Search results for: barriers in disability care

Authors: Anita Ghai

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The present paper explores the imperative to establish disability studies as an independent area of academic inquiry in India through the establishment of specific programmes in disability studies. The case study of the efforts made by the Ambedkar University, Delhi, to develop such programs and courses shall be used to substantiate this imperative as well as to explore some of the challenges entailed. The paper shall explore the certain extent aspects of relevant scholarship in the area of disability studies in India today and critically reflect on the perspectives of disability in this scholarship. The study of disability in India has hitherto been the prerogative of special education, rehabilitation psychology, and social work departments. While instances of these departments adopting critical approaches to disability can be identified, their empirical focus has perpetuated the production of disability as the site of suffering and oppression. The complex cultural, phenomenological, historical and economic discourses within which disability is embedded can be better captured within distinctive programmes that have disability sui generis as their focus. Such programs would foreground disability as an epistemology, which universalizes the study of disability from disabled people alone to an analysis of various other groups who have been historically marginalized. It will also play an important role in recuperating disability from a state of alterity. The interdisciplinary nature of disability studies offers an opportunity to integrate perspectives from the humanities and the social sciences in the proposed programs. Some of the challenges or rather aspects of reflection that emerge in the course of developing these programs are the criteria for determining the suitability of faculty to teach these programs and the challenges in identifying faculty and in addressing any apprehensions about career prospects that prospective students might have. The manner in which these concerns are being addressed through the collaboration of expertise as well as through the interdisciplinary and flexible nature of the program shall be addressed in the course of the paper. In conclusion, the paper shall foreground the need for disability studies programs in India, the re-appropriation of existing scholarship in the process of formulation these programs, emerging concerns and the manner in which these concerns will be addressed.

Keywords: academia, disability studies, epistemology, India

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Authors: Hector Jose Velazquez-Gonzalez, Norma Maldonado-Santiago, Laura Pietri-Gomez

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Cancer is one of the first cause of death in the world, most of them are women. In Puerto Rico, there is a permanent controversy on the conceptuation of what really involves a disability, also in when a chronic illness, like cancer, should be considered a disability. The aim of the research was to identify functional limitation in 50 women survivors of cancer. In turn, to know the meanings that 6 women attributed to cancer with a focus on functionality. We conducted a mix method research based on surveys and narratives. We administered the World Health Organization Disability Assessment, version 2.0, which obtained a Cronbach’s alpha of .949 on the general scale, and from .773 to .956 on the six domains. The domain that obtained the highest average was social participation (M= 33.89, SD= 20.434), but it was not significant in the disability percentage. Also, there was no significance in the disability percentage in the other five domains. In a matter of meanings, we conduct a semistructured interview to 6 participants. All of them do not refer to cancer as a disability, either they do not know that in Puerto Rico cancer is considered as a disability by the law. However, participants agree that cancer at the time of treatment and subsequent to it, has significant effects on functional limitations (fatigue, pain, cognitive limitations, and weakness, among others. Psychooncologic practice should encourage the constant assessment of the functionality to identify the needs that emerge from oncological diagnosis. So that psychosocial intervention could be considered as critical in cancer treatment to promote a better quality of life and well-being in a person with cancer.

Keywords: cancer, Puerto Rico, disability, psychosocial approach

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Authors: Amrin Moger, Martin Mathew, Sagar Bhalerao

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Mass media may be categorized into print and digital, former being the traditional form of reaching the masses to inform and educate on various issues. The Indian print media is more than two centuries old. Its strengths have largely been shaped by its historical experience and, in particular, by its association with the freedom struggle as well as movements for social emancipation, reform, and amelioration. Therefore, it is highly regarded in the Indian society. Persons with disability are part of Indian Society. Persons with Disability have always been looked down upon and not considered as part of the society. People with disabilities were commonly feared, pitied, and neglected. Much of the literature on disability in India has pointed to the importance of the concept of karma in attitudes to disability, with disability perceived either as punishment for misdeeds in the past lives of the PWD, or the wrongdoings of their parents. Some Indian authors consider the passage of the PWD Act as a landmark step in the history of rehabilitation services in India have put it, ‘At a profoundly serious and spiritual level, disability represents divine justice’. The newspaper has to play a role where it changes this attitude of the people. A short comparative content analysis of two English newspapers of Mumbai edition was selected, to analyze the language that is used for reporting disability issues. Software Package for Social Science (SPSS) was used to gather and analyze data.

Keywords: content analysis, disability, newspaper dailies, language

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Authors: Kajori Banerjee, Laxmi Kant Dwivedi

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“Health transition” is defined to be “a process through which high levels of mortality, morbidity and disability are reduced to low levels by influencing cultural, social and behavioural factors”. Life expectancy in India has been on the rise and parallel the burden of disease and disability has also risen noticeably. Borrowing data from Indian Census (2001, 2011), this study identifies the gender-wise burden of disability by calculating disability free life expectancy (DFLE) and life lived with disability (LWD). Sullivan’s method of calculating DFLE using proportion of disabled is used for this purpose. The change in person years lived with disability in the decade 2001-11 is further decomposed using Arriaga’s method into mortality and disability effects (ME and DE) to check the magnitude and direction of contribution of mortality and disability. Nationally, along with DFLE, LWD has amplified too. Despite having the highest life expectancy and DFLE, LWD in Kerala, was highest for both sexes in 2001. But in 2011, the LWD was highest among the males of Orissa and females of Rajasthan. For the overall population, DE is positive for the prime working age groups of 20-40years indicating that there has been an increase in the disability proportion holding mortality constant for 2001-2011. Females exhibit higher positive DE implying greater loss of healthy years due to disability than males. The findings call for an immediate attention to the causes of rising disability burden among the working population, especially females, as this might heavily effect the availability of quality labour force and its relative economic output in the Indian labour market. This also hints at the degrading quality of the elongated life and needs to be given the required attention to enhance the quality of life lead in the Nation.

Keywords: disability-free life expectancy, disability effect, life expectancy, mortality effect

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Authors: Chetna Jaswal, Nishi Srivastava, Ahammedul Kabeer AP, Puja Prasad

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We are a culture of mass media consumers and cinema as its integral part has high visibility and potential influence on public attitude towards disability which maintains no sociocultural boundaries but experiences substantial social marginalization. Given the lack of awareness and direct experience with disability, on-screen or film representations can give powerful and memorable definitions for the public that can contribute to framing the perception and attitude change. Social representation refers to common ways of thinking, conceiving about and evaluating social reality. It is a product of collective cognition, common sense and thought system. This study aims at analyzing the representations and narratives of disability in Indian cinema and Hollywood with the help of a conceptual understanding of social representation and its theoretical framework.

Keywords: disability, social representation, mainstream cinema, diversity

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Authors: Nyla Anjum, Humaira Bano

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Disability, regardless of its type and nature limits one or two significant life activities. These limitations constitute risk factors for suicide. Rate and intensity of problem upsurges in critical age of adolescence. Researches in the field of mental health over look problem of suicide among persons with disability. Aim of the study was to investigate prevalence and risk factors for suicide among adolescents with disability. The study constitutes purposive sample of 106 elements of both gender with four major categories of disability: hearing impairment, physical impairment, visual impairment and intellectual disabilities. Face to face interview technique was opted for data collection. Other variable are: socio-economic status, social and family support, provision of services for persons with disability, education and employment opportunities. For data analysis independent sample t-test was applied to find out significant differences in gender and One Way Analysis of variance was run to find out differences among four types of disability. Major predictors of suicide were identified with multiple regression analysis. It is concluded that ideation, plans and attempts of suicide among adolescents with disability is a multifaceted and imperative concern in the area of mental health. Urgent research recommendations contains valid measurement of suicide rate and identification of more risk factors for suicide among persons with disability. Study will also guide towards prevention of this pressing problem and will bring message of happy and healthy life not only for persons with disability but also for their families. It will also help to reduce suicide rate in society.

Keywords: suicide, risk factors, adolescent, disability, mental health

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Authors: Okupe Temitope Oluwaseun

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Purpose: The paper determines the existing position of attitudes to disability in a Nigerian organisation. It further assessed the progress that has been made in relation to employment matters as an indication of the Nigerian employment market. Design/methodology/approach: The paper discusses an investigative study which adopted survey research-based approach involving a Nigerian Management Agency. Findings: The paper finds that, although there have been some steps forward, not much has been done with regard to disability equality in the Nigerian employment market. Lack of education, lack of implementing and enforcing the law, inadequate awareness process and international culture have contributed to the current situation. International culture, in particular, is one of the major attributes to lack of disability equality. For example, in the rural areas, the majority of people believe that disability is a form of witchcraft. This paper argues that these traditions, attitudes, and beliefs make it difficult for an organisation to recruit people with disability. Practical Implications: This paper provides a deeper understanding of how organisations can address attitudes to disability within the workplace in Nigeria. The research findings give a fresher perspective on some of the issues associated with disability in this country. This increased understanding has potential to improve the education and training of staff in this area. Originality/value: A paper which human resources managers in Nigerian organisation and the rest of the world can reflect upon in order to assess their own organisation attitudes to the employment of staff with a disability.

Keywords: disability, international culture, Nigeria, attitudes

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Authors: Angelika Magiera, Weronika Penar, Czesław Klocek

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Intellectual disability (ID) affects approximately 1.55% of children and adults in the society of developed countries. Depending on the ID degree, the patient is burdened with additional disease entities. Intellectual disability does not only limits a person’s opportunities to participate in social life but also affects whole families. People with ID belong to the group of risk of mental illnesses, they are less emotionally stable, while families are predisposed to depression. The study was held in a day care center for people with intellectual disabilities (of various degrees of disability) on 26 people. Nurses and carers also took part. The age range of study groups ranged from 22 to 67 years. Therapeutic classes were held for four independent mixed groups (sex and intellectual disability degree) from 6 to 7 people each, lasting no more than 30 minutes. They were created by the facility's staff to make sure that a group is stable. The animal assisted activity took place with a 2.5-year-old Ragdoll cat. The animal has passed the exam (certificate entitling her to take part in felinotherapy) and had 1.5 years of work experience. Due to the different degrees of ID, an individual emotional state survey was conducted among the caregivers of those who were involved in the activity, to assess the impact of animal assisted activity with a cat on patients. A positive effect on the emotional state of people with different types of intellectual disability was observed. Caregivers and nurses of those participating in the study express willingness to continue these types of classes and consider them necessary for this group of people.

Keywords: intellectual disabilities, animal-assisted activity, cat, feline, emotions

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Authors: Irene Carter, Roy Hanes, Judy MacDonald

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Considering that disability is universal and people with disabilities are part of all societies; that there is a connection between the disabled individual and the societal; and that it is society and social arrangements that disable people with impairments, contemporary disability discourse emphasizes the social model of disability to counter medical and rehabilitative models of disability. However, the social model does not go far enough in addressing the issues of oppression and inclusion. The authors indicate that the social model does not specifically or adequately denote the oppression of persons with disabilities, which is a central component of progressive social work practice with people with disabilities. The social model of disability does not go far enough in deconstructing disability and offering social workers, as well as people with disabilities a way of moving forward in terms of practice anchored in individual, familial and societal change. The social model of disability is expanded by incorporating principles of anti-oppression social work practice. Although the contextual analysis of the social model of disability is an important component there remains a need for social workers to provide service to individuals and their families, which will be illustrated through anti-oppressive practice (AOP). By applying an anti-oppressive model of practice to the above definitions, the authors not only deconstruct disability paradigms but illustrate how AOP offers a framework for social workers to engage with people with disabilities at the individual, familial and community levels of practice, promoting an emancipatory focus in working with people with disabilities. An anti- social- oppression social work model of disability connects the day-to-day hardships of people with disabilities to the direct consequence of oppression in the form of ableism. AOP theory finds many of its basic concepts within social-oppression theory and the social model of disability. It is often the case that practitioners, including social workers and psychologists, define people with disabilities’ as having or being a problem with the focus placed upon adjustment and coping. A case example will be used to illustrate how an AOP paradigm offers social work a more comprehensive and critical analysis and practice model for social work practice with and for people with disabilities than the traditional medical model, rehabilitative and social model approaches.

Keywords: anti-oppressive practice, disability, people with disabilities, social model of disability

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Authors: Hamzeh Awad

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Disability is considered to be a worldwide complex phenomenon which rising at a phenomenal rate and caused by many different factors. Chronic diseases such as cardiovascular disease and diabetes can lead to mobility disability in particular and disability in general. The ICF is an integrative bio-psycho-social model of functioning and disability and considered by the World Health Organization (WHO) to be a reference for disability classification using its categories and core set to classify disorder’s functional limitations. Specialist programs at Sultan Bin Abdul Aziz Humanitarian City (SBAHC) are providing both inpatient and outpatient services have started to implement the ICF and use it as a problem solving tool in Rehab. Diabetes is leading contributing factor for disability and considered epidemic in several Gulf countries including the Kingdom of Saudi Arabia (KSA), where its prevalence continues to increase dramatically. Metabolic disorders, mainly diabetes are not well covered in Rehab field. The purpose of this study is present to research and clinical rehabilitation field of DREAM and ICF as a framework in clinical and research setting in Rehab service. Also, shed the light on using the ICF as problem solving tool at SBAHC. There are synergies between disability causes and wider public health priorities in relation to both chronic disease and disability prevention. Therefore, there is a need for strong advocacy and understanding of the role of ICF as a reference in Rehab settings in Middle East if we wish to seize the opportunity to reverse current trends of acquired disability in the region.

Keywords: international classification of functioning, disability and health (ICF), prototype, rehabilitation and diabetes

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Authors: Julia Córdoba

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People are not completely autonomous, as we live in society; therefore, people could be defined as relationally dependent. The lack, decrease or loss of physical, psychological and/or social interdependence due to a disability situation is known as dependence. This is related to the need for help from another person in order to carry out activities of daily living. This population group lives with major social limitations that significantly reduce their participation and autonomy. They have high levels of stigma and invisibility from private environments (family and close networks), as well as from the public order (environment, community). The importance of this study lies in the fact that the lack of support and adjustments leads to what authors call the circle of exclusion. This circle describes how not accessing services - due to the difficulties caused by the disability situation impacts biological, social and psychological levels. This situation produces higher levels of exclusion and vulnerability. This study will focus on the process of autonomy and dependence of adults with disability from the model of disability proposed by the International Classification of Functioning, Health and Disability (ICF). The objectives are: i) to write down the relationship between autonomy and dependence based on socio-health variables and ii) to determine the relationship between the situation of autonomy and dependence and the expectations and interests of the participants. We propose a study that will use a survey technique through a previously validated virtual questionnaire. The data obtained will be analyzed using quantitative and qualitative methods for the details of the profiles obtained. No less than 200 questionnaires will be administered to people between 18 and 64 years of age who self-identify as having some degree of dependency due to disability. For the analysis of the results, the two main variables of autonomy and dependence will be considered. Socio-demographic variables such as age, gender identity, area of residence and family composition will be used. In relation to the biological dimension of the situation, the diagnosis, if any, and the type of disability will be asked. For the description of these profiles of autonomy and dependence, the following variables will be used: self-perception, decision-making, interests, expectations and life project, care of their health condition, support and social network, and labor and educational inclusion. The relationship between the target population and the variables collected provides several guidelines that could form the basis for the analysis of other research of interest in terms of self-perception, autonomy and dependence. The areas and situations where people state that they have greater possibilities to decide and have a say will be obtained. It will identify social (networks and support, educational background), demographic (age, gender identity and residence) and health-related variables (diagnosis and type of disability, quality of care) that may have a greater relationship with situations of dependency or autonomy. It will be studied whether the level of autonomy and/or dependence has an impact on the type of expectations and interests of the people surveyed.

Keywords: life project, disability, inclusion, autonomy

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Authors: Andrew Anis Fakhrey Mosaad

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Objectives: Physiotherapy in the intensive care unit (ICU) improves patient outcomes. We aimed to determine the characteristics of physiotherapy practice and critical barriers to applying physiotherapy in ICUs. Materials and Methods: A 54-item survey for determining the characteristics physiotherapists and physiotherapy applications in the ICU was developed. The survey was electronically sent to potential participants through the Turkish Physiotherapy Association network. Sixty-five physiotherapists (47F and 18M; 23–52 years; ICU experience: 6.0±6.2 years) completed the survey. The data were analyzed using quantitative and qualitative methods. Results: The duration of ICU practice was 3.51±2.10 h/day. Positioning (90.8%), active exercises (90.8%), breathing exercises (89.2%), passive exercises (87.7%), and percussion (87.7%) were the most commonly used applications. The barriers were related to physiotherapists (low level of employment and practice, lack of shift); patients (unwillingness, instability, participation restriction); teamwork (lack of awareness and communication); equipment (inadequacy, non-priority to purchase); and legal (reimbursement, lack of direct physiotherapy access, non-recognition of autonomy) procedures. Conclusion: The most common interventions were positioning, active, passive, breathing exercises, and percussion. Critical barriers toward physiotherapy are multifactorial and related to physiotherapists, patients, teams, equipment, and legal procedures. Physiotherapist employment, service maintenance, and multidisciplinary teamwork should be considered for physiotherapy effectiveness in ICUs.

Keywords: intensive care units, physical therapy, physiotherapy, exercises

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Authors: Amanda Noble

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The process of exiting/escaping situations of sex trafficking can be arduous and fraught with numerous barriers. In this paper the results of a national Canadian study on escaping situations of sex trafficking is discussed. Surveys and focus groups were conducted with 201 stakeholders in 8 cities, including 50 survivors of sex trafficking, service providers, health care providers and police. The results show that survivors are both vulnerable to being exploited and experience barriers to exiting as a result of structural factors such as colonialism, poverty, and discrimination based on race and gender. Survivors also face numerous barriers within various systems such as child welfare and the legal system. In addition, survivors contend with multiple psychological and psychosocial factors when exiting including the trauma bond, complex trauma and mental health concerns, substance use, isolation, and adjusting to ‘mainstream’ life. In light of these factors, the service needs of survivors escaping sex trafficking are discussed, and promising practices, such as trauma-informed practice and working from a stages of change model are outlined. This paper is useful for service providers that work with survivors, policy makers, or anyone who has ever wondered why survivors that are not being physically detained don’t ‘just leave’ or escape their exploitative situations.

Keywords: Barriers, Exiting, Promising Practices, Sex Trafficking

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Authors: Mehena Fedoul

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This paper examines the intersection of race, gender, and disability through a Critical disability race theory and black feminist disability perspective in Keah Brown's memoir, "The Pretty One." The background of the study highlights the significance of intersectionality in understanding the multifaceted experiences of individuals who navigate multiple marginalized identities. The study contributes to the underrepresented field of disability studies from Critical race and black feminist perspectives, shedding light on the unique challenges and resilience of black disabled women. The study employs a qualitative analysis of Keah Brown's memoir as a primary text. Drawing on intersectionality theory and black feminist disability scholarship, the analysis focuses on how Brown's memoir illuminates the ways in which her race, gender, and disability intersect and shape her lived experiences. The analysis reveals how Brown's memoir challenges traditional notions of disability, beauty, and empowerment through the unapologetic celebration of her blackness, femaleness, and disability. The major findings of the study indicate that Brown's memoir provides a powerful narrative of the complexity, uniqueness and richness of the lived experiences of black disabled women. It demonstrates how the intersectionality of race, gender, and disability shapes Brown's identity, body image, relationships, and societal interactions. The paper also highlights how Brown's memoir emphasizes the importance of inclusivity and intersectionality in understanding and addressing the challenges faced by black disabled women. In conclusion, this study offers a critical analysis of the intersection of race, gender, and disability in Keah Brown's memoir, "The Pretty One," from a black feminist disability perspective. It contributes to the growing body of literature that recognizes the significance of intersectionality in understanding the experiences of marginalized individuals in the disability community. The study underscores the need for more inclusive and intersectional perspectives in disability studies and advocates for greater recognition of the voices and experiences of black disabled women in academic and societal discourse.

Keywords: disability studies, intersectionality, black feminism, Keah Brown

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Authors: Monika Skura

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People with physical disabilities, as with other people with differences in appearance or style of functioning come under negative social mechanisms. Therefore, it is worth asking what the relationship of the group is, who experience psychosocial effects because of their physical disability, towards people with intellectual disabilities, hearing impairments, visual impairments, mental illnesses, and their own physically disabled group. To analyse the perception of people with a physical disability, the study explores three areas: the acceptance or rejection of society’s stigmatization towards persons with disabilities; the importance of their own experience regarding their disability, in relation to another kind of disability; their level of acceptance to social interactions, in relation to various types of disabilities. The research sample consisted of 90 people with physical disabilities, who suffer from damage to the locomotor system. The data was collected using a questionnaire and the Adjective Check List by H. B. Gough and A. B. Heilbrun. This study utilized focus interviews to develop survey items for the questionnaire. The findings highlight that the response from those who were physically disabled agreed with the opinions of general society, not only with the issue of promoting integrated solutions and offering assistance but also having the same preferences and opinions about specific types of disability. However, their perception regarding their own group was noticeably different from that of general society. In the light of the study, for people with physical disabilities, just as for able-bodied people, it can be challenging to develop a meaningful relationship with people who have disabilities. All forms of disability suffer from negative attitudes and opinions that exist in society. The majority of those who were researched were focused primarily on their own problems, this inevitably hinders the integrity of the entire group, making it more difficult for it to find a cohesive voice, in which to promote their place within society.

Keywords: general society’s opinions about disability, people with different kinds of disability, perception, physical disability

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Authors: Jasmin Glock

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Media plays a significant role in terms of shaping and influencing people’s perception of various themes, including disability. Although recent examples indicate progressive attitudes in society, programs across genres continue to portray disability in a negative and stereotypical way. Such a one-sided or stereotypical portrayal of disabled people can further reinforce their marginalized position by turning them into the other. The common trope of the blind or visually impaired woman, for example, marks the character as particularly vulnerable. These stereotypes are easily absorbed and left unquestioned, especially by younger audiences. As a result, the presentation of disability as problematic or painful can instill a subconscious fear of disability in viewers at a very young age. Now the question arises, how can disability be portrayed to children in a more positive way? This paper focuses on the portrayal of physical disability in children’s programming. Using disabled characters from Nickelodeon’s Avatar: The Last Airbender and Avatar: The Legend of Korra, the paper will show that the chosen animated characters have the potential to challenge and subvert disability-based bias and to contribute to the normalization of disability on screen. Analyzing blind protagonist Toph Beifong, recurring support character and wheelchair user Teo, and villain Ming Hua who has prosthetic limbs, this paper aims at highlighting that these disabled characters are far more than mere stereotyped tokens. Instead, they are crucial to the outcome of the story. They are strong and confident while still being allowed to express their insecurities in certain situations. The paper also focuses on how these characters can make disability issues relatable to disabled and non-disabled young audiences alike and how they can thereby contribute to the reduction of prejudice. Finally, they will serve as an example of what inclusive, nuanced, and even empowering disability representation in animated television series can look like.

Keywords: Children, disability, representation, television

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Authors: Vinay Suhalka

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In India, the official nomenclature used by the State for persons with disability is divyang (literally, the one with a divine limb), a word coming from the Sanskrit language. Disability thus gets portrayed as divine, at least in the welfare sector from where it flows down even to the popular imagination where it gets equated to divinity. This paper looks at reference to persons with disabilities as divyangs and goes on to discusses what such usage for an already marginalized group achieves and misses out. The issue of nomenclature and language has always been a contested one when it comes to disability. At the same time, there is also an issue of who determines these labels for the persons with disability. Nomenclature and language used for disability can have real consequences for the population of persons with disability as it may empower or disempower them. Thus, this paper looks at the issue of what it means for persons with disabilities as ‘exceptionally gifted’ and hence divyang. Language can be a powerful tool to communicate meanings and messages associated with a term. When the persons with disabilities as a group are described as ‘exceptionally gifted, talented and the source of inspiration’, it essentially stereotypes and marginalizes them by putting a burden of performance that all of them ought to be achievers, and it is only then that they would be assimilated in the larger society. This paper also argues that such a situation creates a ‘double bind’ where the person is always trying to match up to the labels (the disabled as ‘achiever, overcomer, inspirational’) created by somebody else and looks at self through the eyes of others. This conceptual paper also presents an overview of disability labels while simultaneously looking at projecting disability as divinity which has the potential to wrongly portray the lives of persons with disability in India due to the official usage of the term. It also explores the question of visibility of disability since the idea of divyang implicitly assumes that all disabilities are visible. In reality, however, it may not be the case simply because all forms of disabilities are not visible, people may choose not to visibilize their disabilities if they can and pass as able-bodied, fearing the stigma that surrounds disability. Finally, it argues for an increased focus on understanding the everyday lived realities of those with disability in order to regard it as an important form of difference which could be a potential resource for the society.

Keywords: persons with disability, labels, language use, divinity

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Authors: Sarah Faulkner, Patrick Faulkner, Caroline Ellison

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Improved mental and physical health, community connection, and increased life satisfaction has been strongly associated with bike riding for those with and without a disability. However, much evidence suggests that people living with a disability face increased barriers to engaging in cycling compared to members of the general population. People with an intellectual disability often live more sedentary and socially isolated lives that negatively impact their mental and physical health, as well as life satisfaction. This paper is based on preliminary findings from a three-year intervention cycling project funded by the South Australian Government. The cycling project was developed in partnership with community stakeholders that provided weekly instruction, training, and support to individuals living with intellectual disabilities to increase their capacity in cycling. This project aimed to support people living with intellectual disabilities to foster and facilitate improved physical and mental health, confidence, and independence and enhance social networking through their engagement in community cycling. The program applied principles of social role valorisation (SRV) theory as its guiding framework. Preliminary data collected is based on qualitative interviews with over 50 program participants, results from two participant wellness questionnaires, as well as a perceptually regulated exercise test administered throughout the project implementation. Preliminary findings are further supplemented with ethnographic analyses by the researchers who took a phenology of life experience approach. Preliminary findings of the program suggest a variety of social motivations behind participants' desire to learn cycling that acknowledges previous barriers to engagement and cycling’s role to address feelings of loneliness and social isolation. Meaningful health benefits can be achieved as demonstrated by increases in predicted V02 max measures, suggesting that physical intervention can not only improve physical health outcomes but also provide a variety of other social benefits. Initial engagement in the project has demonstrated an increase in participants' sense of confidence, well-being, and physical fitness. Implementation of the project in partnership with a variety of community stakeholders has identified a number of critical factors and processes necessary for future service replication, sustainability, and success. Findings from this intervention study contribute to the development of a knowledge base on how best to support individuals living with an intellectual disability to partake in bike riding and increase positive outcomes associated with their capacity building, social interaction, increased physical activity, physical health, and mental well-being. The initial findings of this study provide critical academic insights into the social and physical benefits of cycling for people living with a disability, as well as practical advice for future human service applications.

Keywords: cycling, disability, social inclusion, capacity building

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Authors: Eman Ahmed Alsaleh

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Background: Many studies published in other countries identified certain perceived benefits and barriers to physical activity among patients with coronary heart disease. Nevertheless, there is no data about the issue relating to Jordanian patients with coronary heart disease. Objective: This study aimed to describe the prevalence of level of physical activity, benefits of and barriers to physical activity as perceived by Jordanian patients with coronary heart disease, and the relationship between physical activity and perceived benefits of and barriers to physical activity. In addition, it focused on examining the influence of selected sociodemographic and health characteristics on physical activity and the perceived benefits of and barriers to physical activity. Methods: A cross-sectional design was performed on a sample of 400 patients with coronary heart disease. They were given a list of perceived benefits and barriers to physical activity and asked to what extent they disagreed or agreed with each. Results: Jordanian patients with coronary heart disease perceived various benefits and barriers to physical activity. Most of these benefits were physiologically related (average mean = 5.7, SD = .7). The most substantial barriers to physical activity as perceived by the patients were: feeling anxiety, not having enough time, lack of interest, bad weather, and feeling of being uncomfortable. Sociodemographic and health characteristics that significantly influenced perceived barriers to physical activity were age, gender, health perception, chest pain frequency, education, job, caring responsibilities, ability to travel alone, smoking, and previous and current physical activity behaviour. Conclusion: This research demonstrates that patients with coronary heart disease have perceived physiological benefits of physical activity, and they have perceived motivational, physical health, and environmental barriers to physical activity, which is significant in developing intervention strategies that aim to maximize patients' participation in physical activity and overcome barriers to physical activity.

Keywords: prevalence, coronary heart disease, physical activity, perceived barriers

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Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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Authors: Mehena Fedoul

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This paper examines the intersection of race, gender, and disability through a Critical disability race theory and black feminist disability perspective in Keah Brown's memoir, "The Pretty One." The background of the study highlights the significance of intersectionality in understanding the multifaceted experiences of individuals who navigate multiple marginalized identities. The study contributes to the underrepresented field of disability studies from a Critical race and black feminist perspectives, shedding light on the unique challenges and resilience of black disabled women. The study employs a qualitative analysis of Keah Brown's memoir as a primary text. Drawing on intersectionality theory and black feminist disability scholarship, the analysis focuses on how Brown's memoir illuminates the ways in which her race, gender, and disability intersect and shape her lived experiences. The analysis reveals how Brown's memoir challenges traditional notions of disability, beauty, and empowerment through her unapologetic celebration of her blackness, femaleness, and disability. The major findings of the study indicate that Brown's memoir provides a powerful narrative of the complexity, uniqueness and richness of the lived experiences of black disabled women. It demonstrates how the intersectionality of race, gender, and disability shapes Brown's identity, body image, relationships, and societal interactions. The paper also highlights how Brown's memoir emphasizes the importance of inclusivity and intersectionality in understanding and addressing the challenges faced by black disabled women. In conclusion, this study offers a critical analysis of the intersection of race, gender, and disability in Keah Brown's memoir, "The Pretty One," from a black feminist disability perspective. It contributes to the growing body of literature that recognizes the significance of intersectionality in understanding the experiences of marginalized individuals in the disability community. The study underscores the need for more inclusive and intersectional perspectives in disability studies and advocates for greater recognition of the voices and experiences of black disabled women in academic and societal discourse.

Keywords: Intersectionality, black feminism, disability studies, keah brown

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Authors: Wasim Ahmad, Bir Singh Chavan, Nazli Ahmad

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Objectives: The present investigation is an attempt to find out the efficacy of training the special educators on promoting self-determination among individuals with intellectual disability. Methods: The study equipped the special educators with necessary skills and knowledge to train individuals with the intellectual disability for practicing self-determination. Subjects: Special educators (N=25) were selected for training on self-determination among individuals with intellectual disability. After receiving the training, (N=50) individuals with an intellectual disability were selected and intervened by the trained special educators. Tool: Self-Determination Scale for Adults with Mild Mental Retardation (SDSAMR) developed by Keshwal and Thressiakutty (2010) has been used. It’s a reliable and valid tool used by many researchers. It has 36 items distributed in five domains namely: personal management, community participation, recreation and leisure time, choice making and problem solving. Analysis: The collected data was analyzed using the statistical techniques such as t-test, ANCOVA, and Posthoc Tuckey test. Results: The findings of the study reveal that there is a significant difference at 1% level in the pre and post tests mean scores (t-15.56) of self-determination concepts among the special educators. This indicates that the training enhanced the performance of special educators on the concept of self-determination among individuals with intellectual disability. The study also reveals that the training received on transition planning by the special educators found to be effective because they were able to practice the concept by imparting and training the individuals with intellectual disability to if determined. The results show that there was a significant difference at 1% level in the pre and post tests mean scores (t-16.61) of self-determination among individuals with intellectual disability. Conclusion: To conclude it can be said that the training has a remarkable impact on the performance of the individuals with intellectual disability on self-determination.

Keywords: experiment, individuals with intellectual disability, self-determination, special educators

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Authors: Mohammed Amin, Debra Kerr, Yacoba Atiase, Andrea Driscoll

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Background: Physical activity (PA) is a major component of diabetes self-care management; although this is often stressed to patients, many adults with Type 2 Diabetes Mellitus (T2DM)lead sedentary lifestyles, and barriers exist for uptake of PA. Aim: To explore opinions of healthcare professionals about barriers to PA for adults with T2DM in Ghana. Methods: This qualitative descriptive study included 13healthcare professionals (3 Physiotherapists, 3 exercise physiologists, 3 nurses, and 4 physicians) who provide care to individuals with T2DM in Ghana. Data was collected by semi-structured interviews. The social cognitive theory guided the design of the interview schedule. Data was analysed using thematic analysis. Results: Four main themeswere identified: 1) Individual-related factors, 2) Interpersonal factors, 3) Environment-related factors, and 4) Health system-related factors. Fear of injury, existing co-morbidities, and lack of time make it difficult for people with T2DM to engage in PA. Lack of family support, fear of social ridicule, and cultural beliefs prevent uptake of PA. Poorly designed community spaces, including safe walkways and lack of exercise facilities, inhibit PA participation. Few physical therapists and physical therapy centres exist to support PA participation among people with T2DM. Some nurses and doctors lack adequate knowledge to deliver proper PA education to clients, thereby making clients lack the needed support. Conclusion: Adults with T2DM may be restricted from partaking in PA arising from personal and external factors. This study has identified that barriers to exercise need consideration when designing PA programs that aim to improve health outcomes for people with T2DM in Ghana.

Keywords: type 2 diabetes, physical activity, exercise, ghana, qualitative, barriers

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Authors: Frederic Fovet

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Inclusive provisions have been statutorily mandated in North America for now over two decades. Despite a growing body of literature around inclusive practices, many in-service teachers continue to express difficulties when it comes to tangible implementation of inclusion in the everyday classroom. While there is debate around the various forms inclusion can take (UDL, differentiation, personalization, etc.), there appears to be a more significant hurdle in getting in-service teachers to fully embrace inclusion both as a goal and a practice. This paper investigates teachers’ degree of awareness around the Social Model of Disability. It argues that teachers often lack basic awareness of disability studies, more particularly of the Social Model of Disability, and that this has a direct impact on their capacity to conceptualize and embrace inclusion. The paper draws from the researcher’s experience as a graduate instructor with in-service teachers, as well as from his experience as a consultant working with schools and school boards. The methodology chosen here is phenomenology, and it draws on tools such as auto-ethnography. The paper opens a discussion around the reform and transformation of pre-service teacher training. It argues that disability studies should be integrated into teacher training as it plays a key role in having teachers develop a theoretical understanding of disability as a social construct.

Keywords: disability, K-12, inclusion, social model, in-service teachers

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Authors: Yun-Shan Tsai, Si-Ping Lin, En-Chieh Lin, Xin-Hong Chen, Shin-Yun Ho, Shin-Hong Huang, Ching-ju Hsieh

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Background and significance: Uncorrected refractive errors and cataracts are the main visually debilitating ophthalmological abnormalities in adult participants with intellectual disability (ID). However, not all adult participants with ID may receive a regular and timely ophthalmological assessment. Consequently, some of the ocular diseases may not be diagnosed until late, thereby causing unnecessary ocular morbidity. In addition, recent clinical practice and researches have also suggested that eye-care services for this group are neglected. Purpose: To investigate the unmet need for eye care services, clinical characteristics of cataract, visual function, surgical outcome and prognostic predictors in adult participants with ID at Taipei City Hospital in Taiwan. Methods: This is a one-year prospective clinical study. We recruited about 120 eyes of 60 adult participants with ID who were received cataract surgery. Caregivers of all participants received a questionnaire on current eye care services. Clinical demographic data, such as age, gender, and associated systemic diseases or syndromes, were collected. All complete ophthalmologic examinations were performed 1 month preoperatively and 3 months postoperatively, including ocular biometry, visual function, refractive status, morphology of cataract, associated ocular features, anesthesia methods, surgical types, and complications. Morphology of cataract, visual and surgical outcome was analyzed. Results: A total of 60 participants with mean age 43.66 ± 13.94 years, including 59.02% male and 40.98% female, took part in comprehensive eye-care services. The prevalence of unmet need for eye care services was high (about 70%). About 50% of adult participants with ID have bilateral cataracts at the time of diagnosis. White cataracts were noted in about 30% of all adult participants with ID at the time of presentation. Associated ocular disorders were included myopic maculopathy (4.54%), corneal disorders (11.36%), nystagmus (20.45%), strabismus (38.64%) and glaucoma (2.27%). About 26.7% of adult participants with ID underwent extracapsular cataract extraction whereas a phacoemulsification was performed in 100% of eyes. Intraocular lens implantation was performed in all eyes. The most common postoperative complication was posterior capsular opacification (30%). The mean best-corrected visual acuity was significantly improved from preoperatively (mean log MAR 0.48 ± 0.22) to at 3 months postoperatively (mean log MAR 0.045 ± 0.22) (p < .05). Conclusions: Regular follow up will help address the need for eye-care services in participants with ID. A high incidence of bilateral cataracts, as well as white cataracts, was observed in adult participants with ID. Because of early diagnosis and early intervention of cataract, the visual and surgical outcomes of cataract are good, but the visual outcomes are suboptimal due to associated ocular comorbidities.

Keywords: adult participants with intellectual disability, cataract, cataract surgery

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Authors: Katharina Crepaz

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Both minority rights and disability rights are relatively new fields for policy-making in a European context, and both are affected by the EU’s diversity mainstreaming approach, as well as by the non-discrimination legislation drafted at the European level. These processes correspond to the classic understanding of Europeanization, namely a “top-down” stream of influence from the European to the national and subnational levels. However, both minority and disability rights movements also show instances of “bottom-up” Europeanization, e.g. transnational advocacy networks and efforts to reach joint goals at the EU-level. This paper aims to provide a comparative perspective on Europeanization in both fields, pointing out similar dynamics and patterns, but also explaining in which sectors outcomes may be different and which domestic and other scope conditions may be responsible for these differences.

Keywords: europeanization, disability rights, minority rights, comparative perspective

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Authors: Aynur Kazaz, Yusif Inusah

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In the bid to improve transparency and efficiency as well as to reduce the cost of the public procurement process, Ghana started implementing an electronic Government Procurement System, known as the Ghana Electronic Procurement System (GHANEPS) in November 2019. The implementation of e-tendering technology is new to the stakeholders. Therefore, this research is aimed to identify the critical barriers to e-tendering implementation in the Ghanaian construction industry. Examples of barriers to e-tendering implementation were first identified through a literature review, and questionnaires and interview questions were prepared to gather the data. This study contributes to the in-depth understanding of global e-tendering barriers in the Ghanaian construction industry. The findings could help researchers, practitioners, and governments make strategic investment decisions and overcome e-tendering challenges.

Keywords: barriers, challenges, construction industry, e-procurement, e-tendering

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Authors: Anabel Moriña

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In recent years, advances have been made in disability policy at Spanish universities, especially in terms of creating more inclusive learning environments. Nevertheless, while efforts to foster inclusion at the tertiary level -and the growing number of students with disabilities at university- are clear signs of progress, serious barriers to full participation in learning still exist. The research shows that university responses to diversity tend to be reactive, not proactive; as a result, higher education (HE) environments can be especially disabling. It has been demonstrated that the performance of students with disabilities is closely linked to the good will of university faculty and staff. Lectures are key players when it comes to helping or hindering students throughout the teaching/learning process. This paper presents an analysis of how lecturers respond to students with disabilities, the initial question being: do lecturers aid or hinder students? The general aim is to analyse-by listen to the students themselves-lecturers barriers and support identified as affecting academic performance and overall perception of the higher education (HE) experience. Biographical-narrative methodology was employed. This research analysed the results differentiating by fields of knowledge. The research was conducted in two phases: discussion groups along with individual oral/written interviews were set up with 44 students with disabilities and mini life histories were completed for 16 students who participated in the first stage. The study group consisted of students with disabilities enrolled during three academic years. The results of this paper noted that participating students identified many more barriers than bridges when speaking about the role lecturers play in their learning experience. Findings are grouped into several categories: Faculty attitudes when “dealing with” students with disabilities, teaching methodologies, curricular adaptations, and faculty training in working with students. Faculty does not always display appropriate attitudes towards students with disabilities. Study participants speak of them turning their backs on their problems-or behaving in an awkward manner. In many cases, it seems lecturers feel that curricular adaptations of any kind are a form of favouritism. Positive attitudes, however, often depend almost entirely on the good will of faculty and-although well received by students-are hard to come by. As the participants themselves suggest, this study confirms that good teaching practices not only benefit students with disabilities but the student body as a whole. In this sense, inclusive curricula provide new opportunities for all students. A general coincidence has been the lack of training on behalf of lecturers to adequately attend disabled students, and the need to cover this shortage. This can become a primary barrier and is more often due to deficient faculty training than to inappropriate attitudes on the part of lecturers. In conclusion, based on this research we can conclude that more barriers than bridges exist. That said, students do report receiving a good deal of support from their lecturers-although almost exclusively in a spirit of good will; when lecturers do help, however, it tends to have a very positive impact on students' academic performance.

Keywords: barriers, disability, higher education, lecturers

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Authors: Sankalpa Satapathy

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The stigma attached to disability is very high in India and given its patriarchal society women and their interests have always been pushed to the background. The identity of disabled women is compromised under the social construction of disability which lowers their self-esteem and hampers their development. Disability policies in India have focused on provision of educational and employment opportunities to make them economically productive members of the society. This preoccupation with the materialistic spheres of lives of the disabled has led to a neglect of the private sphere concerning intimate social relationships and motherhood. This paper seeks to bring to forefront the private lives of disabled women. Semi-structured in-depth interviews were conducted with twenty seven women with physical disability (congenital/acquired) from Odisha, a state in India. Sampling was done in a manner to include women from various strata of the society to allow meaningful analysis. In a society where paramount importance is attached to wifehood and motherhood, the chances of marriage for disabled women were very low compared to disabled men. Majority believed that marriage and having a family was meant for non disabled women and had decided against getting married. Socialization process was found to be a major factor in determining the ideas and aspirations of disabled women. They were clearly sidelined by their families on the issue of marriage. Education and employment levels did not seem to increase the appeal of disabled women to prospective suitors. But not all the women interviewed were closed to the idea of intimate relationships and marriage. Disabled women who were married or hoped to get married in future were found to have a better body image and greater self motivation. It is interesting to understand the means by which these women, who have been brought up to internalize ideas of their unattractiveness, undesirability, asexuality and inability to care, established identities which have so long been denied to them. With these stories of personal triumphs an attempt is made for reclamation of private spheres which have been abandoned by disability policies and make them gender sensitive.

Keywords: disability, gender, marriage, relationships

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Authors: Paola Montenegro, Maria de los Angeles Balaguera Villa

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In February 2022 Colombia achieved a historic milestone in ensuring universal access to abortion rights with ruling C-055 of 2022 decriminalising abortion up to 24 weeks of gestation. In the context of this triumph and the expansion of telemedicine services in the wake of the COVID-19 pandemic, this research studied the acceptability of self-care abortion in young people (13 - 28 years) through a telemedicine service and also explored the primary needs that should be the focus of such care. The results shine light on a more comprehensive understanding of opportunities and challenges of teleabortion practices in a context that combines overall higher access to technology and low access to reliable information of safe abortion, stigma, and scarcity especially felt by transnational migrants, racialised people, trans men and non-binary people. Through a mixed methods approach, this study collected 5.736 responses to a virtual survey disseminated nationwide in Colombia and 47 in-person interviews (24 of them with people who were assigned female at birth and 21 with local key stakeholders in the abortion ecosystem). Quantitative data was analyzed using Stata SE Version 16.0 and qualitative analysis was completed through NVivo using thematic analysis. Key findings of the research suggest that self-care abortion is practice with growing acceptability among young people, but important adjustments must be made to meet quality of care expectations of users. Elements like quick responses from providers, lower costs, and accessible information were defined by users as decisive factors to choose over the abortion service provider. In general, the narratives in participants about quality care were centred on the promotion of autonomy and the provision of accompaniment and care practices, also perceived as transformative and currently absent of most health care services. The most staggering findings from the investigation are related to current barriers faced by young people in abortion contexts even when the legal barriers have: high rates of scepticism and distrust associated with pitfalls of telehealth and structural challenges associated with lacking communications infrastructure, among a few of them. Other important barriers to safe self-care abortion identified by participants surfaced like lack of privacy and confidentiality (especially in rural areas of the country), difficulties accessing reliable information, high costs of procedures and expenses related to travel costs or having to cease economic activities, waiting times, and stigma are among the primary barriers to abortion identified by participants. Especially in a scenario marked by unprecedented social, political and economic disruptions due to the COVID-19 pandemic, the commitment to design better care services that can be adapted to the identities, experiences, social contexts and possibilities of the user population is more necessary than ever. In this sense, the possibility of expanding access to services through telemedicine brings us closer to the opportunity to rethink the role of health care models in transforming the role of individuals and communities to make autonomous, safe and informed decisions about their own health and well-being.

Keywords: contraception, family planning, premarital fertility, unplanned pregnancy

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