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E-services for the social inclusion of people with disabilities: A literature review
Abstract
BACKGROUND: It is assumed that e-services support persons with disabilities in their everyday life by improving communication and interaction with healthcare organizations and whilst facilitating their social inclusion. AIM: The aim of this study is to examine the contribution of e-services in terms of how they diminish barriers and constraints on social inclusion. METHOD: A literature review was performed, covering the period between 2010 and 2016 (6 years). Only studies that discussed the social inclusion of people with disabilities or presented prototype solutions to this problem were included. RESULTS: The results of this study show that there is a lack of theoretical framework which can be used to measure the effectiveness of the e-services or innovations in the area of e-services in the contexts that were examined. The existing research studies are normally generic and do not discuss whether the requirements that are imposed on a particular e-service differ depending on (i) type of disability, (ii) the ICT-maturity or skill of the end-user, or (iii) context in which the e-service will be used. In general, previous research in this area claims that e-services do assist people with disabilities access to society (defined as the community in which they live), even when no evidence is actually presented about the impact such services have in this area of the end-user's life. CONCLUSION: The results of the present study present us with new knowledge about the types of ICT-based innovations and e-services that have been proposed to facilitate the social integration of people with disabilities.
... Yleisesti ottaen vammaiset kansalaiset käyttävät valtaväestöä vähemmän digitaaliteknologiaa käytön esteiden liittyessä muun muassa korkeisiin kustannuksiin, huonoon suunnitteluun ja puutteelliseen opastukseen [4][5][6][21][22]. Vammaisten henkilöiden sähköisten palveluiden käyttöä on tutkittu vähemmän kuin heidän tietokoneiden, älypuhelimien tai sosiaalisen median käyttöään [23][24][25][26][27] ja pääasiassa on selvitetty vammaisten kansalaisten terveyspalveluiden käyttöä [28]. Sähköistyvien palveluiden on havaittu tarjoavan osalle vammaisista osallisuusmahdollisuuksia [17,29], mutta väitteitä teknologian vammaisten ihmisten osallisuutta vahvistavasta vaikutuksesta on tehty myös ilman vammaisten henkilöiden moninaisten tilanteiden riittävää huomiointia [28]. ...
... Vammaisten henkilöiden sähköisten palveluiden käyttöä on tutkittu vähemmän kuin heidän tietokoneiden, älypuhelimien tai sosiaalisen median käyttöään [23][24][25][26][27] ja pääasiassa on selvitetty vammaisten kansalaisten terveyspalveluiden käyttöä [28]. Sähköistyvien palveluiden on havaittu tarjoavan osalle vammaisista osallisuusmahdollisuuksia [17,29], mutta väitteitä teknologian vammaisten ihmisten osallisuutta vahvistavasta vaikutuksesta on tehty myös ilman vammaisten henkilöiden moninaisten tilanteiden riittävää huomiointia [28]. Esimerkiksi saamelaisten vammaisten henkilöiden elämään digitalisaation on todettu tuottavan yksi-löllisesti ja yhteisöllisesti sekä mahdollisuuksia että haasteita [10]. ...
... Laadullisen tutkimuksemme tavoitteena on lisätä ymmärrystä vammaisten henkilöiden tilannekohtaisista toimijuuksista SVP-käyttäjinä. Tutkimuksemme paikkaa katvetta, jota on havaittu erilaisten vammojen, palvelun käyttäjien yksilöllisten elämäntilanteiden sekä riittävän teknologisen rajauksen huomioinnissa [28]. Tutkimuksemme myös kohdentaa aiemman kansalaiskyselyn tietoa, jossa vastaajat sijoittivat itsensä muita käyttäjiä ohjaamaan kykeneviksi sähköisten palveluiden asiantuntijakäyttäjiksi, sujuvasti monia palveluja käyttäviksi, peruspalveluja itsenäisesti käyttäviksi tai tukea tarvitseviksi noviisi-käyttäjiksi [12]. ...
Sosiaalihuollon sähköisten palveluiden tutkimus on lisääntynyt, mutta vammaisia henkilöitä sähköisten palveluiden käyttäjinä koskevaa tutkimusta on vähän. Tässä tutkimuksessa tarkastellaan valtavirtateknologioita, kuten tietokoneita ja matkapuhelimia, itsenäisesti käyttävien vammaisten henkilöiden sähköisten vammaispalveluiden (SVP) käyttöä tilannekohtaisen toimijuuden näkökulmasta. Tutkimuksen tarkoituksena on lisätä ymmärrystä vammaisten henkilöiden SVP käyttöön vaikuttavista tekijöistä. Tutkimusaineistona ovat vammaispalveluiden asiakkaina olevien vammaisten henkilöiden teemahaastattelut (n=14). Aineistoa analysoitiin luokittelemalla ja tyypittelemällä. Teoreettisena analyysikehyksenä hyödynnettiin toimijuuden modaliteetti -teoriaa, joka sopii erittelemään toimijuuden muotoutumista yksilöllisten ja ympäristöllisten tekijöiden tilannekohtaisena kudelmana.
Analyysin tulos eriytyvistä toimijuuksista on typologia: taidokkaat, potentiaalit, varaukselliset ja pakotetut SVP-käyttäjät. Taidokkaat käyttäjät ovat suvereeneja kehittäjäasiakkaita, jotka hyötyvät monipuolisesta sähköisten palveluiden tarjonnasta. Potentiaalit käyttäjät ovat palvelunkäyttäjäasiakkaita, jotka kaipaavat lisää tietoa ja tukea SVP hyödyntämiseen. Varaukselliset käyttäjät luottavat muita heikommin sekä palveluihin yleisesti että sähköisiin palveluihin. Pakotetut käyttäjät pyrkivät sopeutumaan sähköistyviin palveluihin turvautuen kuitenkin niiden, kuten yleisemminkin palveluiden käytössä, läheisten tukeen.
Tutkimuksessa esitetään, että vammaisten henkilöiden SVP käyttöön vaikuttaa henkilön aiemmalle elämänkululle rakentuva nykyinen tilanne kaikkine osatekijöineen, joista lähemmin tarkasteltiin vammaan liittyvän tilanteen sekä vammaispalveluasiakkuuden vakiintuneisuutta tai vakiintumattomuutta. Tulosten perusteella suhteellisen vakaassa tilanteessa elävien vammaisten henkilöiden (taidokkaat ja potentiaalit käyttäjät) myönteinen suhde sähköisiin palveluihin ilmenee SVP runsaampana käyttönä kuin vakiintumattomissa tilanteissa elävillä, joiden suhde palvelujärjestelmään on pulmallisempi ja SVP käyttö vähäisempää (varaukselliset ja pakotetut käyttäjät). Kaikkien tyyppien SVP käyttöä edistäisi palveluiden käytettävyyden, saavutettavuuden ja esteettömyyden kohentaminen, mutta toimia tulisi myös eriyttää huomioiden asiakkaiden SVP-käyttäjätyypit.
... This suggests that when trainers assess the potential of cyberspace for older adults, they should start by considering real-life needs as the foundation for designing educational processes. Furthermore, this approach should account for the practicalities of older adults' daily routines and the benefits, as well as the limitations, of ICT-based solutions, such as cost and ease of use (Dąbrowska & Janoś-Kresło, 2019;Manzoor & Vimarlund, 2017). ...
Rapid, continuous, and irreversible technological advancements are reshaping how individuals navigate the information society. The growing range and capabilities of different pieces of software and e-services call for a deeper examination of the relationship between users' needs and the opportunities presented by access to cyberspace. Redefining the framework of digital and media competences in the light of real-world e-services has become essential , particularly in promoting digital inclusion for older adults. The research conducted in Poland in the first half of 2024 explores how older adults engage with digital technologies across multiple life domains. Based on a qualitative study conducted with Polish trainers and potential educators of older adults, nine key categories were identified: daily tasks, finances, education, work and professional development, social relationships, health, leisure and hobbies, civic engagement, and religion. Each of these categories is linked to specific websites that can greatly improve the quality of life for older adults and should be integrated into digital inclusion programs.
... Given the large research gap, McKeon et al. (2017) called for more studies, as "it is important to understand how people with intellectual disability feel about their own social participation, including what they like and do not like, and to understand this from the person's perspective, rather than through proxy" (Wilson et al., 2020, p. 2). In fact, there is evidence that people with disabilities benefit from such e-services or internet-based communication tools, as they reduce barriers, are independent of time and place, and allow for remote monitoring as well as supporting people while they access and participate in the world of work (Manzoor & Vimarlund, 2017). In the present study, an ambulatory monitoring and coaching was used to assist adult people with disabilities during transitions to the primary labor market. ...
... In this context, the combination of Vygotsky's (1978) socio-cultural theory and the implications for inclusion from his work on defectology (1993) are significant. Manzoor and Vimarlund (2017) claim that facilitating self-expression and social communication for individuals with special needs, through writing or assistive technology depending on the disability in question, can contribute to positive social relationships and community experiences. This approach provides a basis for inclusivity and ensures that all individuals (with disabilities or otherwise) are socially integrated rather than marginalised or excluded. ...
Twice-exceptionality (2E) refers to individuals who possess both exceptional intellectual abilities and disabilities. This qualitative exploratory study primarily investigated the experiences of 2E learners and teachers who have previously taught, or currently teach, students with twice-exceptionality. The study examined such lived experiences with reference to philosophical, sociological and socio-cultural theoretical concepts. A combination of interviews and self-administered questionnaires was utilised for data collection following a protracted recruitment process in COVID-19 pandemic and post-pandemic conditions which, it was assumed, had limited consent to participate to seven teachers and five students based primarily in Plymouth. An indicative content analysis of the students` data and reflexive thematic analysis of teachers` data illustrated the importance of acknowledging of paradoxical combinations of ability and disability with additional conditions (e.g., eating disorders and depression). Socialisation difficulties in 2E students with autism and organisational skill problems in high potential students with ADHD were identified. Some teachers observed different characteristics in 2E students such as overconfidence and creative writing skills. However, it was also found that participating teachers were unaware of aspects of 2E and tended to avoid classifying their students as 2E or gifted. Thus, the generation of data on the lack of awareness of 2E provided an additional benefit and contribution to knowledge. The study emphasised the importance of tailored support and inclusive practices, intending to ensure that the voices of 2E students and teachers are heard and to determine their needs. With reference to empirical data and the existing literature, it will contribute the recognition and broader understanding of twice exceptionality, offering valuable insights for educational practitioners, policymakers, and researchers. Further research into this complex intersection of issues in diversity, inclusion, and twice-exceptionality is encouraged to enhance inclusivity and educational systems for 2E individuals.
... Despite much empirical research being based on web accessibility, much of it has focused on the limitations itself of assistive technology, not on accessibility in digital services or accessibility as a competitive advantage. Most of the accessibility studies focus on web accessibility literature reviews (e.g. the studies by Borg, Lantz & Gulliksen 2015); Manzoor & Vimarlund 2017;Kärpänen 2021). Competitive advantage or value creation through digital services studies have been published (Jeansson, Nikou, Lundqvist, Marcusson, Sell & Walden 2017;Rantala et al. 2019;Saunila et al. 2017), but these studies do not include web accessibility point of view. ...
Digitalization and digital services have brought new challenges to organizations. Digital services need to be designed for all, and services need to be accessible to all people. Because of the prevalence of digital services, they should be available and accessible to all people regardless of any limitations that they may have. Web accessibility enhances and improves the usage of digital services for all people by considering technical requirements and cognitive accessibility features such as usability, and understandable content in digital services. This literature review was conducted through meta-synthesis. The purpose of this study was to review the qualitative literature and studies on web accessibility features increasing competitive advantages in digital services and to identify areas of inquiry for future qualitative research in this context. Based on the literature review analyses, the author defined three themes: how web accessibility in digital services can increase competitive advantage. These themes included different competitive advantage features which were categorized under each theme. Based on the literature review results, an understanding of the existing qualitative research and suggestions for possible competitive advantages of web accessibility for the organization was obtained.
... Digital exclusion is a problem because ICT can provide opportunities for people with disabilities to participate in the community (Chadwick et al., 2019;Manzoor & Vimarlund, 2017). ...
Information and communication technology has become an important aspect of everyday life, including community living and social participation. However, people with intellectual disabilities face several societal inequalities, including digital exclusion. Even if people with intellectual disabilities still do not have the same access as others, this group is increasingly involved in digital technology design activities. Although digital technology design activities can lead to several user gains, little is known about how such activities affect digital inclusion. Therefore, we explore whether and how participation in digital technology design activities can support the digital inclusion of young adults with intellectual disabilities. We interviewed seven young adults with intellectual disabilities about their participation in ten digital technology design sessions. We also collected reflective notes from eight support workers who participated in the same design activities. The interviews were analysed thematically. Thematic analysis generated four themes describing how participation in technology design activities can support the digital inclusion of people with intellectual disabilities: improving digital skills and knowledge, displaying skills and competence, increased interest in technology use, and influencing and adapting technology. Participation in digital technology design activities with support workers can provide new opportunities for young adults with intellectual disabilities and can help overcome several digital activity barriers. Designers and researchers should increasingly, and actively involve people with intellectual disability in digital technology design activities as it can support and promote digital inclusion. We talked to young adults with intellectual disabilities about taking part in design activities. The people we talked to said that they learned more about technology, how to use it and became more interested in using it. The results show that taking part in technology design activities supports the digital inclusion of people with intellectual disabilities. When designing technology, it is important to involve people with intellectual disabilities. We talked to young adults with intellectual disabilities about taking part in design activities. The people we talked to said that they learned more about technology, how to use it and became more interested in using it. The results show that taking part in technology design activities supports the digital inclusion of people with intellectual disabilities. When designing technology, it is important to involve people with intellectual disabilities.
... Despite much empirical research based on accessibility, much of it has focused on the disability itself or assistive technology, not cognitive accessibility in general. Most of the studies are focused on literature reviews, e.g. the studies by Borg et al. and Manzoor et al. [12][13], quantitative studies in the accessibility field, e.g. Sintov et al.'s [14] study or mixed-method studies, e.g. by Johansson et al. [15]. ...
The purpose of this study was to review the qualitative literature on cognitive accessibility in a digital environment and areas of inquiry for future qualitative research in this context. The focus of this literature review was to identify qualitative research in the cognitive accessibility field and how commonly this term is mentioned in qualitative research articles. In this study, a literature review was conducted on selected qualitative research studies performed globally related to cognitive accessibility. This literature review analysed through meta-synthesis. Based on the results of the literature review, an understanding of existing qualitative research was obtained in the cognitive accessibility field, as well as topics for further qualitative research in the cognitive accessibility field.
... In contemporary society, mediated interactions (e.g. interactions using a device such as a mobile phone, internet tablet or computer) have increased and now complement face-to-face interactions (Manzoor & Vimarlund 2017;Thomson 1995). However, for young adults with intellectual disability (ID), mediated interactions can be difficult. ...
Staff in residential care are key support people for young adults with mild to moderate intellectual disability in everyday life. The aim of this study was to identify how staff members work with young adults with mild to moderate intellectual disability to enable their independence and participation through Information and Communication Technology (ICT). A narrative approach was used to analyse focus group interviews with staff in a residential care setting. Staff members reported a variety of ways to position themselves in relation to the service-user when using ICT, such as advocates, moral guardians and enablers. These positions bring different consequences for the service-users to realize their rights as stated in the Convention on the Rights of Persons with Disabilities. Organisational resources appear continuously in staff narratives as hindering or supporting in the use of ICT for participation purposes of young adults with ID.
... Studies can also be found on e-services that support individuals' participation in the community and in the labor market [14,15]. In general, the published studies with the focus on social integration of individuals with some disability seem to lack theoretical frameworks framing [16,17] and the e-services or ICT based applications suggested or prototyped are usually developed without any participation of the end-users [18,19]. Further, there are seemed to be a lack of studies that describe how the implementation process should be carried out and which factors that are of special relevance for a successful and sustainable implementation of eservices or ICT based applications for individuals with disabilities. ...
Background: In recent years, the interest of performing research about and providing e-services for individuals with disabilities has grown significantly. However, there is a knowledge gap in the existing literature on how to stimulate the pre-requisites needed for a sustainable implementation of e-services.
Aim and Method: The study aims to contribute to this knowledge gap by performing semi-structured email interviews with twelve project coordinators from the EU programmes of FP6-IST and FP7-ICT.
Results: The findings showed that knowledge-based and financially based resources, the complexity of the project context, ethical issues and the structural responsibility of the implementation process were key issues in creating a sustainable implementation. Furthermore, users often were not able to perceive added value from the e-services as they seldom were developed beyond prototypes within the research project.
Conclusion: The implementation of e-services and / or ICT based applications for individuals with disabilities face similar challenges to the challenges that have been identified when implementing IT-based innovations. Further studies should focus on how users can be involved in the choice and development of e-services they understand as effective, and how to ensure that the implementation strategy will contribute to long-term social inclusion, that is, sustainability.
Many technologies are referenced in the case of digital transformations, but internet technologies, emerging technologies, internet of things (IoT), analytical technologies, and mobile technologies are the most relevant in this chapter. Internet technologies, a collection of internet-based communication tools, can be used in the digital transformation of marginalized populations. Internet of things help marginalized communities seek opportunities, meet new targets, and minimize threats as people can have physical objects or self-reporting devices that improve productivity and rapidly bring vital information to the surface. When all this information has been collected, there is a need to identify the patterns and trends and produce meaningful insights using the analytical tools. Mobile technologies are technologies that go where a user goes, so communication, buying and selling, and making payments are possible with mobile phones. Governments and corporates should facilitate the adoption of digital technologies to promote digital inclusion in marginalized communities.
In today’s world, organizations face constant and various changes, such as new technologies, new markets, changing legal and regulatory frameworks, internal organizational changes, and changes in customer’s needs (Butt, Nawab, Zahid 2018). As public sector organizations, public libraries also face changes and the need for change. Modern society expects libraries to have access to information, to offer cultural and lifelong learning activities, and to contribute in reducing informational, digital and social exclusion. In order to meet the changing needs of society, public libraries are expanding their roles from book supply places to community centers, offering lifelong learning activities, free access to information resources, cultural and information events as well as leisure and spaces for social interaction. Therefore, defining the concept of an inclusive library can, on the one hand, broaden the concept of an inclusive organization and, on the other hand, contribute to improving the quality of library services in order to reduce social exclusion in communities and society in general. Applying the analytical content analysis of theoretical sources and scientific literature on the main features of an inclusive organization, the article aims to define the essential features of a socially inclusive library as a public organization and to analyse the concept of an inclusive library.One of the main goals of organizational change today is to achieve social responsibility and maximize sustainability. Social responsibility in organizations means meeting the needs of stakeholders and the sustainable development of the organization (Mory et al. 2016). In the context of social responsibility, the concept of organizational inclusion emerges. An inclusive organization is a modern organization. Such organization is based on its internal resources and must constantly increase its potential, improve all activities, develop plans to achieve these activities, in other words, it must evolve and be a constantly developing organization (Zakarevicius, 2012). The analysis of the scientific literature suggests, that the definition of inclusive organization in the context of public organizations is widening – from focusing on employee inclusion to a concern for the well-being of all society in general, especially for those, experiencing social exclusion.Today, being public sector organizations, libraries are in the state of constant change. Libraries are influenced by innovations which require changes in their activities (Carrillo, Gregory, 2019). At the same time, society’s expectations for libraries are changing – libraries are becoming community centers, creating and sharing knowledge, and at the same time carrying out traditional bookkeeping and publishing activities (Irwin, Silk, 2019). The following roles of the public libraries are offered in the scientific literature: informational, educational cultural, communal and social role. In the context of changing library roles, the need for the library to become a socially responsible and inclusive organization is emphasized. All public organizations, including public libraries, are required to be accountable for how their services contribute to the well-being of society (Racelis, 2018). Applying the analytical content analysis of theoretical sources, the concept of the inclusive library is defined – the inclusive library is accessible to all members of different social groups in society, inclusive library cares for its employees, develops their competencies, meets customer’s needs, and involves all members of the community it serves. The concept of inclusive library, unlike other inclusive public organizations, emphasizes not only the need to respond to the needs of stakeholders (which is common to all inclusive organizations), but also emphasizes a wide variety of stakeholders and their needs that are not always easily predicted. Library customers include people of all ages and social backgrounds, from children to older people. In addition, libraries can constantly expand their partner network and engage them in activities by collaborating with other formal and informal organizations of the community, that are interested in engaging people in learning, employment, etc. Another important aspect is that the inclusive library must constantly focus on the quality, diversity, accessibility and competencies of its staff, as library staff competencies are essential in ensuring quality of library services.To sum up, it is important to mention, that the changing roles of libraries and the constant desire to respond to and meet the needs of different groups of society members, determine the need for libraries to become socially responsible and inclusive organizations. All public organizations, as well as public libraries, are required to take responsibility for the public good and the delivery of social services to the public. This encourages libraries to change and to become inclusive organizations themselves. By implementing and effectively managing the process of change, libraries can become socially inclusive – libraries whose services are accessible to members of all different social groups in society, which care about the well-being of their employees, meet a customer’s needs, and engage community and serve various people. These features distinguish libraries from other public organizations. Public libraries, being community centers, can provide equal access to cultural, informational, lifelong learning activities, self-education events, and meaningful leisure activities for all people. In this way, the inclusive library creates extra value for society and contributes to social justice. Public libraries can act as social justice executors, providing all members of the society with access to resources of information, enabling them to participate in educational and cultural activities and events. The extensive network, the variety of free services and the availability of these services enable libraries to become community centers – places where people gather to learn, participate in events, and spend their free time.
BACKGROUND: Intelligent Personal Assistants have been booming around the world since 2014, allowing millions of users to interact with different cloud-based software via speech. Unfortunately, the Deaf and Hard of Hearing individuals have been left out without recognizable accessibility to such technologies, although it might be used to make their daily life routine easier. OBJECTIVE: In this research, the researcher studies the interaction and perception of Amazon’s Alexa among the Deaf and Hard of Hearing in the United Arab Emirates in its current set up (Tap-to-Alexa accessibility option) in addition to Sign Language as an input method. The researcher expands on the Technology Acceptance Model to study the acceptance of Alexa as an assistive technology for the Deaf and Hard of Hearing. Additionally, the researcher discusses more suitable input methods and solutions to allow Alexa, and other Intelligent Personal Assistants, be more accessible for the Deaf and Hard of Hearing. METHODS: The mixed method is used in this research in terms of collecting primary data through hands-on experiments, surveys, and interviews with the Deaf and Hard of Hearing participants. RESULTS: The researcher found that the Deaf and Hard of Hearing in the United Arab Emirates perceive that Sign Language combined with a Live interpreter is better than the accessibility option “Tap-to-Alexa”, which is a solution provided by Amazon. The researcher also found that Sign Language combined with a Live interpreter is the most suitable input method to make the device accessible for the Deaf and Hard of Hearing, in addition to translating the “Tap-to-Alexa” to different languages. Finally, the researcher proposes a modification to the Technology Acceptance Model to suit the research study of the Deaf and Hard of Hearing perception of Alexa. CONCLUSIONS: The researcher concludes that the ideal scenario for the Deaf and Hard of Hearing to interact and benefit the most from Amazon’s Alexa, and IPAs in general, is to include Sign Language as an embedded input method in the device and provide live interpreters; this sheds light on the importance of the interpreters’ jobs around the world. Additionally, “Tap-to-Alexa” must be translated into different languages for a better perception of the input method.
In today’s world, information and communication technologies (ICT) and the ability to use their potential effectively, provide access to the latest information, digital services, communication, prompt inclusion in the labour market, participation in lifelong learning, and are an integral part of the successful functioning of society (Ekbia, 2016; Fabre and Popova, 2017). At the same time, the growing importance of ICT creates new challenges in ensuring equal opportunities for all, without exception, to have access to technological equipment, the Internet, the development of digital competences and digital services, and to enable them to use ICT effectively. The need to increase digital inclusion is particularly important in this area. Digital inclusion is associated with enabling socially excluded groups in society to use digital technologies effectively: for effective communication, participation in various activities, involvement in society and community (Real et al. 2014; Newman et al. 2017). The goals of digital inclusion are inseparable from the goals of social inclusion (Farooq et al., 2015; Beyene, 2018), in which the inclusion of all persons without exception, especially those belonging to socially excluded groups, in society and community is important. Caruso (2014), Bertot (2016), Borg and Smith (2018), Beyene (2018), Strover et al. (2020) note that digital inclusion comprises three key principles: access to the latest technologies, ICT adoption and application. The principle of application is the most important principle. It comprises the effective use of ICT, digital information and digital competences for learning, employment, self-education, civic participation, health strengthening and other purposes.
Public libraries are very important organizations in increasing digital inclusion. In order to increase digital inclusion, public libraries should carry out activities aimed at providing access to ICT and the Internet, improving the digital competences and offering digital services. In this area, it is particularly important for public libraries to exploit the potential of their wide network of institutions, the variety of free services and possibilities to cooperate with other organizations. These aspects exclude public libraries from other institutions, enabling them to involve more people in digital inclusion activities and reach the most vulnerable groups of society that often experience social exclusion (Yılmaz and Cevher, 2015; Casselden, Pickard and McLeod, 2015; Appleton et al. 2018; Wyatt, Mcquire and Butt, 2018). The need to foster digital inclusion highlights the necessity to assess the activities of public libraries in increasing digital inclusion empirically. The aim of this article is to investigate the activities of public libraries in increasing the digital inclusion and to identify possible directions for the improvement of digital inclusion. The case of Šiauliai region was chosen for the empirical research. The methods of scientific literature content analysis, structured E- mail interview, systematization and generalization of collected data and secondary data analysis were employed in this research.
The empirical research has shown that the activities of Šiauliai region libraries in the field of increasing digital inclusion include the main ones discussed in the scientific literature (Caruso, 2014; Nemer, 2015; Bertot, 2016; Luterek 2017; Beyene, 2018; Gregg and McKendry, 2018; Strover et al. 2020); ensuring free access to ICT and the Internet, developing digital competences and providing digital services. Free access to ICT and the Internet offered by public libraries is important for people with disabilities and seniors, providing opportunities to take care of health, communicate with relatives and save money. Digital literacy training in libraries, individual consultations and some digital services (e.g. e-books, virtual events) are relevant to these target groups. However, the involvement of people with disabilities and seniors in these activities is insufficient, especially in the area of access to digital services. The empirical research showed that the involvement of these target groups in the digital inclusion activities offered by libraries is limited. This limitation is caused by such reasons as lack of personal motivation, lack of digital skills, not adapted libraries infrastructure and technological equipment and lack of information about these activities.
Taking these aspects into account, it is recommended for public libraries to increase the diversity of access to digital services, intensify initiatives to publicize information about these services and develop cooperation with organizations, representing these target groups (care homes, associations of the disabled, organizations representing seniors, daycare centers, etc.). This cooperation could increase the involvement of people with disabilities and seniors in the activities offered by libraries and contribute to the increase of digital inclusion.
Purpose and Originality: This study aims to analyse the concept of an inclusive and socially
responsible library, to develop the theoretical model of an inclusive library for people with disabilities,
and to investigate the practical possibilities for implementing this model in regional libraries in order to
reduce social exclusion of people with disabilities and to increase their social inclusion. The paper
presents the results of empirical research conducted in two counties of Lithuania. Based on the results
of the interviews of heads of libraries and heads of organizations representing people with disabilities,
the model of an inclusive library was supplemented and the change management of an inclusive library
was actualized.
Method: The methods of this study are based on stakeholder theory (Dangi & Gribb, 2018, pp. 339–
341; Harrison, Freeman & Abreu, 2015, pp. 859–860; Lipiński & Jamro, 2018, p. 225), where the
management of stakeholders involves meeting their needs and ensuring their wellbeing. The theoretical
part of the research uses the methods of scientific literature analysis, generalization, and systematization,
which enabled to theoretically define the concept of an inclusive public library for people with
disabilities, substantiate the instrument of the empirical research, and discuss the results of the empirical
research. In the empirical part, a qualitative method of e-mail interviews was chosen to conduct the
opinion survey of organizations representing people with disabilities and heads of libraries. The
obtained results were analysed, then the theoretical model of an inclusive library was supplemented
with practical insights of the empirical research.
Results: The results of the research showed that a changing public attitude towards public services and
their accessibility (expectation is greater accessibility and diversity) stipulates the change in the roles of
budget-based libraries and preconditions the development of an inclusive library for people with
disabilities. Based on the theoretical and empirical findings obtained during the research, the model of
an inclusive library for people with disabilities was developed and substantiated. Also, it was proved
that the development of an inclusive library for people with disabilities requires the change management
which involves stakeholders, i.e. representatives of people with disabilities and institutions
implementing public policy at the national and local level, into all stages of the transformation process
to become an inclusive organization for people with disabilities.
Society: This study highlights the need to increase the social inclusion of libraries to meet the needs of
all stakeholders, including people with disabilities. Increasing the social inclusion of libraries can reduce
the social exclusion of people with disabilities and promote their inclusion in the community and society in broad terms. An inclusive library creates added value for society and contributes to the
implementation of social justice.
Limitations / further research: The empirical research was conducted in two counties of Lithuania
(Šiauliai and Telšiai), involving 10 libraries. Because budget-based libraries in Lithuania have a similar
management structure, operate on the grounds of the same strategic documents of the Republic of
Lithuania, have similar opportunities provided by the Government and the Ministry of Culture to engage
in innovative activities and address social problems, the results of the empirical research can be applied
at the national level, except for the capital region, which should be investigated separately due to the
high concentration of specialized libraries and the National Library. It would also be useful to analyse
the best practices of other European countries whose libraries have made the largest progress in
promoting social inclusion.
Many state governments, local officials, academics and even policy advocacy organizations continue to seek models of approaches that will help them assess the probability of municipal financial distress and crisis as we face an uncertain future. Local communities meet challenges where important decisions will need to be made about to efficiently and effectively allocate scarce public resources with limited capacity. This research aims at examining the spatial patterns of local governments' fiscal condition. More specifically, the proximity of a municipality to the urban centers of Omaha and Lincoln, NE.
Recently, there have been numerous innovations and advancements in technology to improve the health of people with mobility limitations. These changes are expected to enhance their living standards leading to potential employment opportunities and to improve the overall economics for them, their supporters, and their communities. To address those changes, we looked into assistive technologies and the surrounding technical improvements around those devices to address their economic impacts. The advances include the progress with information and communication technologies, brain-controlled interactions, and connectivity of all these devices or the Internet of Things to provide solutions for these populations to improve their abilities for better employment opportunities to create more value in the economy. Although there are many promising devices, communication tools, interconnections, and networks to allow the disabled to enhance their livelihood, yet there are also many barriers and challenges to consider to achieve economic benefits to the full extent.
We hypothesized that the effects of immediate video feedback (IVF) on training ramp, wheelie, and curb wheelchair skills for persons with spinal cord injury (SCI) would be equivalent to or better than the traditional wheelchair skill training. Participants were manual wheelchair users with recent SCI (thoracic 1-lumbar 1) who were matched (9 pairs) on motor function level, age, and sex and randomly assigned to a control group (conventional training) or an experimental group (IVF training). Participants learned three wheelchair skills and then went through the wheelchair skill competency test, retention test, and transfer test. Paired t-tests were used to examine the differences in training time (minutes), spotter intervention needed (counts), and successful rate in performance between the two groups. A 2 (groups) x 3 (skills) x 3 (tests) repeated-measures analysis of variance and Bonferroni adjustment test were used to examine differences between groups on wheelchair skills and tests. No differences were found between two groups in training times (minutes) on three wheelchair skills (experimental vs control: ramp 14.92 +/- 5.80 vs 11.69 +/- 7.85; wheelie 17.79 +/- 6.03 vs 19.92 +/- 13.42; and curb 38.35 +/-23.01 vs 48.59 +/- 15.21). This study demonstrated that IVF for training manual wheelchair skills may produce similar results as the conventional training and may be an alternative training method for wheelchair skills.
Recent growth in information technology has set the pace for an electronic revolution leading to emergence of electronic services. Business to consumer e-service assists organizations to decrease costs, speed up delivery time and serve more customers. Therefore, many enterprises have already moved or planning to move their services and goods to the electronic environment. In this regard, it is crucial to recognize the characteristics of each type of products and services. The main goal of this research is to provide an extensive review and gather conceptual perspectives of electronic services. In order to understand the nature of electronic services it is essential to explore the characteristics, advantages and barriers of e-services. This study sets theoretical and research foundation for future empirical researches by differentiates of service and e-service features and furthermore categorization of e-service users.
This article explores the dynamics of a long-term telephone support group, over eight years, for individuals with multiple sclerosis (MS). MS is a progressive neurological disease that frequently affects mobility and engenders isolation. All of the participants in this group are physically disabled by their disease. The mobility challenges of this population led to the idea of using conference call technology as a treatment modality. Incorporating theory from neurobiology research, this article chronicles the implementation of the group and offers observations about the interplay between individual self-esteem, group participation, and the use of technology in mental health treatment.
This paper highlights the necessity to respect international accessibility and e-learning standards in creating Web sites or assistive software and provides solutions for access to learning objects, through web services using voice synthesis and speech recognition in Romanian. Inclusive education aims are facilitating the access to information, learning and the reduction of the possible risk of social exclusion. This article also aims to find the most appropriate way to combine the promotion and the awareness of both the general public and of those directly involved, of the importance and usefulness of such solutions in Romania.
Background:
Walking-related disability is the most frequent reason for inpatient stroke rehabilitation. Task-related practice is a critical component for improving patient outcomes.
Objective:
To test the feasibility of providing quantitative feedback about daily walking performance and motivating greater skills practice via remote sensing.
Methods:
In this phase III randomized, single blind clinical trial, patients participated in conventional therapies while wearing wireless sensors (triaxial accelerometers) at both ankles. Activity-recognition algorithms calculated the speed, distance, and duration of walking bouts. Three times a week, therapists provided either feedback about performance on a 10-meter walk (speed only) or walking speed feedback plus a review of walking activity recorded by the sensors (augmented). Primary outcomes at discharge included total daily walking time, derived from the sensors, and a timed 15-meter walk.
Results:
Sixteen rehabilitation centers in 11 countries enrolled 135 participants over 15 months. Sensors recorded more than 1800 days of therapy, 37 000 individual walking bouts, and 2.5 million steps. No significant differences were found between the 2 feedback groups in daily walking time (15.1 ± 13.1 vs 16.6 ± 14.3 minutes, P = .54) or 15-meter walking speed (0.93 ± 0.47 vs 0.91 ± 0.53 m/s, P = .96). Remarkably, 30% of participants decreased their total daily walking time over their rehabilitation stay.
Conclusions:
In this first trial of remote monitoring of inpatient stroke rehabilitation, augmented feedback beyond speed alone did not increase the time spent practicing or improve walking outcomes. Remarkably modest time was spent walking. Wireless sensing, however, allowed clinicians to audit skills practice and provided ground truth regarding changes in clinically important, mobility-related activities.
Background
Arthritis and musculoskeletal conditions are the leading cause of long-term work disability (WD), an outcome with a major impact on quality of life and a high cost to society. The importance of decreased at-work productivity has also recently been recognized. Despite the importance of these problems, few interventions have been developed to reduce the impact of arthritis on employment. We have developed a novel intervention called “Making It Work”, a program to help people with inflammatory arthritis (IA) deal with employment issues, prevent WD and improve at-work productivity. After favorable results in a proof-of-concept study, we converted the program to a web-based format for broader dissemination and improved accessibility. The objectives of this study are: 1) to evaluate in a randomized controlled trial (RCT) the effectiveness of the program at preventing work cessation and improving at-work productivity; 2) to perform a cost-utility analysis of the intervention.
Methods/Design
526 participants with IA will be recruited from British Columbia, Alberta, and Ontario in Canada. The intervention consists of a) 5 online group sessions; b) 5 web-based e-learning modules; c) consultations with an occupational therapist for an ergonomic work assessment and a vocational rehabilitation counselor. Questionnaires will be administered online at baseline and every 6 months to collect information about demographics, disease measures, costs, work-related risk factors for WD, quality of life, and work outcomes. Primary outcomes include at-work productivity and time to work cessation of > 6 months for any reason. Secondary outcomes include temporary work cessation, number of days missed from work per year, reduction in hours worked per week, quality adjusted life year for the cost utility analysis, and changes from baseline in employment risk factors. Analysis of Variance will evaluate the intervention’s effect on at-work productivity, and multivariable Cox regression models will estimate the risk of work cessation associated with the intervention after controlling for risk factors for WD and other important predictors imbalanced at baseline.
Discussion
This program fills an important gap in arthritis health services and addresses an important and costly problem. Knowledge gained from the RCT will be useful to health care professionals, policy planners and arthritis stakeholders.
Trial registration
ClinicalTrials.gov NCT01852851; registered April 13, 2012; first participant randomized on July 6, 2013.
Purpose ‐ The purpose of this paper is to show how personalisation of learning resources and services can be achieved for students with and without disabilities, particularly responding to the needs of those with multiple disabilities in e-learning systems. The paper aims to introduce ONTODAPS, the Ontology-Driven Disability-Aware Personalised E-Learning System, which has the mechanism for such personalisation. Design/methodology/approach ‐ This paper reviews current e-learning systems that provide personalisation for students, including their strengths and weaknesses. The paper presents personalisation and its techniques and then presents ONTODAPS, which personalises learning resources and services to students. In total, three case studies are considered to show how personalisation is achieved using ONTODAPS. Findings ‐ This paper shows that it is possible to use automated ontology-based agents intercommunicating to provide an effective personalisation for disabled students. The results reveal that ONTODAPS is flexible enough to provide enough control and freedom to drive their learning. The results also suggest that ONTODAPS has the ability to provide appropriate levels of learner control by allowing them to self-direct learning through personalising learning resources and then allowing them to choose which resources they wish to access. This thus gives them a sense of ownership and control. Research limitations/implications ‐ This research reveals that it is possible for e-learning systems to personalise learning for users with multiple disabilities. Thus, by considering the needs of such users and consulting them in the design and development process, developers of e-learning systems can produce systems that are both accessible and usable by students with disabilities. Practical implications ‐ The inclusion of multiple formats of learning resources and personalisation of their presentation to students means students will have increased access to such resources, with the potential of consuming and assimilating the information. This also has the potential of improving understanding and hence and improvement in results. Social implications ‐ This research shows that ONTODAPS is a medium where disabled students can have equivalent learning experience with their non-disabled peers. This could potentially increase access to learning for disabled students and possibly help improve their results due to an increase in accessibility of learning resources and usability of the system. This system thus complies with contemporary legislation which requires "reasonable adjustments" or "reasonable accommodations" to be made to meet the needs of disabled people. Originality/value ‐ Although personalisation has been applied in e-commerce systems, making them very successful, such personalisation is still a wish for e-learning systems which struggle to catch up. This research proposes a solution in the e-learning domain and its novelty is in its application to disabled students, including those with multiple disabilities.
The Veterans Health Administration (VHA) has promoted the use of telehealth technologies to deliver mental health care to veterans with limited access to services on account of geographic and other barriers. The use of technology to deliver interventions to veterans with posttraumatic stress disorder (PTSD) has been a particular focus within VHA. Much less attention has been paid to the use of telehealth technologies to diagnose veterans with PTSD for both treatment and/or disability compensation purposes, in spite of the need for such services. The literature evaluating the use of video teleconferencing methods in the assessment of PTSD is limited; to our knowledge, only 1 previous study has been published. The current study evaluated the psychometric characteristics of the Clinician Administered PTSD Scale (CAPS) administered by video teleconferencing with a larger and more diverse sample of veterans. The CAPS raters had high interrater reliability and there were strong correlations between face-to-face CAPS assessments and video teleconferencing CAPS assessments for diagnosis and total severity. The results suggest that the CAPS can and should be used via video teleconferencing with veterans who have barriers to face-to-face evaluations. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Four groups of postsecondary students, 25 who were deaf/hard of hearing (D/HH), 25 with a learning disability, 25 who were
English language learners (ELLs), and 25 without an identified disability studied notes that included text and graphical information
based on a physics or a marine biology lecture. The latter 3 groups were normally hearing. All groups had higher scores on
post- than on pretests for each lecture, with each group showing generally similar gains in amount of material learned from
the pretest to the posttest. For each lecture, the D/HH students scored lower on the pre- and posttests than the other 3 groups
of participants. Results indicated that students acquired measurable amounts of information from studying these types of notes
for relatively short periods and that the notes have equal potential to support the acquisition of information by each of
these groups of students.
The general adoption of mobile devices and its wide network coverage made it possible to make
emergency calls virtually everywhere, even in the absence of a valid contact. However, there is still generally the need for audio connection.
This restriction is a problem for deaf people, but also for the elderly and people without disabilities who face sudden situations where speech is hard to articulate. In this context, this paper presents SOSPhone, a prototype of a mobile application that was developed to enable users to make emergency calls using an iconographic touch interface running in a touchscreen mobile device. The prototype implements the client-side of the application and was demonstrated and evaluated by a large number of users, including people without any disability, emergency services' professionals and deaf people. This paper describes the SOSPhone prototype and presents the results of the interface evaluation process, which is important to validate the main client-side interaction and architectural principles in order to proceed with the integration with each specific national emergency services' platform.
Purpose:
Technology could support the self-management of long-term health conditions such as chronic pain. This article describes an evaluation of SMART2, a personalised self-management system incorporating activity planning and review, feedback on behaviour- and acceptance-based therapeutic exercises.
Method:
The SMART2 system was evaluated over a four-week trial in the homes of people in chronic pain. At conclusion, participants were interviewed to understand the experience of using and living with the SMART2 system as a therapeutic tool.
Results:
Qualitative analysis of the interviews found that participants liked the system and reported making associated changes to their behaviour. Goal setting and feedback were the most useful elements of the system. A third key and unexpected element was that by simulating some of the functions of a therapist, SMART2 also simulated some of the process of interacting with a therapist.
Conclusions:
People in chronic pain may experience positive outcomes when using a self-management system designed for behaviour change. Furthermore, some of the supportive aspects of the therapeutic context can be elicited by self-management technologies. Implications of Rehabilitation Self-management technology has the potential to assist rehabilitation by supporting goal setting and providing feedback. By simulating some of the functions of a therapist, technology can simulate some of the process of therapy during rehabilitation. People in chronic pain liked using the technology in their own home and thought it could augment services delivered by clinical practitioners. Complex programmes of therapeutic exercises delivered by technology had limited success in engaging people in chronic pain.
Purpose:
To evaluate typing and pointing performance and improvement over time of four able-bodied participants using an intra-oral tongue-computer interface for computer control.
Background:
A physically disabled individual may lack the ability to efficiently control standard computer input devices. There have been several efforts to produce and evaluate interfaces that provide individuals with physical disabilities the possibility to control personal computers.
Method:
Training with the intra-oral tongue-computer interface was performed by playing games over 18 sessions. Skill improvement was measured through typing and pointing exercises at the end of each training session.
Results:
Typing throughput improved from averages of 2.36 to 5.43 correct words per minute. Pointing throughput improved from averages of 0.47 to 0.85 bits/s. Target tracking performance, measured as relative time on target, improved from averages of 36% to 47%. Path following throughput improved from averages of 0.31 to 0.83 bits/s and decreased to 0.53 bits/s with more difficult tasks.
Conclusions:
Learning curves support the notion that the tongue can rapidly learn novel motor tasks. Typing and pointing performance of the tongue-computer interface is comparable to performances of other proficient assistive devices, which makes the tongue a feasible input organ for computer control.
Implications for rehabilitation:
Intra-oral computer interfaces could provide individuals with severe upper-limb mobility impairments the opportunity to control computers and automatic equipment. Typing and pointing performance of the tongue-computer interface is comparable to performances of other proficient assistive devices, but does not cause fatigue easily and might be invisible to other people, which is highly prioritized by assistive device users. Combination of visual and auditory feedback is vital for a good performance of an intra-oral computer interface and helps to reduce involuntary or erroneous activations.
Various models of the information society have been developed so far and they are so different from country to country that it would be rather unwise to look for a single, all-encompassing definition. In our time a number of profound socio-economic changes are underway. The application of these theories and schools on ICT is problematic in many respects. First, as we stated above, there is not a single, widely used paradigm which has synthesised the various schools and theories dealing with technology and society. Second, these fragmented approaches do not have a fully-fledged mode of application to the relationship of ICT and (information) society. Third, SCOT, ANT, the evolutionary-or the systems approach to the history of technology when dealing with information society – does not take into account the results of approaches studying the very essence of the information age: information, communication and knowledge. The list of unnoticed or partially incorporated sciences, which focuses on the role of ICT in human information processing and other cognitive activities, is much longer.
Touch technology is becoming more prevalent as functionality improves and cost decreases. Therefore, it is important that this technology is accessible to users with diverse abilities. The objective of this study was to investigate the effects of button and gap size on performance by individuals with varied motor abilities. Participants with (n = 38) and without (n = 15) a motor control disability completed a digit entry task. Button size ranged from 10 to 30 mm and gap size was either 1 or 3 mm. Results indicated that as button size increased, there was a decrease in misses, errors, and time to complete tasks. Performance for the non-disabled group plateaued at button size 20 mm, with minimal, if any gains observed with larger button sizes. In comparison, the disabled group's performance continued to improve as button size increased. Gap size did not affect user performance. These results may help to improve accessibility of touch technology.
The increasing spread of the Internet holds much potential for enhancing opportunities for people with disabilities. However, scarce evidence exists to suggest that people with disabilities are, in fact, participating in these new developments. Will the spread of information technologies (IT) increase equality by offering opportunities for people with disabilities? Or will a growing reliance on IT lead to more inequality by leaving behind certain portions of the population including people with disabilities? In this paper, the authors draw on nationally representative data regarding Americans' Internet uses to (1) identify the extent to which people with disabilities are embracing use of the Internet; (2) how their use of the Internet compares with the Internet uses of the rest of the population; (3) how having a disability relates to and interacts with other social statuses (e.g. socioeconomic status, age, gender) with regard to Internet use; and (4) what explains these trends. They draw on representative data collected by the Bureau of Labor Statistics and the Census of the United States to answer these questions. It is found that people with disabilities are less likely to live in households with computers, are less likely to use computers and are less likely to be online. However, once socioeconomic background is controlled for, it is found that people with hearing disabilities and those who have limited walking ability are not less likely to be Internet users. This research enables a deeper understanding of both the use of the Internet by people with disabilities and the spread of new IT more generally.
Pain is generally undertreated in the United States, owing to a number of barriers including geographic distance from specialty treatment providers; functional disability that limits mobility; treatment-related stigma; economic limitations; and educational barriers. Pain undertreatment exacerbates pain chronicity and emotional disruption that can significantly erode a pain patient's quality of life, and there is widespread agreement that pain care must evolve to address this significant problem. The growing field of telehealth (defined for the purposes of this paper as technology that allows for distance interaction between providers and/or patients) offers a novel opportunity to expand pain assessment, consultation, and treatment services beyond the walls of the specialty pain clinic, but there is limited availability of resources describing how to best use this technology to improve access to care. A recent literature review (September 2011) using universally endorsed MeSH search criteria revealed only 32 MEDLINE references focusing on telehealth for pain. This is surprising in light of the very large number of references covering telehealth (14,164 references) and pain (104,564 references), respectively. Of the studies available, there are very few randomized trials of telehealth pain care and only one general overview of e-health and chronic pain, which dedicates just a few paragraphs to telehealth. This manuscript represents one of the first comprehensive reviews of the current state of telehealth and pain management research and practice. The goals are to provide a rationale for the potential benefit of telehealth-based pain management services; describe the various applications of telehealth technology for pain management; orient the reader to cost models for telehealth; present examples of services in place; and offer recommendations for future research based on the current state of knowledge.
Over the last few years, information and communication technologies have become an essential part of daily life, affecting education, employment, and leisure, among other activities. Nonetheless, many individuals still reap few or no benefits from these technologies, and there are resilient gaps in their use. Within this larger context, the authors examine the Internet digital divide between people with and without disabilities from a multidimensional approach. Rather than analyzing the gap in terms of “haves” and “have-nots,” a range of Internet-related dimensions—affordability, motivation and attitudes, skills, usage, and others—is taken into account.
Caregivers and clinicians may be confronted with the dilemma whether to allow people in early stages of dementia to go outside independently with the risk of getting lost, or to limit their autonomy and mobility. Newly available technology may offer a solution. This pilot study is focused on the feasibility, acceptability, and effectiveness of a three-month use of Global Positioning System (GPS) by care receivers and caregivers.
Numbers and percentages of participants with positive responses to self-report questions were calculated. Differences between the pre- and post-test scores of role-overload and worry were tested with paired t-tests and effect-sizes were calculated.
Of the 33 dyads of care receivers and caregivers, 28 remained in the study (dropout rate 15%). The majority of the caregivers was able to use the technology and integrate the use into their daily routines and would recommend the use of GPS. Almost half of the participants with dementia experienced more freedom and were less worried when they were outside unaccompanied, a quarter mentioned that they were more outside independently and a fifth that they had less conflicts with their caregiver after three months. Caregivers showed a trend to feel less worried, especially caregivers who could reach their relative using the telephone connection. No changes in caregivers' feelings of role-overload were found.
The GPS device used in this study seems to be promising for people in early stages of dementia and their informal caregivers. A next step is to carry out a randomized controlled trial.
The concept of community access is a multidimensional term, which may involve issues related to physical access, knowledge and information, power and control, relationships and communications, advocacy, participation and quality of life [21]. This paper discusses historical and emerging practices and interventions related to physical access to community and community based information for individuals with cognitive disabilities such as intellectual disability, autism or traumatic brain injury. While much societal attention has been paid to features of independent community access for populations such as individuals with hearing, vision or physical disabilities, less attention has focused on independent community access for people with intellectual and other significant cognitive disabilities. Attitudes and actions by families and professional service communities are often mixed for some individuals in this population. The somewhat limited research base in these areas is explored, including a case study review and results from several promising feasibility studies. The paper concludes with comments concerning future prospects and recommendations for improving independent community access for persons with significant cognitive disabilities.
Wheeled mobility and seating assessments for individuals with mobility impairments living in rural or distant locations are problematic due to the lack of expertise and available resources. The objective of this study was to measure satisfaction based on one's evaluation and prescription as well as comfort level when being evaluated by telerehabilitation (TR). Patient satisfaction data from real-time interactive TR clinical consultations between an expert practitioner located at least 125 miles away and four remote wheelchair clinics set up by the research team were collected and evaluated. The results revealed that there was a statistically significant difference between participants' pre- and postevaluation scores, t(39) = -13.92, p < .05, as well as pre- and postprescription scores, t(39) = -13.15, p < .05. In addition, all mean scores were significantly higher than the scale midpoint of3.5 on a TR survey. The study's findings are consistent with those of previous telemedicine satisfaction studies. Overall, the results indicate a high level of patient satisfaction using TR.
In order to provide services for children with disabilities which are family focused, strengthening and enabling families in addition to meeting the child's identified needs, it is important to understand families' lives. This study investigates whether time-use diaries can provide an acceptable tool to explore the daily lives of parents with a disabled child.
A precoded time-use diary divided into 15 min time slots was designed. Father-mother pairs with a preschool child with either autism (ASD) or technology dependence (TD) were asked to complete a 7-day diary independently, over the same time period. Each parent was then interviewed separately to ascertain their experiences of using the diary. Participants were identified through their involvement with a Child Development Centre.
Twenty-six parents (13 father-mother pairs) were invited to participate. Eighteen parents agreed to be involved; 16 completed the diaries and interviews. Three father-mother pairs in the ASD group and one father-mother pair in the TD group declined to be involved. One father-mother pair from the TD group withdrew from the study. Of the 18 parents who agreed to participate, 15 found the diaries acceptable and either easy or straightforward to complete. One parent with dyslexia and one who described himself as a non-reader completed the diaries successfully, finding the colour coding helpful. Parents spent between 10 and 60 min a day completing the diaries, with the median 20-30 min. The diaries provided information on the total amount of time spent on different activities and how much time parents spent together, with their other children, at home or elsewhere.
The time-use diaries designed for this study were acceptable to the majority of parents and provided detailed information about their daily lives.
Video conferencing (VC) technology has great potential to increase accessibility to healthcare services for those living in rural or underserved communities. Previous studies have had some success in validating a small number of psychological tests for VC administration; however, VC has not been investigated for use with persons with intellectual disabilities (ID). A comparison of test results for two well known and widely used assessment instruments was undertaken to establish if scores for VC administration would differ significantly from in-person assessments.
Nineteen individuals with ID aged 23-63 were assessed once in-person and once over VC using the Wechsler Abbreviated Scale of Intelligence (WASI) and the Beery-Buktenica Test of Visual-Motor Integration (VMI).
Highly similar results were found for test scores. Full-scale IQ on the WASI and standard scores for the VMI were found to be very stable across the two administration conditions, with a mean difference of less than one IQ point/standard score.
Video conferencing administration does not appear to alter test results significantly for overall score on a brief intelligence test or a test of visual-motor integration.
Generalised Anxiety Disorder (GAD) is a highly prevalent psychiatric disorder. Effective prevention in young adulthood has the potential to reduce the prevalence of the disorder, to reduce disability and lower the costs of the disorder to the community. The present trial (the WebGAD trial) aims to evaluate the effectiveness of an evidence-based online prevention website for GAD.
The principal clinical question under investigation is the effectiveness of an online GAD intervention (E-couch) using a community-based sample. We examine whether the effect of the intervention can be maximised by either human support, in the form of telephone calls, or by automated support through emails. The primary outcome will be a reduction in symptoms on the GAD-7 in the active arms relative to the non active intervention arms.
The WebGAD trial will be the first to evaluate the use of an internet-based cognitive behavioural therapy (CBT) program contrasted with a credible control condition for the prevention of GAD and the first formal RCT evaluation of a web-based program for GAD using community recruitment. In general, internet-based CBT programs have been shown to be effective for the treatment of other anxiety disorders such as Post Traumatic Stress Disorder, Social Phobia, Panic Disorder and stress in clinical trials; however there is no evidence for the use of internet CBT in the prevention of GAD. Given the severe shortage of therapists identified in Australia and overseas, and the low rates of treatment seeking in those with a mental illness, the successful implementation of this protocol has important practical outcomes. If found to be effective, WebGAD will provide those experiencing GAD with an easily accessible, free, evidence-based prevention tool which can be promoted and disseminated immediately.
In recent years, we have witnessed the revolutionary advances of Information
Technology and Telecommunications. Technological progress is now rapidly
leading us to a new concept of an Information Society, where citizens with
different abilities, requirements, educational and cultural backgrounds and
preferences, will need to perform, in the context of their everyday life activities,
multi-modal interactions with multi-media applications and telematic services.
This unstoppable technology push offers new opportunities for all citizens in
society, including disabled and elderly people. However, it may also introduce
new barriers, human isolation and alienation, if the diverse requirements of all
potential users are not taken seriously into consideration.
Interactive, mobile, AGIle and novel education (IMAGINE) is a conceptual framework to help students with disabilities (SwD) participate more in the physical space and become more engaged in school. IMAGINE recommends and reminds students, and allows them to make requests of key learning resources (LRs). The goal of IMAGINE is to provide SwD with the location and time for attending a LR that is most optimal with respect to their learning style and preference, learning performance and other activities. IMAGINE will be a means through which SWD will be provided with tailored recommendations with respect to their daily activities to improve learning outcomes. A pilot was conducted with SwD who used IMAGINE’s navigation and wayfinding functionality, and the subjects reported that it aligns well with their needs. Preliminary results suggest that after completing a training and using the tool, SwD reported that they are more likely to use the tool and their participation may increase as a result. In contrast to before the trial, the SwD were also able to better describe the tool’s benefits and how to improve its functionality after using the tool for four weeks.
Some people without independent mobility are candidates for powered mobility but are unable to use a traditional power wheelchair joystick. This proof-of-concept study tested and further developed an innovative method of driving power wheelchairs for people whose impairments prevent them from operating commercial wheelchair controls. Our concept, Self-referenced Personal Orthotic Omni-purpose Control Interface (SPOOCI), is distinguished by referencing the control sensor not to the wheelchair frame but instead to the adjacent proximal lower-extremity segment via a custom-formed orthosis. Using a descriptive case-series design, we compared the pre-post functional power wheelchair driving skill data of 4 participants, measured by the Power Mobility Program, using descriptive analyses. The intervention consisted of standard-care power wheelchair training during 12 outpatient occupational or physical therapy sessions. All 4 participants who completed the 12-wk intervention improved their functional power wheelchair driving skills using SPOOCI, but only 3 were deemed safe to continue with power wheelchair driving.
Usage of mobile digital broadcasting technologies i n education is the most important of required technologies to provide main goals in distance educ ation. It offers learning and data accession opport unities to learners notwithstanding time and place. In acad emic education, it was found that one of the critic al problem is the appreciate education tool for disabi lities students. Students with special education ha ve difficulties to develop cognitive abilities and acq uire new knowledge. They could also need to improve their behavior, communication and relationships with thei r environment. The development of customizable and adaptable applications tailored to them provides ma ny benefits as it helps mold the learning process t o different cognitive, sensorial or mobility impairme nts. This reviewed paper defines mobile technologie s universally designed devices and technology for lea rning, presents examples of how designed technology hardware and software applications promote increased learning to school and university settings to enh ance learning outcomes of all students, including those with disabilities. The reviewed results found that application of the instrumental enrichment of mobil e technologies universally designed devices and technology can have an effect in terms of anticipat ed effects and thus have a positive influence on bo th learning skills and results in school and universit y students with a learning disability. The students mainly appreciated the mobile devices and technology and o ptimistic approach to the learner and to possibilit ies of modification of their own learning style. The mobil e device and technology provide students with optio ns to access the content multiple times in different sett ings while using a variety of technology applicatio ns. The concluded results also challenged educators to reth ink the nature of the disability students’ curricul um and empower them with the flexibility to serve a divers e population of learners.
E-services are services delivered over the Internet. Such services have different properties and dimensions, e.g. targeting different sectors, being accessible through different channels, or intended for frequent or infrequent use. Throughout this article the authors address e-services from a mobility perspective. They do this by 1) positioning mobile e-services within the research field; 2) reviewing related work on mobile e-services; and 3) presenting and examining existing challenges (both difficulties and opportunities) when combining mobility and e-services. They see mobile e-services as the next generation of internet-based services and discuss important focus areas and future directions, giving extra notion to challenges and opportunities in the areas of acceptance and adoption, availability anytime and anywhere, and co-operation. In turn, these areas potentially set the scene for enhanced e-participation.
Abstract Interactive, mobile, AGIle and novel education (IMAGINE) is a conceptual framework to help students with disabilities (SwD) participate more in the physical space and become more engaged in school. IMAGINE recommends and reminds students, and allows them to make requests of key learning resources (LRs). The goal of IMAGINE is to provide SwD with the location and time for attending a LR that is most optimal with respect to their learning style and preference, learning performance and other activities. IMAGINE will be a means through which SWD will be provided with tailored recommendations with respect to their daily activities to improve learning outcomes. A pilot was conducted with SwD who used IMAGINE's navigation and wayfinding functionality, and the subjects reported that it aligns well with their needs. Preliminary results suggest that after completing a training and using the tool, SwD reported that they are more likely to use the tool and their participation may increase as a result. In contrast to before the trial, the SwD were also able to better describe the tool's benefits and how to improve its functionality after using the tool for four weeks. Implications for Rehabilitation The IMAGINE tool may be a means through which SwD can be provided with tailored recommendations with respect to their daily activities to improve learning outcomes. PWD should be involved (as research study participants and research study team members) in the design and development of tools like IMAGINE to improve participation. IMAGINE and similar tools may not only encourage better learning outcomes, but also more physical participation in the community, and could be used across education and employment settings.
Purpose:
Despite the common use of rollators (four-wheeled walkers), understanding their effects on gait and balance is limited to laboratory testing rather than everyday use. This study evaluated the utility of an ambulatory assessment approach to examine balance and mobility in everyday conditions compared to a laboratory assessment.
Methods:
Standing and walking with a rollator was assessed in three neurological rehabilitation in-patients under two conditions: (1) in laboratory (i.e. forceplate, GaitRite), and (2) while performing a natural walking course within and outside of the institution. An instrumented rollator (iWalker) was used to measure variables related to the balance control (e.g. upper limb kinetics), destabilizing events (e.g. stumbling), and environmental context.
Results:
Two of three patients demonstrated greater reliance on the rollator for standing balance (2.3-5.9 times higher vertical loading, 72-206% increase in COP excursion) and 29-42% faster gait during the walking course compared to the laboratory. Importantly, destabilizing events (collisions, stumbling) were recorded during the walking course. Such events were not observed in the laboratory.
Conclusion:
This study illustrated a greater reliance on the rollator during challenges in everyday use compared to laboratory assessment and provided evidence of specific circumstances associated with destabilizing events that may precipitate falls in non-laboratory settings. Implications for Rehabilitation The value of combining laboratory and ambulatory assessment approaches to provide a more comprehensive profile of the risks and benefits of rollator use to prevent falling was studied. Patients demonstrated greater reliance on rollator assistive devices for standing balance and exhibited higher gait speeds during ambulatory assessment, compared to standard laboratory protocols. Repeated instances of events that may precipitate falls (e.g. collisions, stumbling, and unloading behaviors) were observed only during the ambulatory assessment. Individual challenges to balance can be used to identify specific training targets, assess suitability for assistive devices, and recommend rehabilitation goals.
Objectives:
E-health services are increasingly offered to provide clients with information and a link to healthcare services. The aim of this study is to investigate the perceived access to and the potential to use technologies important for e-health services among older adults with mild cognitive impairment (MCI) or mild Alzheimer's disease (AD) and controls.
Method:
The perceived access to and perception of difficulty in the use of everyday technology (such as cell phones, coffee machines, computers) was investigated in a sample of older adults (n = 118) comprising three subsamples: adults with MCI (n = 37), with mild AD (n = 37), and controls (n = 44) using the Everyday Technology Use Questionnaire (ETUQ). The use of seven technologies important for e-health services was specifically examined for each subsample and compared between the subsamples.
Results:
The findings demonstrated that the older adults in all subsamples perceive access to e-health technologies and potentially would use them competently in several e-health services. However, among persons with AD a lower proportion of perceived access to the technology was described, as well as for persons with MCI.
Conclusion:
To make the benefits of e-health services available and used by all clients, it is important to consider access to the technology required in e-health services and also to support the clients' capabilities to understand and use the technologies. Also, the potential use of the ETUQ to explore the perceived access to and competence in using e-health technologies is a vital issue in the use of e-health services.
To describe methods used in operationalizing environmental factors, to describe the results of a research project to develop measures of environmental factors that affect participation, and to define an initial item set of facilitators and barriers to participation following stroke, traumatic brain injury, and spinal cord injury.
Instrument development included an extensive literature review, item classification and selection, item writing, and cognitive testing following the approach of the Patient-Reported Outcomes Measurement Information System (PROMIS).
General community.
Ten content-area and outcome measurement experts contributed to instrument development; 200 individuals with the target conditions participated in focus groups and 15 participated in cognitive testing.
None.
Environmental factor items were categorized in six domains: assistive technology; built and natural environment; social environment; services, systems, and policies; access to information and technology; and economic quality of life.
We binned 2,273 items across the six domains, winnowed this pool to 291 items for cognitive testing, and recommended 274 items for pilot data collection.
Five of the six domains correspond closely to the ICF taxonomy of environmental factors; the sixth domain, economic quality of life, reflects an important construct that reflects financial resources that affect participation. Testing with a new and larger sample is underway to evaluate reliability, validity, and sensitivity.
Recent studies report that the majority of older adults wish to live in their own homes, for as long as possible. This creates a growing interest in technologies to enable older people to remain living independently at home. The purpose of this article is to provide a narrative review of current technology appropriate for older adults’ home use. The key research questions were as follow: 1- What is the evidence demonstrating that gerontechnologies are effective in enabling independent living? 2- What are devices designed specifically for frail elderly persons ? Several publications were identified about devices targeting social isolation (videophonic communication, affective orthotic devices or companion-type robots, personal emergency response systems [security]), autonomy loss (technologies for maintenance of autonomy in the activities of daily living) and cognitive disorders (cognitive orthotics, wandering management systems, telemonitoring). Very few articles dealt specifically with the frail older person. In particular, there was extremely limited evidence on use and efficacy of these devices within this population. There is a need to obtain a consensus on definition of the technologies, and also to revisit work strategies and develop innovative business models. To meet this goal, we need to create a network of technological companies, aging services organizations, end-users, academics, and government representatives to explore the real needs of the frail older population and to develop and validate new devices promoting aging at home.
Communication-oriented Internet technologies and activities such as social media sites and blogs, have become an important component of community and employment participation, not just in the specific function of activities, but as a link to larger communities of practice and professional connections. The occurrence of these activities, evident in their presence on Facebook, LinkedIn and other online communities, represents an important opportunity to reframe and re-conceptualize manifestation of communities especially those in which distributed networks and communities substitute for geographic proximity, offering new opportunities for engagement, especially those who might be functionally limited in terms of mobility.
For people with disabilities, as well as the aging, increasingly interacting online, the readiness of social networking sites to accommodate their desire to participate in conjunction with their readiness as users to maximize the potential of platform interfaces and architecture, are critical to achieving the medium’s potential for enhancing community and employment benefits. This essay explores representation/presence of disability and aging using as frames, Facebook and LinkedIn groups. Target identity/member groups on Facebook and LinkedIn were cataloged to explore the presence and representation of disability and aging identities in a socially networked setting.
The groups for this study were identified using the search feature designed into the platform architecture, which allow a user to search on specifically designated entities or keywords. Findings suggest that from a policy perspective, institutions need to be cognizant of population characteristics as well as platform opportunities implementing advocacy and relevant support services for people with disabilities and older adults to full ensure engagement and participation.
Introduction - Disability Definitions: The Politics of Meaning - The Cultural Production of Impairment and Disability - Disability and the Rise of Capitalism - The Ideological Construction of Disability - The Structuring of Disabled Identities - The Social Construction of the Disability Problem - The Politics of Disablement: Existing Possibilities - The Politics of Disablement: New Social Movements - Postscript: The Wind is Blowing - Bibliography - Index
Background:
The demand for (care) services for people with intellectual disabilities (ID) is on the rise, because of an expanding population of people with ID as resources are concurrently diminishing. As a result, service providers are increasingly turning to technology as a potential answer to this problem. However, the use and application of surveillance technology (ST) in the care for people with ID provokes conflicting reactions among ethicists and healthcare professionals, and no ethical consensus has been reached as of yet. The aim of this study was thus to provide an overview of how ST is viewed by (care) professionals and ethicists working in the field by investigating what the ideal application of ST in the residential care for people with ID might entail.
Methods:
Use was made of the concept mapping method as developed by Trochim; a computer-assisted procedure consisting of five subsequent steps: brainstorming, prioritising, clustering, processing by the computer and finally analysis. Various participants (ranging from ethicists, physicians to support workers) were invited on the basis of their intended (professional) background. Prior to this study, the views of care professionals on the (ideal) application of ST in the residential care of people with dementia have been consulted and analysed using concept mapping. A comparison between the two studies has been made.
Results:
Results show that the generated views represent six categories, varying from it being beneficial to the client; reducing restraints and it being based on a clear vision to (the need for) staff to be equipped; user friendliness and attending to the client. The results are presented in the form of a graphic chart. Both studies have produced very similar results, but there are some differences, as there appears to be more fear for ST among care professionals in the care for people with ID and views are expressed from a more developmental perspective rather than a person-centred perspective with regard to people with dementia.
Conclusions:
When it comes to views on using technology both in dementia care and the care for people with ID, there appears to be an inherent duality, often rooted in the moral conflict between safety versus freedom or autonomy. What is more, elaboration on abstract concepts often presumed to be self-evident, whether ethical or not, has proven to be difficult. How ST is viewed and apprehended is not so much dependent of the care setting and care needs, but rather whether it is clear to everyone affected by ST, what one wants to achieve with ST.
Objective:
To determine whether conditions for use of clinical video telehealth technology might affect the accuracy of measures of physical function.
Design:
Repeated measures.
Setting:
Veterans Administration Medical Center.
Participants:
Three healthy adult volunteers for a sample size of n=30 independent trials for each of 3 physical function tasks.
Interventions:
None.
Main outcome measures:
Three tasks capturing differing aspects of physical function: fine-motor coordination (number of finger taps in 30s), gross-motor coordination (number of gait deviations in 10ft [3.05m]), and clinical spatial relations (identifying the proper height for a cane randomly preset ±0-2in [5.1cm] from optimal), with performance simultaneously assessed in person and video recorded. Interrater reliability and criterion validity were determined for the measurement of these 3 tasks scored according to 5 methods: (1) in person (community standard), (2) slow motion review of the video recording (criterion standard), and (3-5) full speed review at 3 Internet bandwidths (64kps, 384kps, and 768kps).
Results:
Fine-motor coordination-Interrater reliability was variable (r=.43-.81) and criterion validity was poor at 64kps and 384kps, but both were acceptable at 768kps (reliability r=.74, validity β=.81). Gross-motor coordination-Interreliability was variable (range r=.53-.75) and criterion validity was poor at all bandwidths (β=.28-.47). Motionless spatial relations-Excellent reliability (r=.92-.97) and good criterion validity (β=.84-.89) at all the tested bandwidths.
Conclusions:
Internet bandwidth had differing effects on measurement validity and reliability for the fine-motor task, the gross-motor task, and spatial relations, with results for some tasks at some transmission speeds well below acceptable quality standards and community standards.
Australia is a vast country with one-third of the population living outside capital cities. Providing specialist rheumatologist services to regional, rural and remote Australians has generally required expensive and time-consuming travel for the patient and/or specialist. As a result, access to specialist care for remote Australians is poor. Rheumatoid arthritis is a common disease, but like many rheumatic diseases, it is complex to treat. Time-dependent joint damage and disability occur unless best evidence care is implemented. The relatively poor access to rheumatologist care allotted to nonmetropolitan Australians therefore represents a significant cause of potentially preventable disability in Australia. Telehealth has the potential to improve access to specialist rheumatologists for patients with rheumatoid arthritis and other rheumatic diseases, thereby decreasing the burden of disability caused by these diseases. Advances in videoconferencing technology, the national broadband rollout and recent Federal government financial incentives have led to a heightened interest in exploring the use of this technology in Australian rheumatology practice. This review summarises the current evidence base, outlines telehealth's strengths and weaknesses in managing rheumatic disease, and discusses the technological, medicolegal and financial aspects of this model of care. A mixed model offering both face-to-face and virtual consultations appears to be the best option, as it can overcome the barriers to accessing care posed by distance while also mitigating the risks of virtual consultation.
In this paper, we develop a process model for assessing and managing e-service quality based on the underlying components of the e-service system and, in turn, address the growing need to look in more detail at the system component level for sources of poor quality. The proposed process model is comprised of a set of entities representing the e-service system, a network defining the linking between all pairs of entities via transactions and product flows, and a set of outcomes of the processes in terms of quality dimensions. The process model is developed using Unified Modeling Language (UML), a pictorial language for specifying service designs that has achieved widespread acceptance among e-service designers. Examples of applications of the process model are presented to illustrate how the model can be use to identify operational levers for managing and improving e-service quality.
The Nintendo Wii™ is becoming an increasingly popular technology for the training and assessment of balance in older adults. Recent studies have shown promising results for its use in fall prevention. However, it is not clear how scores on the WiiFit™ balance games relate to current standardized tests of balance and mobility. The purpose of this study was to evaluate the relationship between WiiFit™ Plus balance tests, and standardized tests of older adult fitness, balance, mobility, self-reported balance confidence, and visual attention and processing. Results from 34 older adult participants indicate that WiiFit™ balance tests do not correlate well with standardized functional balance, mobility and fitness tests. However, the Wii balance score, as measured by the Basic Balance Test of the WiiFit™, does correlate with visual processing speed as measured by the Useful Field of View (UFOV(®)) test. These results indicate that WiiFit™ balance tests may provide advantageous information supplementary to information obtained through standard functional mobility and balance tests; however, caution should be used when using the WiiFit™ balance tests in isolation. Further research is necessary as these technologies become widely used in clinical and home settings for balance training and assessment.
Purpose
The purpose of this paper is to present findings of a study which examined the searching experience of university students with a print disability and their use of screen reading software to navigate three proprietary databases.
Design/methodology/approach
Participants completed a series of tasks in three different online databases using their screen‐reading software. Screen‐recording software provided video and audio documentation of the process. Survey data were collected pre‐ and post‐study as well as after each database search session.
Findings
The paper provides insights on the information‐seeking behavior of students with print disabilities as well as the barriers encountered while navigating online databases using screen‐reading software.
Research limitations/implications
The study focuses only on a small sample of university students with print disabilities and therefore lacks a control group of non‐print‐disabled students against which the results could be measured.
Practical implications
Database vendors are aware of the barriers their databases pose for users of screen readers. It is in the best interest of vendors to assist libraries in promoting the accessible features that already exist in their databases. Libraries can assist students by providing database instruction tailored to users of screen readers and by assisting database vendors in usability feedback and in marketing options.
Originality/value
Participants consisted of students with learning, visual and mobility disabilities and who were native users of screen‐reading software. There is a lack of research on the intersection of databases design and its impacts on the information literacy skills of students with print disabilities. This paper provides some insights on the first step in the information‐seeking process (gathering information) by students with a print disability and the barriers encountered.
This paper presents a virtual reality system (the BlindAid) developed for orientation and mobility training of people who are newly blind. The BlindAid allows users to interact with different virtual structures and objects via auditory and haptic feedback. This case study aims to examine if and how the BlindAid, in conjunction with a traditional rehabilitation programme, can help people who are newly blind develop new orientation and mobility methods. Follow-up research based on this study, with a large experiment and control group, could contribute to the area of orientation and mobility rehabilitation training for the newly blind. The case study research focused on A., a woman who is newly blind, for 17 virtual sessions spanning ten weeks, during the 12 weeks of her traditional orientation and mobility rehabilitation programme. The research was implemented by using virtual environment (VE) exploration and orientation tasks in VE and physical spaces. The research methodology used both qualitative and quantitative methods, including interviews, questionnaire, videotape recording, and user computer logs. The results of this study helped elucidate several issues concerning the contribution of the BlindAid system to the exploration strategies and learning processes experienced by the participant in her encounters with familiar and unfamiliar physical surroundings. [Box: see text].
To identify quantitative measurement variables that characterize mobility in older adults, meet reliability and validity criteria, distinguish fall risk, and predict future falls.
Observational study with 1-year weekly falls follow-up.
Mobility laboratory.
Community-dwelling volunteers (N=74; age, 65-94y) categorized at entry as 27 nonfallers or 47 fallers by using Medicare criteria (1 injury fall or >1 noninjury fall in the previous year).
None.
Test-retest and within-subject reliability, criterion and concurrent validity; predictive ability indicated by observed sensitivity and specificity to entry fall-risk group (falls status), Tinetti Performance Oriented Mobility Assessment (POMA), computerized dynamic posturography Sensory Organization Test (SOT), and subsequent falls reported weekly.
Measurement variables were selected that met reliability (intraclass coefficient of correlation >.6) and/or discrimination (P<.01) criteria (clinical variables: turn steps and time, gait velocity, step-in-tub time, downstairs time; forceplate variables: quiet standing Romberg ratio sway area, maximal lean anterior-posterior excursion, sit-to-stand medial-lateral excursion, sway area). Sets were created (3 clinical, 2 forceplate) using combinations of variables appropriate for older adults with different functional activity levels, and composite scores were calculated. Scores identified entry falls status and concurred with POMA and SOT scores. The full clinical set (5 measurement variables) produced sensitivity of 80% and specificity of 74% to falls status. Composite scores were more sensitive and specific overall in predicting subsequent injury falls and multiple falls compared with falls status and POMA or SOT score.
Sets of quantitative measurement variables obtained with this mobility battery provided sensitive prediction of future injury falls and screening for multiple subsequent falls by using tasks that should be appropriate to diverse participants.
PURPOSE. Effective delivery of dysphagia exercises requires intensive repetition, yet many brain injury survivors demonstrate difficulty adhering to home programmes. The Television Assisted Prompting (TAP) system provides a novel method to deliver intensive in-home therapy prompts. Specific research questions compared the effectiveness of the TAP system to typical practice on programme adherence, satisfaction and caregiver burden. METHOD. A within-participant alternating treatment design with random assignment of treatment condition compared exercise programme adherence across TAP and typical practice delivery conditions, replicated across three participants. Data included quantitative programme completion rates, satisfaction survey reports and caregiver burden questionnaire results, as well as qualitative interview findings. RESULTS. A large treatment effect was demonstrated for two participants; exercise programme completion rates increased by 6-17 times typical practice levels with the TAP system. TAP supported sustained practice over the course of the experiment for the third participant despite minimal differences between conditions. Participants reported high satisfaction and endorsed the TAP system. There was no significant change in caregiver burden. CONCLUSION. The TAP system provided a novel assistive tool to support home programme completion of intensive exercise regimens for clients with cognitive impairment and care providers with significant burden. Future research must ensure continued development of a reliable and intuitive system.
Onsite standard care and remote telecare supports were provided to adults with intellectual disabilities living in integrated community settings and evaluated in terms of effectiveness as consumers completed a series of novel household activities.
Using an alternating treatment design with baseline and follow-up conditions in this single-case study, investigators compared the prompting effectiveness provided by onsite standard care staff and a remote telecare provider.
While both types of supports resulted in consumers completing tasks, results indicated consumers achieved slightly more independence when prompted by the telecare support provider. Additionally, telecare supports resulted in greater duration for task completion per consumer.
Although consumers completed tasks with greater independence using telecare supports, caution should be used when interpreting results due to the small number of participants. The potential for this technology certainly exists in supporting consumers in their own homes thus, suggestions for future investigations are provided.
Powered wheelchairs are an important mobility aid for the elderly and for persons with disability. According to World Health Organization statistics, most of the accidents were due to personal mistakes; if there is an auto-navigating system such as auxiliary, mistaken manipulation will decrease efficiency. This study attempted to improve the global positioning system (GPS) navigation of electric powered wheelchairs (EPWs) through the addition of an electric compass (EC) and tested the navigation of EPWs with EC-aided and non-EC-aided GPS navigation along a 25 m road. According to these tests, the use of the EC significantly reduces the errors in GPS navigation during movements such as go straight ahead, turn right and turn left. Therefore, the navigation reduced the error of the expected trajectories with the EC-aided navigation.