Barrierefreiheit von Informations- und Kommunikationstechnologien für Menschen mit Behinderungen

Die Gesetzesgrundlage fordert Barrierefreiheit für jeden Menschen, speziell für Personen mit Behinderungen. Die Rechte von Menschen mit Behinderungen werden national im österreichischen Bundesbehindertengleichstellungsgesetz (vgl. österreichisches Bundesbehindertengleichstellungsgesetz, 2012) geregelt sowie international in der UNKonvention (vgl. Übereinkommen über die Rechte von Menschen mit Behinderungen, o. J.) festgehalten. Im universitären Rahmen existiert im österreichischen Universitätsgesetz ein Leitsatz, welcher die nationalen Hochschulen dazu verpflichtet, Studierende mit Behinderungen speziell zu berücksichtigen (vgl. Österreichisches Universitätsgesetz, 2012, Paragraph 2 Ziffer 11). Ausgehend von der internationalen, österreichischen sowie universitären Rechtslage soll das Thema der Barrierefreiheit an der Universität Wien problematisiert und untersucht werden. Bezüglich der Untersuchung der Barrierefreiheit wird in dieser Masterarbeit der Fokus auf Barrierefreiheit von Informations- und Kommunikationstechnologien gelegt. Dieses Hauptaugenmerk basiert auf der Entwicklung der Gesellschaft von einer Industrie- zu einer Informations-/ Wissensgesellschaft bei der die Komponente Information immer mehr an Relevanz gewinnt. Die Ablösung der Industrie durch das Wissen hat nicht nur Auswirkung auf die Gesellschaft, sondern auch auf die Bildung. Dabei sind die Bedingungen, Methoden, sowie Inhalte von und Anforderungen an Bildung betroffen. (vgl. Pfeffer-Hoffman, 2007) Somit stellt das Aufkommen der Informations- und Kommunikationstechnolo91 gien in Zusammenhang mit dem Gesellschaftswandel einen ausschlaggebenden Faktor für die Bildung dar. Ausgehend vom Gesellschaftswandel und dessen Bedingungen für den Bildungssektor wird die Barrierefreiheit der Website der Universität Wien als Informations- und Kommunikationstechnologie für Studenten, zukünftige Studierende, Wissenschaftlern sowie für jeden Menschen, der Informationen über die Universität Wien sucht und durch Behinderungen bei der Nutzung eingeschränkt ist, untersucht. Die Untersuchung überprüft, ob Barrieren bei der Nutzung der von der Universität Wien eingesetzten Informations- und Kommunikationstechnologien existieren. Dabei wird die Untersuchung der Barrierefreiheit auf die Website der Universität Wien und auf eine Evaluierung dieser beschränkt. Die Überprüfung der Barrierefreiheit im speziellen die Bewertung der Website geschieht mit der Absicht, die Universität Wien hinsichtlich des gesetzlichen Leitsatzes, dass sie sich dazu verpflichtet Studierende mit Behinderungen besonders zu berücksichtigen, zu beurteilen. Infolge dessen wird bewertet, ob die Universität Wien Nutzer mit Behinderungen an der Teilhabe der Kommunikationsgemeinschaft und der Beschaffung von Informationen hindert oder unterstützt. Die Bewertung also Evaluierung der Barrierefreiheit der Website der Universität Wien wird anhand von Accessibility-Richtlinien durchgeführt. Werden diese Richtlinien bei der Erstellung einer Website berücksichtigt wird dadurch die Barrierefreiheit und Zugänglichkeit gefördert. Diesbezüglich werden im ersten Schritt Kriterien mittels der Accessibility-Richtlinien formuliert. Im zweiten Schritt wird ein Kriterienkatalog erstellt, mit welchem die Evaluierung vorgenommen wird. Das Ergebnis der Evaluation stellt der ausgewertete Kriterienkatalog dar, anhand dessen die Barrierefreiheit des Webauftritts der Universität Wien beurteilt wird

The use of pediatric health care services in Switzerland : a claims data analysis (preliminary results)

Exposure to unfavorable circumstances in childhood has been shown to have negative implications on physical, cognitive and psychological health in adulthood. Health problems in childhood should, therefore, be detected and treated at an early stage. Adequate pediatric health care, and in particular, preventive pediatric health screenings, play a key role in this context. In Switzerland, children and adolescents from 0-14 years are recommended to go through ten preventive health screenings. These screenings are performed at the parents’ initiative by the pediatrician or family doctor, except for two to three compulsory screenings at around the age of 6, 10 and 14 years, which are typically performed by the school medical services. However, little is known about the extent to which these screenings are performed and about potential barriers limiting the utilization of health care services. The aim of our study is to evaluate children’s access to adequate health care in Switzerland. In particular, we aim to identify potential inequalities in the use of pediatric health care between socioeconomic groups. We employ two strategies: a) Using data from the school medical services in the city of Bern, we assess the extent of foregone pediatric health care in different socioeconomic groups by evaluating the incidence of untreated or inadequately treated health problems. b) Using claims data from a large Swiss health insurer, we assess the health care utilization patterns throughout childhood and the extent to which preventive health screenings are performed. The identification of groups at risk of inadequate health care and a better understanding of the underlying mechanisms can contribute to improving access to preventive health care services and, hence, to reducing health inequalities in childhood

Highlighting the Multifaceted Role of Orai1 N-Terminal- and Loop Regions for Proper CRAC Channel Functions

Orai1, the Ca2+-selective pore in the plasma membrane, is one of the key components of the Ca2+release-activated Ca2+ (CRAC) channel complex. Activated by the Ca2+ sensor in the endoplasmic reticulum (ER) membrane, stromal interaction molecule 1 (STIM1), via direct interaction when ER luminal Ca2+ levels recede, Orai1 helps to maintain Ca2+ homeostasis within a cell. It has already been proven that the C-terminus of Orai1 is indispensable for channel activation. However, there is strong evidence that for CRAC channels to function properly and maintain all typical hallmarks, such as selectivity and reversal potential, additional parts of Orai1 are needed. In this review, we focus on these sites apart from the C-terminus; namely, the second loop and N-terminus of Orai1 and on their multifaceted role in the functioning of CRAC channels

Social mixing and risk exposures for SARS-CoV-2 infections in elderly persons

AIMS OF THE STUDY: During the transitional phase between the two pandemic waves of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infection rates were temporarily rising among younger persons only. However, following a temporal delay infections started to expand to older age groups. A comprehensive understanding of such transmission dynamics will be key for managing the pandemic in the time to come and to anticipate future developments. The present study thus extends the scope of previous SARS-CoV-2-related research in Switzerland by contributing to deeper insight into the potential impact of “social mixing” of different age groups on the spread of SARS-CoV-2 infections. METHODS: The present study examined persons aged 65 years and older with respect to possible SARS-CoV-2 exposure risks using longitudinal panel data from the Swiss COVID-19 Social Monitor. The study used data from two assessments (survey “May” and survey “August”). Survey “May” took place shortly after the release of the lockdown in Switzerland. Survey “August” was conducted in mid-August. To identify at-risk elderly persons, we conducted a combined factor/k-means clustering analysis of the survey data assessed in August in order to examine different patterns of adherence to recommended preventive measures. RESULTS: In summary, 270 (survey “May”) and 256 (survey “August”) persons aged 65 years and older were analysed for the present study. Adherence to established preventive measures was similar across the two surveys, whereas adherence pertaining to social contacts decreased substantially from survey “May” to survey “August”. The combined factor/k-means clustering analysis to identify at-risk elderly individuals yielded four distinct groups with regard to different patterns of adherence to recommended preventive measures: a larger group of individuals with many social contacts but high self-reported adherence to preventive measures (n = 86); a small group with many social contacts and overall lower adherence (n = 26); a group with comparatively few contacts and few social activities (n = 66); and a group which differed from the latter through fewer contacts but more social activities (n = 78). Sociodemographic characteristics and risk perception with regard to SARS-CoV-2 infections among the four groups did not differ in a relevant way across the four groups. CONCLUSIONS: Although many elderly persons continued to follow the recommended preventive measures during the transitional phase between the two pandemic waves, social mixing with younger persons constitutes a way for transmission of infections across age groups. Pandemic containment among all age groups thus remains essential to protect vulnerable populations, including the elderly

Adequate use of pediatric primary health care during the first three years of life in Switzerland : an analysis using claims data

Introduction: Adequate pediatric primary care, in particular health screenings, is important for the early detection and treatment of diseases or developmental disorders in early childhood. Therefore, pediatric associations recommend regular screenings for children. In Switzerland, there is little systematic knowledge about the uptake of pediatric primary care in early childhood. The aim of this study is to investigate the uptake of pediatric primary health care consultations in the first three years of life and to identify possible differences between socioeconomic subgroups. Methods: We used health care claims data from a large Swiss health insurer from 2012 to 2018. We identified medical consultations in the age of 0 to 7 months, 0 to 13 months, and 14 to 30 months and included pediatricians, general practitioners (GPs), and hospital in- and outpatient care. We analyzed associations with primary care supply accessibility, area of residence, nationality, as well as individual health insurance premium reduction and having a supplementary coverage, which serve as proxy measures for socioeconomic status. Prevalence estimates are based on logit regressions. Results: In the first seven months of life, 3.4% of children had never visited a primary care physician (pediatrician or GP), and 17% had had less than the four consultations recommended for screening purposes. In the first year (0 to 13 months) the non-uptake of any primary care consultations decreased to 2.1%. Taking hospital care into consideration, the share of children that did not have any contact with a care provider decreased to 1.1%. Foreign nationality, living in rural areas, low accessibility of primary care services, and not having a supplementary coverage are associated with lower uptake of pediatric consultations. Discussion: Most children seem to have an adequate number of health care consultations in early childhood. However, in rural areas, a substantial share of pediatric care is provided by GPs and not by specialized pediatricians. Also, there seem to be barriers to pediatric care for a few children who do not have any or not at least the number of consultations corresponding to the national screening recommendations

TRPV6 Regulation by Cis-22a and Cholesterol

The highly calcium-selective transient receptor potential vanilloid-type channel TRPV6 is important for epithelial Ca2+ transport. Proper regulation of the inherently constitutively active TRPV6 channels is intricate in preserving Ca2+ homeostasis, whereby structural and functional data suggest that lipids hold an essential role. Altered expression levels or specific TRPV6 mutations may lead to diseases, hence, TRPV6 represents an interesting target for pharmacological modulation. Recent cryo-EM data identified that the specific TRPV6 blocker cis-22a binds, apart from the pore, to a site within the tetrameric channel that largely matches a lipid binding pocket, LBS-2. Therein, cis-22a may replace a lipid such as cholesterol that is bound in the open state. Based on site-directed mutagenesis and functional recordings, we identified and characterized a series of residues within LBS-2 that are essential for TRPV6 inhibition by cis-22a. Additionally, we investigated the modulatory potential of diverse cholesterol depletion efforts on TRPV6 activity. While LBS-2 mutants exhibited altered maximum currents, slow Ca2+-dependent inactivation (SCDI) as well as less inhibition by cis-22a, TRPV6 activity was resistant to cholesterol depletion. Hence, lipids other than cholesterol may predominate TRPV6 regulation when the channel is expressed in HEK293 cells

Genotype–Phenotype Relations for the Atypical Parkinsonism Genes: MDSGene Systematic Review

This Movement Disorder Society Genetic mutation database Systematic Review focuses on monogenic atypical parkinsonism with mutations in the ATP13A2, DCTN1, DNAJC6, FBXO7, SYNJ1, and VPS13C genes. We screened 673 citations and extracted genotypic and phenotypic data for 140 patients (73 families) from 77 publications. In an exploratory fashion, we applied an automated classification procedure via an ensemble of bootstrap-aggregated (“bagged”) decision trees to distinguish these 6 forms of monogenic atypical parkinsonism and found a high accuracy of 86.5% (95%CI, 86.3%–86.7%) based on the following 10 clinical variables: age at onset, spasticity and pyramidal signs, hypoventilation, decreased body weight, minimyoclonus, vertical gaze palsy, autonomic symptoms, other nonmotor symptoms, levodopa response quantification, and cognitive decline. Comparing monogenic atypical with monogenic typical parkinsonism using 2063 data sets from Movement Disorder Society Genetic mutation database on patients with SNCA, LRRK2, VPS35, Parkin, PINK1, and DJ-1 mutations, the age at onset was earlier in monogenic atypical parkinsonism (24 vs 40 years; P = 1.2647 × 10−12) and levodopa response less favorable than in patients with monogenic typical presentations (49% vs 93%). In addition, we compared monogenic to nonmonogenic atypical parkinsonism using data from 362 patients with progressive supranuclear gaze palsy, corticobasal degeneration, multiple system atrophy, or frontotemporal lobar degeneration. Although these conditions share many clinical features with the monogenic atypical forms, they can typically be distinguished based on their later median age at onset (64 years; IQR, 57–70 years). In conclusion, age at onset, presence of specific signs, and degree of levodopa response inform differential diagnostic considerations and genetic testing indications in atypical forms of parkinsonism

Genotype–Phenotype Relations for the Atypical Parkinsonism Genes : MDSGene Systematic Review

This Movement Disorder Society Genetic mutation database Systematic Review focuses on monogenic atypical parkinsonism with mutations in the ATP13A2, DCTN1, DNAJC6, FBXO7, SYNJ1, and VPS13C genes. We screened 673 citations and extracted genotypic and phenotypic data for 140 patients (73 families) from 77 publications. In an exploratory fashion, we applied an automated classification procedure via an ensemble of bootstrap-aggregated (“bagged”) decision trees to distinguish these 6 forms of monogenic atypical parkinsonism and found a high accuracy of 86.5% (95%CI, 86.3%–86.7%) based on the following 10 clinical variables: age at onset, spasticity and pyramidal signs, hypoventilation, decreased body weight, minimyoclonus, vertical gaze palsy, autonomic symptoms, other nonmotor symptoms, levodopa response quantification, and cognitive decline. Comparing monogenic atypical with monogenic typical parkinsonism using 2063 data sets from Movement Disorder Society Genetic mutation database on patients with SNCA, LRRK2, VPS35, Parkin, PINK1, and DJ-1 mutations, the age at onset was earlier in monogenic atypical parkinsonism (24 vs 40 years; P = 1.2647 × 10−12) and levodopa response less favorable than in patients with monogenic typical presentations (49% vs 93%). In addition, we compared monogenic to nonmonogenic atypical parkinsonism using data from 362 patients with progressive supranuclear gaze palsy, corticobasal degeneration, multiple system atrophy, or frontotemporal lobar degeneration. Although these conditions share many clinical features with the monogenic atypical forms, they can typically be distinguished based on their later median age at onset (64 years; IQR, 57–70 years). In conclusion, age at onset, presence of specific signs, and degree of levodopa response inform differential diagnostic considerations and genetic testing indications in atypical forms of parkinsonism