (TS = "health care worker") OR (TS = "health care workers") OR (TS = "health care professional") OR (TS = "health care professionals") OR (TS = "healthcare professionals") OR (TS = ”healthcare provider”) OR (TS = ”health care provider”) OR (TS = clinican) OR (TS = clinicians) OR (TS = ”primary health care”) OR (TS = ”health personnel”) OR (TS = ”health care worker”).