1,896 research outputs found

    Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

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    Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

    Community-based rehabilitation for people with disabilities in low- and middle-income countries: a systematic review

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    Review question: We reviewed the evidence about the impact of community-based rehabilitation on the lives of people with disabilities and their carers in low- and middle-income countries. Background: People with disabilities include those who have long-term physical, mental, intellectual or sensory impairments, which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others. There are estimated to be over one billion people with disabilities globally and 80% of them live in low- and middle-income countries. They are often excluded from education, health, and employment and other aspects of society leading to an increased risk of poverty. Community-based rehabilitation interventions are the strategy endorsed by the World Health Organization and other international organisations (e.g. ILO, IDDC) for addressing the needs of this group of people in low- and middle-income countries. These interventions aim to enhance the quality of life of people with disabilities and their carers, by trying to meet their basic needs and ensuring inclusion and participation using predominantly local resources. These interventions are composed of up to five components: health, education, livelihood, social and empowerment. Currently only few people who need them benefit from these interventions, and so it is important to assess the available evidence to identify how to best implement these programmes. Study characteristics: The evidence in this review is current to July 2012. This review identified 15 studies that assessed the impact of community-based rehabilitation on the lives of people with disabilities and their carers in low- and middle-income countries. The studies included in the review used different types of community-based rehabilitation interventions and targeted different types of physical (stroke, arthritis, chronic 7 The Campbell Collaboration | www.campbellcollaboration.org obstructive pulmonary disease) and mental disabilities (schizophrenia, dementia, intellectual impairment). Key results: Overall, randomised controlled trials suggested a beneficial effect of community-based rehabilitation interventions in the lives of people with physical disabilities (stroke and chronic obstructive pulmonary disease). Similar results were found for non-randomised studies for physical disabilities (stroke and arthritis) with the exception of one non-randomised study on stroke showing community-based rehabilitation was less favourable than hospital-based rehabilitation. Overall, randomised controlled trials suggested a modest beneficial effect of community-based rehabilitation interventions for people with mental disabilities (schizophrenia, dementia, intellectual impairment), and for their carers (dementia). Similar results were found for non-randomised studies for mental disabilities (schizophrenia). However, the methodological constraints of many of these studies limit the strength of our results. In order to build stronger evidence, future studies will need to adopt better study designs, will need to focus on broader clients group, and to include economic evaluations

    The health and well-being of older adults with dual sensory impairment (DSI) in four countries

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    Objectives Dual sensory impairment (DSI) is a combination of vision and hearing impairments that represents a unique disability affecting all aspects of a person’s life. The rates of DSI are expected to increase due to population aging, yet little is known about DSI among older adults (65+). The prevalence of DSI and client characteristics were examined among two groups, namely, older adults receiving home care services or those residing in a long-term care (LTC) facility in four countries (Canada, US, Finland, Belgium). Methods Existing data, using an interRAI assessment, were analyzed to compare older adults with DSI to all others across demographic characteristics, functional and psychosocial outcomes. Results In home care, the prevalence of DSI across the four countries ranged from 13.4% to 24.6%; in LTC facilities, it ranged from 9.7% to 33.9%. Clients with DSI were more likely to be 85+, have moderate/severe cognitive impairment, impairments in activities of daily living, and have communication difficulties. Among residents of LTC facilities, individuals with DSI were more likely to be 85+ and more likely have a diagnosis of Alzheimer’s disease. Having DSI increased the likelihood of depression in both care settings, but after adjusting for other factors, it remained significant only in the home care sample. Conclusions While the prevalence of DSI cross nationally is similar to that of other illnesses such as diabetes, depression, and Alzheimer’s disease, we have a limited understanding of its affects among older adults. Raising awareness of this unique disability is imperative to insure that individuals receive the necessary rehabilitation and supportive services to improve their level of independence and quality of life

    Promoting and maintaining health of people with sight loss: A scoping study

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    This study was undertaken in response to a request by the Thomas Pocklington Trust to identify and explore the following issues: • The needs and concerns regarding immediate risks to health and safety related to sight loss; • Additional risks arising from sight loss for those who are also managing a long term disease; • The difficulties in maintaining and promoting health; • Whether or not health promotion activities and policies sufficiently address perceived needs. Findings pertaining to these objectives have been generated from data collected in Leeds, UK, a city where innovative programming for sight loss has either been planned or is being incorporated into health planning and a review of the literature. Findings related to the last two issues indicate that gaps exist in service provision for maintaining health and emphasise the need for more explicitly targeted health promotion initiatives that could address current weaknesses. - A review of the literature; - Focus group discussions with a range of people who had experienced sight loss; - Interviews with professional practitioners engaged in service provision to this population; - An expert hearing with four professional practitioners, one of whom had sight loss, and two service users with sight loss. Most participants were from the West Yorkshire region and the services described in the study are largely located in Leeds. Evidence from the literature review suggests that people with visual impairment have increased risk of accidents within the home and that ensuing consequences include injuries incurred and decreased confidence. Rates of depression among people who are blind or partially sighted are far higher than in the wider population and the likelihood of depression increases with age, although psycho-social interventions and technological assistance can be successfully implemented to improve quality of life. Sight loss together with other long term health conditions exacerbates the impact of other health conditions and has particularly severe impact on the wellbeing of older people insofar as it may affect their mobility, which in turn increases their risk of falls and depression. The nature and level of support available to people is variable but it is clear that access both to the right information at the right time and to appropriate services is a critical issue. Focus group discussions, interviews and the expert hearing corroborated and extended the themes noted in the literature and discuss the differential impact of different risks to health and the difficulties of coping with these at different times in a person’s life. A simple typology was defined using two dimensions of experience (‘stage of life’ and ‘early/late onset of sight loss’) as a means of organizing findings and providing a means of making further distinctions in interpreting the data. Potentially, this scheme can allow health promotion initiatives to be targeted more effectively to stages at which people with sight loss are more likely to encounter specific difficulties in managing and maintaining their health. There was a clear consensus throughout the study that interventions to meet the needs of people with sight loss must be tailored to meet the specific needs of individuals: people with sight loss are not a homogeneous group and the way in which each person experiences the challenges of sight loss and of managing their health will inevitably vary from person to person. Recommendations generated by this study include: • The scope for more pro-active services and need for closer collaboration between service providers; • The need for provision and promotion of targeted information; • The need for greater awareness of the needs of people with visual impairments among generic service providers; and • Further research that explores the usefulness of the typology with a larger sample more representative of population demographics such as BME communities that are more likely to slip through the cracks of service provision

    Surveying Persons with Disabilities: A Source Guide

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    In 2003, The National Institute on Disability and Rehabilitation Research (NIDRR) funded a Rehabilitation Research and Training Center on Disability Demographics and Statistics (StatsRRTC) at Cornell University‘s Employment and Disability Institute (EDI). The goal of the Center is to ―explore the reliability of existing data sources and collection methods and evaluate ways to improve and expand current data collection efforts‖ (EDI 2008). As a collaborator with the StatsRRTC, Mathematica Policy Research, Inc. (MPR), has been working on a project that identifies the strengths and limitations in existing disability data collection in both content and data collection methodology. The intended outcomes of this project include expanding and synthesizing knowledge of best practices and the extent to which existing data use those practices, informing the development of data enhancement options, and contributing to a more informed use of existing data

    Overcoming barriers and increasing independence: service robots for elderly and disabled people

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    This paper discusses the potential for service robots to overcome barriers and increase independence of elderly and disabled people. It includes a brief overview of the existing uses of service robots by disabled and elderly people and advances in technology which will make new uses possible and provides suggestions for some of these new applications. The paper also considers the design and other conditions to be met for user acceptance. It also discusses the complementarity of assistive service robots and personal assistance and considers the types of applications and users for which service robots are and are not suitable

    Review of the current status of research on smart homes and other domestic assistive technologies in support of the TAHI trials

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    The study provides an overview of developments in smart home technology and its use in the assistive technology sector. It includes an extensive literature review and detailed descriptions of current smart home installations in the UK and Europe. The report highlights the complexity of providing products and services in this area, and the relative immaturity of smart home technology in this sector. Many of the available products have emerged from office automation technologies developed for use in building control applications or from small niche markets in the assistive sector. Smart home developments have also concentrated on home control applications, but larger potential markets are also now being identified in other areas. Many of the trials described use technology to improve the safety and security of older and disabled people, concentrating more on the monitoring rather than home environment control. The report also demonstrates the practical difficulties faced in developing services in this sector. For many organisations these have been exploratory first steps in the use of technology to support care, and this lack of experience is reflected in common difficulties in specification and installation of equipment especially when retrofitting installations into buildings. Many developments have suffered from the lack of relevant experience of electrical and other contractors, so that it has proved difficult for organisations to identify both suppliers of equipment and people with the skills to install the technology. In the majority of cases there has been no formal evaluation of the developments, and it is therefore difficult to obtain evidence of the costs and benefits of using such technology to provide care and support independent living

    Validation of a cognitive screening tool for hearing impaired older adults

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    Dementia usually starts in individuals aged over 65, and one-third of people in this age group have disabling hearing impairment. Moreover, older adults with hearing impairment are nearly 2 times more likely to develop dementia compared with their normal-hearing peers. This makes early and accurate screening for mild cognitive impairment (MCI) among this population even more important. The Montreal cognitive assessment (MoCA) is a commonly used cognitive screening tool to early identify the individuals at risk of MCI. However, the tool relies on verbal administration of the instructions and target words/sentences which as shown in a previous meta-analysis could be a disadvantage for the hearing-impaired population, making the screening inaccurate. The MoCA for hearing-aid users (MoCA-HA) was developed and validated. The development phase was done with feedback from professionals and the older adult hearing-aid users, the tool’s final target population. The appropriate cut-point score of below 26 out of 30 is proposed for an onward cognitive assessment referral which yields a similarly high sensitivity to the traditional MoCA. It had an excellent discrimination property and correlated well with other existing cognitive measures. The MoCA-HA is suitable to be used in hearing aid centres for early screening for potential mild cognitive impairment. Despite measuring with the visually presented tool such as MoCA-HA, the information encoding ability was slightly reduced in the hearing-impaired cohort. The information retrieval ability was well preserved among the hearing-impaired population but was reduced when they had additional mild cognitive impairment. This also affected their performance and reliability of the self-reported hearing difficulty questionnaires. The visuospatial ability of the hearing-impaired population was better than the norms. With additional MCI, the ability was decreased but still comparable to the norms. These considerations could formulate better and holistic care plans for the hearing-impaired population with potential cognitive impairment

    The importance of "scaffolding" in clinical approach to deafness across the lifespan

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    Throughout the present work of thesis, the concept of scaffolding will be used as a fil rouge through the chapters. What I mean for “scaffolding approach”, therefore, is an integrated and multidisciplinary clinical and research methodology to hearing impairments that could take into account persons as a whole; an approach that needs to be continuously adapted and harmonized with the individuals, pursuant to their progress, their limits and resources, in consideration of their audiological, cognitive, emotional, personal, and social characteristics. The following studies of our research group will be presented: A study (2020) designed to assess the effects of parent training (PT) on enhancing children’s communication development (chapter two); Two studies of our research group (2016; 2020) concerning variables influencing comprehension of emotions and nuclear executive functions in deaf children with cochlear implant (chapter three and chapter four) In chapter five a presentation and description of our Mind-Active Communication program, main topics and aims, multidisciplinary organizations of group and individual sessions with a description of used materials and methodology is given. Finally, a preliminary evaluation to explore the use of this multidisciplinary rehabilitative program on quality of life, psychological wellbeing, and hearing abilities in a sample of cochlear implanted elderly persons is reported
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