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A high prevalence of manual wheelchair rear-wheel misalignment could be leading to increased risk of repetitive strain injuries

OTT, Joseph
HENDERSON, Travis
WILSON-JENE, Holly
KOONTZ, Alicia
PEARLMAN, Jonathan
2021

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Purpose: To determine the prevalence and severity of manual wheelchair rear wheel misalignment in community-dwelling manual wheelchair users and estimate the associated increases in rolling resistance (RR) and risk of repetitive strain injuries (RSIs).


Materials and Methods: Data were collected in an outpatient rehabilitation clinic, a university research laboratory, and at adaptive sporting events in the United States. Two hundred active, self-propelling man- ual wheelchair users were recruited. Angular misalignment (referred to as toe angle) while the wheelchair was loaded with the user, and the difference between the maximum and minimum toe angle (referred to as slop) with the wheelchair unloaded.

 

Results: Average results for toe angle and slop (movement in the rear wheels) were 0.92 and 0.61 degrees, respectively. Using a lab-based testing method, we quantified the impact of increased RR forces due to misalignment in increased RR forces. Our results indicate that the average toe angle while under load and slop, without loading, measured in the community increase required propulsion force by 3.0 N. Combined toe angle and slop (i.e., the worst-case scenario) added increased propulsion force by 3.9 N. Conclusions: We found that rear-wheel misalignment was prevalent and severe enough that it may increase the risk for RSIs and decrease participation. To mitigate this issue, future work should focus on reducing misalignment through improved maintenance interventions and increased manufacturing qual- ity through more stringent standards.

Implementing music therapy through telehealth: considerations for military populations

VAUDREUIL, Rebecca
LANGSTON, Diane G
MAGEE, Wendy L
BETTS, Donna
KASS, Sara
LEVY, Charles
2020

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Purpose

Telehealth provides psychotherapeutic interventions and psychoeducation for remote populations with limited access to in-person behavioural health and/or rehabilitation treatment. The United States Department of Défense and the Veterans Health Administration use telehealth to deliver primary care, medication management, and services including physical, occupational, and speech-language therapies for service members, veterans, and eligible dependents. While creative arts therapies are included in telehealth programming, the existing evidence base focuses on art therapy and dance/movement therapy, with a paucity of information on music therapy.

 

Methods

Discussion of didactic and applied music experiences, clinical, ethical, and technological considerations, and research pertaining to music therapy telehealth addresses this gap through presentation of three case examples. These programmes highlight music therapy telehealth with military-connected populations on a continuum of clinical and community engagement: 1) collaboration between Berklee College of Music in Boston, MA and the Acoke Rural Development Initiative in Lira, Uganda; 2) the Semper Sound Cyber Health programme in San Diego, CA; and 3) the integration of music therapy telehealth into Creative Forces®, an initiative of the National Endowment for the Arts.

 

Results

These examples illustrate that participants were found to positively respond to music therapy and community music engagement through telehealth, and reported decrease in pain, anxiety, and depression; they endorsed that telehealth was not a deterrent to continued music engagement, requested continued music therapy telehealth sessions, and recommended it to their peers.

 

Conclusions

Knowledge gaps and evolving models of creative arts therapies telehealth for military-connected populations are elucidated, with emphasis on clinical and ethical considerations.

Microsoft launches initiative to help 25 million people worldwide acquire the digital skills needed in a COVID-19 economy

SMITH, Brad
June 2020

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Around the world, 2020 has emerged as one of the most challenging years in many of our lifetimes. In six months, the world has endured multiple challenges, including a pandemic that has spurred a global economic crisis. As societies reopen, it’s apparent that the economy in July will not be what it was in January. Increasingly, one of the key steps needed to foster a safe and successful economic recovery is expanded access to the digital skills needed to fill new jobs. And one of the keys to a genuinely inclusive recovery are programs to provide easier access to digital skills for people hardest hit by job losses, including those with lower incomes, women, and underrepresented minorities.

To help address this need, today Microsoft is launching a global skills initiative aimed at bringing more digital skills to 25 million people worldwide by the end of the year. This initiative will bring together every part of our company, combining existing and new resources from LinkedIn, GitHub, and Microsoft. It will be grounded in three areas of activity:

(1) The use of data to identify in-demand jobs and the skills needed to fill them;

(2) Free access to learning paths and content to help people develop the skills these positions require;

(3) Low-cost certifications and free job-seeking tools to help people who develop these skills pursue new jobs.

Recommendations for Immediate COVID-19 Action

Marcie Roth
March 2020

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This document provides recommendations for rapid response solutions for federal and state governments to close the real and anticipated gaps in the COVID-19 outbreak and public health emergency-related continuity of operation for people with disabilities, older adults, and people with access and functional needs. Our recommendations include contingency plans for disability and aging services, supports, and programs funded directly with federal or state funds or through federal assistance to state, local, tribal and territorial governments and non-government providers.

Medication management for people with disabilities

SINGLECARE
September 2019

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This guide provides tips for people with disabilities and their caregivers to properly handle prescriptions and manage medications. Practical advice is given on:

  • How to read medication labels
  • Managing medications at home
  • Medication strategies for people with visual impairments
  • Medication management for people with a physical disability and/or mobility limitations
  • Medication management for people with intellectual disabilities
  • Tips for effective medication management as the caregiver of a person with a disability

Resources for business owners with disabilities

GRAVER, Sarah
February 2019

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A USA based blog providing a guide for entrepreneurs and business owners with disabilities. It includes information on business plans, marketing strategies, funding, training and networking. The US PASS (Plan to Achieve Self-Support) program and the requirements for it are outlined. There is a list of resources for people living with specific disabilities who are interested in self-employment including people with visual, hearing, developmental and mobility disabilities.

Mobility Analysis of AmpuTees (MAAT 4): classification tree analysis for probability of lower limb prosthesis user functional potential

WURDEMAN, Shane R
STEVENS, Phillip M
CAMPBELL, James H
2019

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Purpose: 

To develop a predictive model to inform the probability of lower limb prosthesis users’ functional potential for ambulation.

 

Materials and Methods: 

A retrospective analysis of a database of outcomes for 2770 lower limb prosthesis users was used to inform a classification and regression tree analysis. Gender, age, height, weight, body mass index adjusted for amputation, amputation level, cause of amputation, comorbid health status and functional mobility score [Prosthetic Limb Users Survey of Mobility (PLUS-M™)] were entered as potential predictive variables. Patient K-Level was used to assign dependent variable status as unlimited community ambulator (i.e., K3 or K4) or limited community/household ambulator (i.e., K1 or K2). The classification tree was initially trained from 20% of the sample and subsequently tested with the remaining sample.

 

Results: 

A classification tree was successfully developed, able to accurately classify 87.4% of individuals within the model’s training group (standard error 1.4%), and 81.6% within the model’s testing group (standard error 0.82%). Age, PLUS-M™ T-score, cause of amputation and body weight were retained within the tree logic.

 

Conclusions: 

The resultant classification tree has the ability to provide members of the clinical care team with predictive probabilities of a patient’s functional potential to help assist care decisions.

Fully accessible guide to flying with disabilities

2018

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A table is provided of the top 15 US airports giving notes on restrooms, pet relief areas, parking for people with disabilities and wheelchair services. Advantages of the use of specific credits cards by disabled people when travelling by plane in the USA are highlighted.

Bridging the gap – your role in transporting children with disabilities to school in developing countries

ACCESS EXCHANGE INTERNATIONAL
AJUWON, Paul
January 2017

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This guide provides practical information for people who want to improve transportation for children with disabilities in developing countries. The guide will help parents and their children, teachers, heads of schools, and education officials to improve transport to and from school for children with disabilities. It will help transportation officials and transport providers, as well as agencies promoting sustainable development in developing countries. The guide addresses a variety of circumstances found in it's case studies, ranging from children with disabilities riding on school buses in large cities to children walking to school in some rural areas where roads do not even exist. Key findings and recommendations are presented from research carried out, case studies and interviews with school heads 

Mobile for development : transforming global healthcare through mobile technology

THEVATHASAN, Vanessa
GRADZEWICZ, Agnes
RUETZEL, Sonja
2015

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This paper outlines the need for greater connectivity & accessibility in less developed countries. Following this, the authors present the benefits of various different ‘mHealth’ solutions, presented through case studies. The report concludes by outlining some of the constraints holding back greater ‘mHealth’ innovation, including financing and sustainability issues

Human Rights

www.macao-tz.org
December 2014

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Malezi AIDS Care Awareness Organization (MACAO) is a non-profit organization reaching out to neglected Indigenous people in Ngorongoro District, Arusha Region of Northern Tanzania.  Macao founded in 2003, Macao is a humanitarian organization that provides assistance to approximately 200,000 Indigenous Maasai community in Ngorongoro district for addressing needs of water and sanitation, food security, health Care Research, Education, Research environment, Maasai Traditional Research, Human Rights and sustainable economic development by strengthening their livelihoods.  In addition to responding to major relief situations, MACAO focuses on long-term community development through over 4 Area Development Project. We welcome the donors and volunteers to join us in this programs, we are wolking in ruro villages.

Evacuation of people with visual impairments

Sørensen, Janne Gress
2014

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This Study aimed to increase knowledge and data on evacuation characteristics of vulnerable people and with a special focus on blind and visually impaired people.

 

An experimental program designed to obtain data on walking speeds horizontally and descending stairs, interaction between participants and their interaction with the building environment. Experiments were conducted in different buildings including office buildings, an institutional building and a tunnel. In total 148 people have participated in the experiments. Parallel to the evacuation experiments participants were interviewed not only about their experience with the experiments but also their use of different building types and the difficulties they meet.

Rocking the cradle : ensuring the rights of parents with disabilities and their children

NATIONAL COUNCIL ON DISABILITY
2012

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"The report analyzes how U.S. disability law and policy apply to parents with disabilities in the child welfare and family law systems, and the disparate treatment of parents with disabilities and their children. Examination of the impediments prospective parents with disabilities encounter when accessing assisted reproductive technologies or adopting provides further examples of the need for comprehensive protection of these rights"

Inclusive information and communication technologies for people with disabilities

SIMPSON, Jennifer
2009

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Information and Communications Technology (ICT) has the potential both to enhance access for people with disabilities and to contribute to creating barriers. What we now call the digital divide actually began long before the introduction of computers — barriers have existed and still exist today with telephones, television, the Internet and other information technology. It is important to remember that people with disabilities have many different accessibility needs and that there are different ways to make technology accessible and that new accessibility needs emerge as technology changes. This paper looks at the state of accessibility policy in the U.S. in several technology infrastructures that may provide some lessons and directions for increasing inclusive information and communication technologies worldwide. For instance, if the many provisions involving technology in the UN Convention on the Rights of Persons with Disabilities are to have real and substantive meaning, policy and implementation at the infrastructure level must occur.

An ADA guide for local governments making community emergency preparedness and response programs accessible to people with disabilities

US DEPARTMENT OF JUSTICE, Civil Rights Division
2008

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This guide provides guidance for how to make local government emergency preparedness and response program accessible for persons with disabilities. It helps to identify needs and evaluate effective, accessible and inclusive emergency management practices. The following issues are explored: planning, notification, evacuation, sheltering, returning home and contracting for emergency services

International best practices in universal design : a global review

DION, Betty
et al
August 2007

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This review provides an international overview of the technical information on accessibility criteria for the built environment that is being used by countries as they prepare to ratify the Convention on the Rights of Persons with Disabilities. The document compares the accessibility codes and standards from 16 international jurisdictions, including the new standards from Canada and the USA, as well as standards from Mexico, Uruguay, Sweden, Ireland, Spain, South Africa, Bangladesh, Philippines, Malaysia, Singapore, Australia and Lebanon

Universal design and visitability : from accessibility to zoning

NASAR, Jack L., EVANS-COWLEY, Jennifer
Eds
2007

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This book is a collection of best practices gathered from an international conference on universal design. It features guiding principles, statistics and examples of universal design. This comprehensive book offers detailed chapters on the following key issues: principles of universal design; inclusive housing and neighbourhoods; architecture and spatial cognition without sight; and research and teaching of accessibility. It features case studies in Brazil, Thailand, Norway and Maryland, USA. This book would be useful for those interested in universal design, accessibility, and disability and development

Using geographic information system technology to improve emergency management and disaster response for people with disabilities

ENDERS, Alexandra
BRANDT, Zachary
2007

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Disability, as a product of person–environment interaction, is particularly sensitive to catastrophic events and disasters. Disasters are specific to a physical location, as are the resources needed to handle the aftermath of the event. Geographic information systems (GIS) technology provides the ability to spatially coordinate resources from separate systems, which is vital for emergency management. GIS provides the capacity to go beyond surveillance and identification of at-risk people with disabilities to actively address the spatial nature of the person–environment interaction. GIS may provide the basis for further investigation and development of the science of environmental factors in the person–environment interaction. Mapping resources, and not just people, in the environment can change the perception and portrayal of people with disabilities in disaster incidents from people with “special needs” to people and organizations that are community contributors. Disability policy advocates, working at the state level, need to get disability-relevant geospatial data into the critical infrastructure used for emergency planning and response. A map showing the proximity of available resources demonstrates the importance of GIS to people with disabilities by identifying available resources in disaster response and recovery.

 

Journal of Disability Policy Studies, Vol 17, No 4

The concept of reasonable accommodation in selected national disability legislation

DEPARTMENT FOR ECONOMIC AND SOCIAL AFFAIRS (DESA), UNITED NATIONS
December 2005

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This paper describes how national legislation in selected countries has managed to incorporate the concept of reasonable accommodation for persons with disabilities. It utilises case studies from the following selected countries: Australia, Canada, European Union, Ireland, Israel, New Zealand, the Philippines, South Africa, Spain, Sweden, United Kingdom, United States and Zimbabwe

A historical overview of health disparities and the potential of eHealth solutions

GIBBONS, M
2005

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Over the past decade a rapidly expanding body of literature has demonstrated the existence of disparities in health and health care. While consensus has not emerged regarding the causes of disparities, they are generally thought to be related to sociocultural, behavioural, economic, environmental, biologic, or societal factors. To effectively address disparities, several authorities have suggested the need for greater information technology research and investments. eHealth researchers may be able to make significant contributions in this area through research and its applications. This paper begins with a historical overview of health disparities in the United States and Europe. It then discusses the role that the Internet, and access to the Internet, may play in the genesis of health disparities. Finally, this paper closes with a discussion of the potential benefits of eHealth applications and the possible contributions of the field to overcoming disparities in health and health care

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