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How Koalaa is aiming to create sustainable access to prosthetics globally

MARSHALL, Niall (Koalaa)
September 2023

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A short talk given in the Disability Innovation Summit: Inclusive Interactions conference organised by the GDI hub on 13 Sept 2023.

 

The start up, development and potential progress of a technology company manufacturing upper limb prosthetics is outlined. Pilot projects were set up and that in Sierra Leone is briefly described. It began with developing a network, listening to users comments, redeveloping the product and representing it to users. The challenges of the next step into larger scale manufactuing and supply, following positive outcomes from pilot projects round the world, are outlined. 

What works

AUSTIN, Vicki
McKINNON, Anne
BELL, Diane
September 2023

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Presented at the Disability Innovation Summit: Inclusive Interactions conference organised by the GDI hub on 13 Sept 2023.

 

Outcomes of the first 5 years of the AT2030 project are summarised including: 15 AT country capacity surveys; 11 new assistive technologies; 31 AT ventures brought to sustainability and 70 journal papers. Funding thus far and for the future is also discussed.

Work to supply hearing aids to those with hearing loss in the global south, particularly in South Africa is outlined. Areas highlighted include: work with suppliers; work to ignite innovation and provide products at scale; work with UNICEF and the procurement catalogue; work with HEARX to provide screening and aid fine tuning via a phone app to enable community health AT service.

Questions from the audience highlight issues surrounding acquiring AT in the emergency/humanitarian setting  

Beyond Barriers: Journeying from Exclusion to Inclusion with R2D2 and NCAHT-IITM

SRINIVASAN, Sujatha
September 2023

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Presented at the Disability Innovation Summit: Inclusive Interactions conference organised by the GDI hub on 13 Sept 2023.

 

Challenges in the development and bringing to market of functional, affordable, high quality AT devices are outlined. The development of the manual standing wheelchair and the lessons learnt in taking it from prototype to market (using the GRID model) are introduced. The challenges of affordability and of awareness of AT including by professionals is highlighted. The work of the National Centre for Assistive Health Technologies (NCAHT at AIIMS, New Delhi) including experience zones of architectural barriers where people can try wheelchars on different surfaces and realise that disability is imposed by the environment is briefly described. Wheelchair skills training and community outings are part of the centre. Other topics mentioned include: the need to normalise disability; the need for collaborations; funders; scalability; fragmented markets and the need to access global markets 

Listen Include Respect: International Guidelines for Inclusive Participation

Inclusion International
June 2022

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The Listen Include Respect guidelines help organisations understand what they need to do to make sure people with intellectual disabilities are included in their work.

​They were written by Inclusion International and Down Syndrome International.

Over 1,500 people with intellectual disabilities and their families from almost 100 countries helped write them.

The Convention on the Rights of Persons with Disabilities (CRPD) tells us that all people with disabilities have the right to “meaningful participation.”

“Meaningful participation” is what happens when people with intellectual disabilities get everything they need to be fully included, participate equally, and feel valued.

These guidelines will help organisations to make this happen.

Moral distress and ethical decision-making of eldercare professionals involved in digital service transformation

FRENNERT, Susanne
2020

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Aim

Technology affects almost all aspects of modern eldercare. Ensuring ethical decision-making is essential as eldercare becomes more digital; each decision affects a patient’s life, self-esteem, health and wellness.

 

Methods

We conducted a survey and interviews with eldercare professionals to better understand the behavioural ethics and decision making involved in the digital transition of eldercare.

 

Conclusion

Our qualitative analysis showed three recurrent roles among eldercare professionals in regard to digital service transformation; makers, implementers and maintainers. All three encountered challenging and stressful ethical dilemmas due to uncertainty and a lack of control. The matter of power relations, the attempts to standardize digital solutions and the conflict between cost efficiency and if digital care solutions add value for patients, all caused moral dilemmas for eldercare professionals. The findings suggest a need for organizational infrastructure that promotes ethical conduct and behaviour, ethics training and access to related resources.

Disability design and innovation in computing research in low resource settings

MORGADO-RAMIREZ, Dafne Zuleima
BARBARESCHI, Giulia
DONOVON-HALL, Maggie Kate
SOBUH, Mohammad
ELLYAN, Nida'
TAKANDI, Brenda T
SSEKITOLEKO, Robert
OLENJA, Joyce
MAGOMERE, Grace Nyachomba
DAYMONDE, Sibylle
HONEYWILL, Jake
HARRIS, Ian
MBUGUA, Nancy
KENNEY, Laurence
HOLLOWAY, Catherine
October 2020

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80% of people with disabilities worldwide live in low resourced settings, rural areas, informal settlements and in multidimensional poverty. ICT4D leverages technological innovations to deliver programs for international development. But very few do so with a focus on and involving people with disabilities in low resource settings. Also, most studies largely focus on publishing the results of the research with a focus on the positive stories and not the learnings and recommendations regarding research processes. In short, researchers rarely examine what was challenging in the process of collaboration. We present reflections from the field across four studies. Our contributions are: (1) an overview of past work in computing with a focus on disability in low resource settings and (2) learnings and recommendations from four collaborative projects in Uganda, Jordan and Kenya over the last two years, that are relevant for future HCI studies in low resource settings with communities with disabilities. We do this through a lens of Disability Interaction and ICT4D.

 

ASSETS '20: Proceedings of the 22nd International ACM SIGACCESS Conference on Computers and Accessibility; 2020

https://doi.org/10.1145/3373625.3417301

Measure It Super Simple (MISS) activity tracker: (re)design of a user-friendly interface and evaluation of experiences in daily life

UMMELS, Darcy
BRAUN, Susy
STEVENS, An
BEEKMAN, Emmylou
BEURSKENS, Anna
2020

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Purpose

The purposes of this study were, first, to (re)design the user-interface of the activity tracker known as the MOX with the help of input from elderly individuals living independently and, second, to assess the use of and experiences with the adapted Measure It Super Simple (MISS) activity tracker in daily life.

 

Methods

The double diamond method, which was used to (re)design the user-interface, consists of four phases: discover, define, develop, and deliver. As a departure point, this study used a list of general design requirements that facilitate the development of technology for the elderly. Usage and experiences were assessed through interviews after elderly individuals had used the activity tracker for 2 weeks.

 

Results

In co-creation with thirty-five elderly individuals (65 to 89-years-old) the design, feedback system, and application were further developed into a user-friendly interface: the Measure It Super Simple (MISS) activity. Twenty-eight elderly individuals (65 to 78-years-old) reported that they found the MISS activity easy to use, needed limited help when setting the tracker up, and required limited assistance when using it during their daily lives.

 

Conclusions

This study offers a generic structured methodology and a list of design requirements to adapt the interface of an existing activity tracker consistent with the skills and needs of the elderly. The MISS activity seemed to be successfully (re)designed, like the elderly who participated in this pilot study reported that anyone should be able to use it.

Disability Inclusive Development - Nigeria Situational Analysis

THOMPSON, Stephen
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Nigeria?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Nigeria. It will be helpful for anyone interested in disability inclusion in Nigeria, especially in relation to stigma, employment, education, health, and humanitarian issues.

Women's Integrated Sexual Health (WISH) Programme for Results: independent verification, evidence, and learning

Monteath-van Dok, Adrienne
Lagaay, Mary
April 2020

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As part of the Department for International Development’s (DFID’s) Women’s Integrated Sexual Reproductive Health (WISH) programme, an evidence gap map (EGM) has been developed to map interventions on ‘what works’ to enable access to sexual reproductive health (SRH) services for persons with disabilities in low and middle-income countries (LMICs). EGMs are a user-friendly presentation of the available, relevant evidence for a particular sector, which is systematically gathered and mapped onto a framework, visually highlighting the gaps or concentration of evidence. This EGM aims to support WISH programming by consolidating evidence and identifying tools/approaches which could be brought into the programme. In addition, it aims to identify where evidence is weak and how the WISH programme can contribute to evidence generation.

This report provides a written accompaniment to the Evidence Gap Map (EGM) to explain the methodology, findings on the availability of evidence, and key recommendations. When scoping for this EGM, it was recognised early on that some of the best practices and interventions on ‘what works’ to support persons with disabilities access SRH services in LMICs are not always empirically tested. Therefore, a decision was made to develop an EGM which includes both peer-reviewed and grey literature. This approach diverges from the norm, as EGMs typically only include peer-reviewed literature.

Zero Project Report 2020: Inclusive education. 75 Innovative Practices and 11 Innovative Policies from 54 countries

BUTCHER, Thomas
et al
January 2020

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There are several sections in this report:

  • Executive summary
  • Impact of the Zero Project: Survey results
  • Innovative policies and practices: Factsheets and life stories
  • The Zero Project Impact Transfer accelerator programme
  • An analysis of ICT supporting innovations in inclusive education
  • SDGs, Data and inclusive education
  • Summary of report in Easy Read. 

Themes were:

  • Early childhood and preschool
  • Formal education (primary and secondary education)
  • Universities (tertiary education)
  • Vocational education and training
  • Non-formal education
  • ICT-driven solutions related to education/digital skills

Objective and subjective measures of physical functioning in women with fibromyalgia: what type of measure is associated most clearly with subjective well-being?

MUNGUIA-IZQUIERDO, Diego
PULIDO-MARTOS, Manuel
ACOSTA, Francisco M
ACOSTA-MANZANO, Pedro
GAVILAN-CARRERA, Blanca
RODRIGUEZ-AYLLON, Maria
GEENEN, Rinie
DELGADO-FERNANDEZ, Manuel
ALVAREZ-GALLARDO, Inmaculada C
SEGURA-JIMENEZ, Victor
WALITT, Brian
ESTEVEZ-LOPEZ, Fernando
October 2019

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Purpose: To find modifiable factors that are related to subjective well-being would be valuable for improving interventions in fibromyalgia. Physical activity, sedentary behaviour, and physical fitness may represent potential areas to optimize treatment regimens. In fibromyalgia, there is a discordance between clinical observations and patient-reported outcomes (objective and subjective assessments). Therefore, the present study aims at analyzing the associations of objective and subjective evaluations of physical activity, sedentary behaviour, and physical fitness with subjective well-being and determine if and how objective and subjective associations differ.

 

Methods: In this population-based cross-sectional study participated 375 women with fibromyalgia from the al-Ándalus project (Spain). Physical activity, sedentary behaviour, and physical fitness were objectively (accelerometers and performance testing) and subjectively (questionnaires) measured. Participants self-reported their levels of positive affect, negative affect, and life satisfaction.

 

Results: In the most conservative multivariate analysis, we found independent associations of the objective measures of physical activity with positive affect and life satisfaction and sedentary behaviour with positive affect. No such relationship was seen with subjective measures of the same behaviours. Moreover, we observed that objective and subjective physical fitness evaluations were independent of each other related to subjective well-being.

 

Conclusions: Independent associations of the objective measures (but not the subjective assessments) of physical activity with positive affect and life satisfaction, and of sedentary behaviour with positive affect were observed. However, objective measures and subjective appraisals of physical fitness appear to be independently related to well-being, which should be considered when developing physical exercise interventions for fibromyalgia.

United Nations Disability Inclusion strategy

UNITED NATIONS
June 2019

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The United Nations Disability Inclusion Strategy provides the foundation for sustainable and transformative progress on disability inclusion through all pillars of the work of the United Nations: peace and security, human rights, and development.
 
The Strategy enables the UN system to support the implementation of the Convention on the Rights of Persons with Disabilities and other international human rights instruments, as well as the achievement of the Sustainable Development Goals, the Agenda for Humanity and the Sendai Framework for Disaster Risk Reduction.

The Strategy includes a policy and an accountability framework, with benchmarks to assess progress and accelerate change on disability inclusion. The policy establishes a vision and commitment for the United Nations system on the inclusion of persons with disabilities.

 

The strategy is based on three over-arching approaches to achieve disability inclusion: twin track approach; intersectionality; and coordination

There are four core areas of responsibility: leadership, strategic planning and management; inclusiveness; programming; and organisational culture

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.

Development, reliability, and piloting of a wheelchair caster failure inspection tool (C-FIT)

MHATRE, Anand A
LACHELL, Stephanie
PEARLMAN, Jonathan L
2019

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Introduction: 

Wheelchair casters fail frequently in the field causing multiple user consequences and wheelchair breakdowns. To inform caster design improvement, there exists no validated tools that can collect caster failures. This need motivated the development of a user-reported, caster failure inspection tool (C-FIT).

 

Methods: 

To develop C-FIT, a multistep design and testing approach was used which included face validity testing, test-retest reliability testing and expert review. Reliability testing was conducted with two independent cohorts of wheelchair professionals who inspected caster failures physically and online through pictures. The tool was revised based on testing outcomes and expert feedback. For preliminary data collection and evaluating usability, C-FIT was piloted at wheelchair service centers in Scotland, Indonesia and Mexico.

 

Results: 

Caster failure items reported in the literature were screened to develop the initial list of C-FIT items. Face validity testing conducted through surveys with wheelchair experts (n = 6) provided 14 items for C-FIT inclusion. The test-retest reliability was found to be high for 10 items with physical failure inspections (n = 12). For each of these items, 75% or more participants had substantial to almost perfect agreement scores (κ = 0.6–1.0). Lower reliability scores were found with online failure inspections (n = 11). C-FIT received positive usability feedback from study participants and data collectors in the field. Pilot field data (n = 31) included comprehensive details about failures useful for manufacturers, designers and researchers to improve caster designs.

Conclusions: 

The C-FIT tool developed in this study has substantial reliability and can be used for documenting caster failures at wheelchair service centers.

Deaf people in Pacific Island countries. A design for the Pacific deaf strenthening program

JENKIN, Elena
WATERS, Philip
SEN, Krishneer
ADAM, Robert
2019

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Pacific Disability Forum (PDF) is committed to advancing the rights of people with disabilities living in Pacific Island Countries (PICs). Developing an evidence base to understand more about deaf children and adults’ experiences and priorities will better assist communities, DPOs, organisations and governments to plan inclusive communities, policy and programs.

 

The development of the design was deliberately planned to be highly collaborative and the team met with 161 people who shared their views. This provided opportunities for deaf people and DPOs to contribute to the design, along with representatives from government, non-government and regional organisations. This collaboration occurred in three countries in the Pacific, namely Solomon Islands, Samoa and Fiji. Within Fiji, the design team met with deaf and DPO representatives of other PIC’s along with regional multi-lateral organisations such as UNICEF and the Pacific Island Forum Secretariat (PIFS). Consultations also occurred remotely with supporting organisations and development workers that are focused on disability inclusion in the Pacific. The design undertook a desk review to learn what is known about deaf children and adults in the Pacific region. Participatory methods ensured the process was highly respectful of the views of deaf people. DPOs, other organisations and governments will be asked to identify to what extent deaf children, adults and their families are participating in services, programs and establishments, and to identify potential supports required to increase deaf people’s participation.  A capacity building element has been carefully built into the design. The report is divided into three parts. Part A rationalizes the design, with background information and a brief desk review to collect evidence from and about deaf children and adults in the Pacific. Part B describes the design development process and reports findings. Part C details the design for the situation analysis.  

Disability inclusion and accountability framework

McCLAIN-NHLAPO, Charlotte
et al
June 2018

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The main objective of the Disability Inclusion and Accountability Framework is to support the mainstreaming of disability in World Bank activities. It lays out a road map for (a) including disability in the Bank's policies, operations and analytical work, and (b) building internal capacity for supporting clients in implementing disability-inclusive development programs. The primary target audience of the Framework is Bank staff but it is also relevant to the Bank's client countries, development partners and persons with disabilities. The framework provides four main principles for guiding the World Bank’s engagement with persons with disabilities: nondiscrimination and equality, accessibility, inclusion and participation, and partnership and collaboration. 

 

The appendices to this framework highlight key areas in which the Bank can have a significant impact on the inclusion, empowerment, and full participation of persons with disabilities. These areas include transport, urban development, disaster risk management, education, social protection, jobs and employment, information and communication technology, water sector operations, and health care. 


Report No. 126977
 

Assistive technology products: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit

SMITH, Roger O
SCHERER, Marcia J
COOPER, Rory
BELL, Diane
HOBBS, David A
PETTERSSON, Cecilia
SEYMOUR, Nicky
BORG, Johan
JOHNSON, Michelle J
LANE, Joseph P
SUJATHA, S
RAO, PVM
OBIEDAT, Qussai M
MACLACHLAN, Malcolm
BAUER, Stephen
2018

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This paper is based on work from the Global Research, Innovation, and Education on Assistive Technology (GREAT) Summit that was coordinated by WHO’s Global Cooperation on Assistive Technology (GATE). The purpose of this paper is to describe the needs and opportunities embedded in the assistive product lifecycle as well as issues relating to the various stages of assistive product mobilization worldwide.

The paper discusses assistive technology product terminology and the dangers of focusing on products outside the context and rolling out products without a plan. Additionally, the paper reviews concepts and issues around technology transfer, particularly in relation to meeting global needs and among countries with limited resources. Several opportunities are highlighted including technology advancement and the world nearing a state of readiness through a developing capacity of nations across the world to successfully adopt and support the assistive technology products and applications.

The paper is optimistic about the future of assistive technology products reaching the people that can use it the most and the excitement across large and small nations in increasing their own capacities for implementing assistive technology. This is expressed as hope in future students as they innovate and in modern engineering that will enable assistive technology to pervade all corners of current and potential marketplaces. Importantly, the paper poses numerous topics where discussions are just superficially opened. The hope is that a set of sequels will follow to continue this critical dialog.

Learning From Experience: Guidelines for locally sourced and cost-effective strategies for hygiene at home for people with high support needs.

World Vision/CBM Australia
May 2018

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This learning resource is the result of a partnership between World Vision Australia and CBM Australia that aims to improve inclusion of people with disabilities in World Vision’s Water, Hygiene and Sanitation (WASH) initiatives, including in Sri Lanka. The guidelines are based on experiences and observations from World Vision’s implementation of the Rural Integrated WASH 3 (RIWASH 3) project in Jaffna District, Northern Province, funded by the Australian Government’s Civil Society WASH Fund 2. The four year project commenced in 2014. It aimed to improve the ability of WASH actors to sustain services, increase adoption of improved hygiene practices, and increase equitable use of water and sanitation facilities of target communities within 11 Grama Niladari Divisions (GNDs) in Jaffna District.

To support disability inclusion within the project, World Vision partnered with CBM Australia. CBM Australia has focused on building capacities of partners for disability
inclusion, fostering connections with local Disabled People’s Organisations, and providing technical guidance on disability inclusion within planned activities. World Vision also partnered with the Northern Province Consortium of the Organizations for the Differently Abled (NPCODA) for disability assessment, technical support and capacity building on inclusion of people with disabilities in the project.

HYGIENE AT HOME FOR PEOPLE WITH HIGH SUPPORT NEEDS
This document is one of two developed in the Jaffna District and describes strategies that used to assist households and individuals in hygiene tasks at home. The strategies were designed to be low cost and were developed using locally available materials and skills in the Jaffna District of Sri Lanka.

NOTE: The development of this learning resource was funded by the Australian Government's Civil Society WASH Fund 2.

Digital Accessibility Toolkit

CBM
May 2018

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The purpose of this toolkit is to share a selection of tools and recommendations pertaining to the accessibility of Information and Communication Technologies (ICT). Based on international standards and a scan of available technologies, these tools and recommendations are intended to contribute to the social and economic inclusion of persons with disabilities by ensuring that information is equitably accessible.

The goals of this toolkit are:

  • To outline the key international frameworks around digital accessibility and why it is critical for inclusion of persons with disabilities.
  • To link people with tools, practice examples, free online training, and other resources so that their practice is digitally accessible.
  • To ensure that digital accessibility is an inherent aspect of daily practice.
  • To align the practices of those working with and for CBM. 

This toolkit is intended to be used as a guide and practice resource by people working with and for CBM so that we produce accessible digital content and communications, and place accessibility at the centre of our ICT procurement processes. We hope that the toolkit will be a resource for the wider community of persons with disabilities, Disabled People’s Organisations (DPOs), and nongovernmental organisations (NGOs).

Kinect4FOG: monitoring and improving mobility in people with Parkinson’s using a novel system incorporating the Microsoft Kinect v2

AMINI, Amin
BANITSAS, Konstantinos
YOUNG, William R
2018

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Parkinson’s is a neurodegenerative condition associated with several motor symptoms including tremors and slowness of movement. Freezing of gait (FOG); the sensation of one’s feet being “glued” to the floor, is one of the most debilitating symptoms associated with advanced Parkinson’s. FOG not only contributes to falls and related injuries, but also compromises quality of life as people often avoid engaging in functional daily activities both inside and outside the home. In the current study, we describe a novel system designed to detect FOG and falling in people with Parkinson’s (PwP) as well as monitoring and improving their mobility using laser-based visual cues cast by an automated laser system. The system utilizes a RGB-D sensor based on Microsoft Kinect v2 and a laser casting system consisting of two servo motors and an Arduino microcontroller. This system was evaluated by 15 PwP with FOG. Here, we present details of the system along with a summary of feedback provided by PwP. Despite limitations regarding its outdoor use, feedback was very positive in terms of domestic usability and convenience, where 12/15 PwP showed interest in installing and using the system at their homes.

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