Search results for: disability adjusted life Years

Authors: Barbara A. Perry

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In 1996, the New Zealand government and the Ministry of Education announced that they were setting up a "world class system of inclusive education". As a parent of a son with high and complex needs, a teacher, school Principal and Disability studies Lecturer, this author will track the changes in the journey towards inclusive education over the last 20 years. Strategies for partnering with families to ensure educational success along with insights from one of those on the crest of the wave will be presented. Using a narrative methodology the author will illuminate how far New Zealand has come towards this world class system of inclusion promised and share from personal experience some of the highlights and risks in the system. This author has challenged the old structures and been part of the setting up of new structures particularly for providing parent voice and insight; this paper provides a unique view from an insider’s voice as well as a professional in the system.

Keywords: disability studies, inclusive education, special education, working with families with children with disability

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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: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: Evidence exists that pneumonia is a frequently encountered complication after stroke which is associated with a higher rate of mortality and increased long-term disability Purpose: To determine the predictors associated with the risk of one-year disability in acute stroke. Methods: Data for this longitudinal follow-up study were extracted from a tertiary referral medical center’s stroke registry database in Northern Taipei. Eligible patients with acute stroke admitted to the hospital and completed a one-year follow up were recruited for analysis. Favorable outcome was defined as a modified Rankin Scale score ≤ 2. SAS version 9.2 was used for the multivariable regression analyses to examine the factors correlated with the one-year disability in stroke patients. Results: From January 2012 to December 2013, a total of 1373 (mean age: 70.49±15.4 years, 913(66.5%) males) consecutively administered acute stroke patients were recruited. Overall, the rate of one-year disability was 37.20%(404/1086) in those without post-stroke pneumonia. It increased to 82.93 %(238/287) in patients developed post-stroke pneumonia. Factors associated with increased risk of disability were age ≧ 75(OR= 4.845, p<.0001), female /gender (OR=1.568, p =.0062), previous stroke (OR= 1.868, p = <. 0001) ,dementia (OR= 2.872, p =.0047), ventilator use (OR= 4.653, p <. 0001),age ≧ 75 /pneumonia (OR=1.236, p <. 0001) , ICU admission (OR=3.314, p <.0001) , nasogastric tube insertion (OR= 4.28, p <.0001), speech therapy (OR= 1.79, p =.0142), urinary tract infection (OR= 1.865, p =.0018), estimated glomerular filtration rate (eGFR > 60 )(OR= 0.525, p= .0029), Admission NIHSS >11 (OR= 2.101, p = .0099), Length of hospitalization > 30(d) (OR= 5.182, p <.0001). Conclusion: Older age, severe neurological deficit, complications, rehabilitation intervention, length of hospitalization >30(d), and cognitive impairment were significantly associated with Post-stroke functional impairment, especially those with post-stroke pneumonia. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, disability

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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: Anwaar Anwar Tayel

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Background: Rheumatic arthritis (RA) affect all aspects of patients' life, lead to various degrees of disability, and ultimately has a profound impact on the social, economic, psychological, and sexual aspects of the patient's life. Aim of the study: Identify physical, psychological, and sexual implications of rheumatoid arthritis among women in reproductive age. In addition to investigating the correlations between physical functional disability, psychological problems, and sexual dysfunction.Settings: The study was conducted at Rheumatology Clinic at the Main University Hospital of Alexandria. Subjects: Purposive sample was chosen from women patients with rheumatoid arthritis to be subjects of this study (n=250). Tools: Four tools were used to collect data. Tool I: Socio-demographic questionnaire. Tool II: Stanford Health Assessment Questionnaire Disability Index (HAQ- DI). Tool III: Depression Anxiety Stress Scale (DASS). Tool IV: The Sexual Dysfunction Questionnaire (SDQ) Results: The majority of the studied women suffer from severe physical disability, extreme level of depression, anxiety, and about half of them had an extreme level of stress. Also, the majority of the studied women had a severe level of sexual dysfunction. Also, statistically significant correlations between women's physical disability index, psychological problems, and sexual dysfunction were detected. Conclusion: The findings from this study confirm that women patients with RA suffer from multiple negative implications on the physical, psychological and sexual functions. Recommendations: Provide ongoing support to the patients from the time of diagnosis throughout their care and management. To help them to manage their pain and disabilities, improve their sexual function, promote their mental health, and optimize psychosocial functioning

Keywords: pysical, spycholgical, sexual, implication, rheumatic arthritis

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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: Olga Muries-Cantan, Alice Schippers, Climent Gine, Noelle van den Heuvel

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A systematic review of the literature about the quality of life perceptions of siblings of people with intellectual and developmental disabilities (ID/DD) has shown differences and similarities among siblings’ perceptions around the world. Some of these differences might be explained by the influence of cultural and religious backgrounds on siblings’ quality of life through values, beliefs, and perceptions of ‘normalcy’ and stigma. The main goal of the multiple case study that we present, is to explore the quality of life perceptions of two adolescent siblings of individuals with ID/DD in order to identify the role cultural influence has played in their perceptions of quality of life. Two siblings from different European regions will participate in the study: one from a Southern European country (Spain) and the other one from a Western European country (The Netherlands). Taking a cross-cultural perspective, concepts such as values, cultural beliefs regarding disability, expectations, identity, supports, desires, and sibling relationships, will be discussed in a semi-structured interview with each sibling. Data will be analysed following an interpretative phenomenological analysis (IPA). It is expected that findings will show the particularities of the experience of having a brother or a sister with ID/DD and the singular influence of the culture on siblings’ perceptions of quality of life. The results of this study will help to spread awareness around the necessity that researchers, practitioners, and policymakers take into account the cultural background of the individuals in order to provide them with better services and support. In this line, more culturally situated research is required to enlarge the knowledge in this field.

Keywords: culture, intellectual disability, quality of life, siblings

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Authors: Luigi Iannacci

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This study critically explores how disability and disability are presently and problematically configured within education. As such, pedagogies, discourses, and practices that shape this configuration are examined to forward a reconceptualization of disability as it relates to education and the inclusion of students with special needs in mainstream classroom contexts. The study examines how the dominant medical/deficit model of disability positions students with special needs and advocates for a shift towards a social/critical model of disability as applied to education and classrooms. This is demonstrated through a critical look at how language, processes, and ‘interventions’ name and address deficits people who have a disability are presumed to have and, as such, conceptualize these deficits as inherent flaws that are in need of ‘fixing.’ The study will demonstrate the necessary shifts in thinking, language and practice required to forward a critical/social model of disability. The ultimate aim of this research is to offer a much-needed reconceptualization of inclusion that recognizes disability as epistemology, identity, and diversity through a critical exploration of dominant discourses that impact language, policy, instruction and ultimately, the experiences students with disabilities have within mainstream classrooms. The presentation seeks to explore disability as neurodiversity and therefore elucidate how people with disabilities can demonstrate these ways of knowing within inclusive education that avoids superficial approaches that are not responsive to their needs. This research is, therefore, of interest and use to educators teaching at the elementary, secondary, and in-service levels as well as graduate students and scholars working in the areas of inclusion, special education, and literacy. Ultimately the presentation attempts to foster a social justice and human rights-focused approach to inclusion that is responsive to students with disabilities and, as such ensures a reconceptualization of present language, understandings and practices that continue to configure disability in problematic ways.

Keywords: inclusion, disability, critical approach, social justice

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Authors: Bekhemmas Youcef

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The category of the disabled, like other social groups, is considered to have been affected by fate with a disability that led to a reduction in the fulfillment of its social roles to the fullest extent or led to its complete abandonment. Psychological, and until we understand its behavioral methods that express a lot of this complexity and intertwining, and despite all that, this category has not yet received the appropriate great interest from specialized researchers, and even officials, and it is natural that the category of people with disabilities has psychological and social requirements in order to regains their capabilities or some From her, it also needs to prepare the environment in which she lives in order to integrate into society As the motor disability is one of the most common types of disability in the world, and it is constantly increasing, considering the increase in the causes leading to it, such as the traffic accident, and the motor disability often affects individuals from a psychological point of view, but it also affects their social surroundings, whether close or extended, and thus it draws limits and quality For their way of life, as well as determining roles for them as actors of a special kind within their societies. The methodology is similar to the organizational framework for the production of any scientific knowledge and based on the fact that sociology is a project that aims to understand and interpret the social reality scientifically and through the nature of the subject studied in the framework of the reality of the disabled in the city and in order to get closer to the daily life of the physically disabled within the urban center, we adopted the qualitative approach A choice that complies with the spirit of Viberian sociology, especially since Max Weber insists on the need to search for the meaning that the social actor gives to his behavior. Through the results reached in this study, it was found that the city still suffers from several deficiencies at the level of equipment and urban planning in a way that keeps pace with the number of people with disabilities in the city.

Keywords: physically, handicapped, in, the city

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Authors: Grzegorz Kubinski

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The proposed paper is focused on forms of identity expression in people with disabilities (PWD) in the social networks like Instagram. Theoretical analysis widely proposes using the new media as an assistive tool for improving wellbeing and labour activities of PWD. This kind of use is definitely important and plays a key role in all social inclusion processes. However, Instagram is not a place where PWD only express their own problems, but in the opposite, allows them to construct a new definition of disability. In the paper, the problem how this different than a classical approach to disability is created by PWD will be discussed. This issue will be scrutinized mainly in two points. Firstly, the question of how disability is changed by other everyday activities, like fashion or sport, will be described. Secondly, and this could be seen as more important, the point how PWD redefining their bodies creating a different form of aesthetic will be presented. The paper is based on content analysis of Instagram accounts. About 20 accounts created by PWD were analyzed for 6 month period, taking into account elements like photos, comments and discussions. All those information were studied in relation to 'everyday life' category and 'aesthetic' category. Works by T. Siebers, L. J. Davis or R. McRuer were used as theoretical background. Conclusions and interpretations presented in the proposed paper show that the Internet can be used by PWD not only as prosthetic and assistive tools. PWD willingly use them as modes of expression their independence, agency and identity. The paper proposes that in further research this way of using the Internet communication by PWD should be taken into account as an important part of the understanding of disability.

Keywords: body, disability, identity, new media

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Authors: Santosh Kumar Yadav, Shobha Keswani, Nishat Quddus, Sohrab Ahmad Khan, Zuheb Ahmad Shiddiqui, Varsha Chorsiya

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Introduction: Early onset diabetes is more aggressive than the late onset diabetes. Diabetic individual has a greater spectrum of life period to suffer from its damage, complications, and long-term disability. This study aimed at assessing knee joint muscle performance under various durations of diabetes. Method and Materials: A total of 30 diabetic subjects (18 male and 12 females) without diabetic neuropathy were included for the study. They were divided into three groups with 5 years, 10 years and 15 years of duration of disease each. Muscle performance was evaluated through strength and flexibility. Peak torque for quadriceps muscle was measured using isokinetic dynamometer. Flexibility for quadriceps and hamstring muscles were measured through Ducan’s Elys test and 90/90 test. Results: The result showed significant difference in muscle strength (p<0.05), flexibility (p≤0.05) between groups. Discussion: Optimal muscle strength and flexibility are vital for musculoskeletal health and functional independence. Conclusion: The reduced muscle performance and functional impairment in nonneuropathic diabetic patients suggest that other mechanism besides neuropathy that contribute to altered biomechanics. These findings of this study project early management of these altered parameters through disease-specific physical therapy and assessment-based intervention. Clinical Relevance: Managing disability is more costly than managing disease. Prompt and timely identification and management strategy can dramatically reduce the cost of care for diabetic patients.

Keywords: muscle flexibility, muscle performance, muscle torque, type 2 diabetes

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Authors: Ravan Samadov

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Mentally disabled people are the most discriminated against among other disabled people and face much stronger negative attitudes across many cultures. The most complex and severe form of exclusion of these people is deprivation of liberty on the grounds of their disability. This problem was for many years overlooked to a great extent by the core human rights instruments. However, the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD), adopted in 2006, is considered a potential tool to successfully fill the gap. It is especially vital for the developing countries with the vast majority of disabled people of the world and the CRPD is presumed to be able to trigger drastic positive changes. Article 14 of the mentioned human rights treaty has brought into the international forum a new notion, as prohibits deprivation of liberty on the grounds of disability. It is to be understood as an absolute prohibition of deprivation of liberty on the grounds of disability, including mental disability, which manifests in the form of non-consensual psychiatric hospitalisation. The interpretation by the CRPD Committee indicates that this prohibition well embraces all types of non-consensual psychiatric hospitalisation – whether it is based on illness, impairment or disability. This prohibition also extends to such justifications as ‘dangerousness’, ‘need for treatment’ and ‘diminished capacity’. Moreover, providing due substantive and/or procedural safeguards does not render any legitimacy to application of deprivation of liberty on the grounds of mental disability. Logically, this new prohibition form was to be duly considered by different UN human rights bodies, and was subsequently to bring changes to their practices. However, the analyses of post-CRPD work of those bodies allows for asserting the contrary, as they have continued displaying the position which recognises deprivation of liberty on the grounds of disability to be legitimate. While such a position could be justified in the pre-CRPD time as stemming from the silence of human rights documents about it, the continuation of this course after the CRPD entered into force may call the integrity and coherence of the UN human rights treaty system into question. The non-coherent approaches of different UN bodies to this novelty give grounds for misinterpretation thereof, and hinder its due implementation by the States Parties. The paper will discuss the nature of the mentioned new prohibition and the controversial approaches to that notion by different UN human rights bodies.

Keywords: CRPD, deprivation of liberty, mental disability, non-consensual psychiatric hospitalisation, UN bodies

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Authors: Leoni Van Der Merwe

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Historically, in South Africa, disability has been viewed as a dilemma of the individual. The discourse surrounding the definition of disability and applicable theories are as fluid as the differing needs of persons with disabilities within society. In 1997, the Office of the Deputy President published the White Paper on the Integrated National Disability Strategy (WPINDS) which sought to integrate disability issues in all governmental development strategies, planning and programs as well as to solidify the South African government’s stance that disability was to be considered according to the social model and not the, previously utilized, medical model of disability. The models of disability are conceptual frameworks for understanding disability and can provide some insight into why certain attitudes exist and how they are reinforced in society. Although the WPINDS was regarded as a critical milestone in the history of the disability rights struggle in South Africa; it has taken approximately twenty years for the publication of a similar document taking into account South Africa’s changing social, economic, political and technological dispensation. December 2015 marked the approval of the White Paper on the Rights of Persons with Disabilities (WPRPD) which seeks to update the WPINDS, integrate principles contained in international law instruments and endorse a mainstreaming trajectory for realizing the rights of persons with disabilities. While the WPINDS and the WPRPD were published two decades apart, both documents contain an emphasis on a transition from the medical model to the social model. Whereas, the medical model presupposes that disability is mainly a health and welfare matter and is focused on an individualistic and dependency-based approach; the social model requires a paradigm shift in the manner in which disability is constructed so as to highlight the shortcomings of society in respect of disability and to bring to the fore the capabilities of persons with disabilities. The social model has led to unmatched success in changing the perceptions surrounding disability. This article seeks to investigate the progress made in the implementation of the social model in South Africa by taking into account the effect of the diverse political and cultural landscape in promoting the historically entrenched medical model and the rise of disability activism prior to the new democratic dispensation as well as legislation, case law, policy documents and barriers in respect of persons with disabilities that are pervasive in South African society. The research paper will conclude that although numerous interventions have been identified and implemented to promote the consideration of disability within a social construct in South Africa, such interventions require increased national and international collaboration, resources and pace to ensure that the efforts made lead to sustainable results. For persons with disabilities, what remains to be seen is whether the proliferation of activism by interest groups, social awareness as well as the development of policy documents, legislation and case law will serve as the impetus to dissipate the view that disability is burden to be carried solely on the shoulders of the person with the disability.

Keywords: disability, medical model, social model, societal barriers, South Africa

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Authors: Luca Vascelli, Silvia Iacomini, Giada Gueli, Francesca Cavallini, Carlo Cavallini, Federica Berardo

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The study was conducted to evaluate the effect of training on Big 6 + 6 motor skills to promote daily living skills. Precision teaching (PT) suggests that improved speed of the component behaviors can lead to better performance of composite skills. This study assessed the effects of the repeated timed practice of component motor skills on speed and accuracy of composite skills related to daily living skills. An 18 years old adolescent with intellectual disability participated. A pre post probe single-subject design was used. The results suggest that the participant was able to perform the component skills at his individual aims (endurance was assessed). The speed and accuracy of composite skills were increased; stability and retention were also measured for the composite skill after the training.

Keywords: big 6+6, daily living skills, intellectual disability, precision teaching

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Authors: Sireen Irsheid, Stephanie Keeney Parks, Michael A. Lindsey

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The medical and mental health field have been organized as reactive systems to respond to symptoms of mental health problems and disability. This becomes problematic particularly for those harmed by structural violence and racism, typically pushing us in the direction of alleviating symptoms and personalizing structural problems. The current paper examines how we assess, diagnose, and treat mental health and disability challenges in clinical spaces. We provide the readers with some context to think about the problem of racism and mental health/disability, ways to deconstruct the problem through the lens of structural violence, and recommendations to critically engage in clinical assessments, diagnosis, and treatment for young people impacted by structural violence and racism.

Keywords: mental health, disability, race and ethnicity, structural violence, structural racism, young people

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Authors: Jayathilake Wijethunga B. G. Mudiyanselage, Jeewantha Ranawaka, Nirosha Lansakara

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Introduction: Women imprisonment is rising in the world. Imprisoned women have more psychological problems and more adverse childhood experiences than the general population. Female prisoners who had psychological problems had more adverse childhood experiences than the prisoners who did not have psychological problems. Most of the imprisoned women are mothers. Mothers are the principal carer for the children. The psychological status of imprisoned female is worth seeking along with its associates since this is a group of women who need others assistance to make their life adjusted. Any intervention that could uplift their psychological wellbeing would make their life better if they are to be released out of the prison. Since there are no studies done in Sri Lanka to study the imprisoned women psychological wellbeing and their childhood experiences, it is important to study on this to find the magnitude of the problem in Sri Lanka. Methodology: A descriptive cross-sectional study was done at the Welikada Prison, Colombo, among the imprisoned women. 273 imprisoned women were selected using simple random sampling technique. Using interviewer administered questionnaire 270 women were interviewed. Three women did not consent for the study. Frequencies of the selected socio demographic characteristics and selected childhood experiences calculated. GHQ 30 questionnaire was used to assess the psychological distress. Odds ratio was used to calculate the associations between the psychological distress and the selected socio demographic characteristics, selected childhood experiences. Results: Response rate was 98.9%. Mean age of the imprisoned women were 41.28years (SD ±11.86yrs) and Most of women were within the age group of 35-49 years (38.1%). Of them 68.5% were currently married and majority had at least one child. (86.3%). House hold member’s smoking (58.5%) and alcohol (40.4%) use was the commonest adverse childhood experience experienced by the imprisoned women. Nearly one fourth (22.6%) of the imprisoned women had attempted suicide during their life and more than half (55.7%) of them had attempted before the age of 18 years. Similarly of the 258 women who had been sexually active during their life, half (50.0%) of the women had exposed to sexual activities during first eighteen years of life and mean age at first sexual exposure was 19.2 (SD±4.86) years. Nearly three forth (73.7%) of imprisoned women were psychologically distressed in the study sample. Being a women of aged less than 25 years((OR=4.51, 95% CI=1.035-19.64)),previous history of suicidal attempts(OR=2.10,95%CI =1.00-4.41), not having enough foods to eat( OR=2.97, 1.009-8.75) and absence of someone to tell worries (OR=0.355, 95% CI =0.113-0.945) during childhood were significantly associate with psychological distress. Conclusion: Nearly three forth of the imprisoned women were psychologically distressed and younger age, history of suicidal attempts, the absence of someone to tell their worries and not having enough food to eat during childhood were risk factors for psychological distress. Recommendation: Need to strengthen the rehabilitation and mental health services to the imprisoned women.

Keywords: adverse childhood experiences, imprisoned women, psychological distress, prisoners

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Authors: Tzu-Ting Hu, Jung-Der Wang, Ming-Yeng Lin, Jin-Luh Chen, Perng-Jy Tsai

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The vinyl chloride monomer (VCM) has been classified as group 1 (human) carcinogen by the IARC. Workers exposed to VCM are known associated with the development of the liver cancer and hence might cause economical and health losses. Particularly, for those work for the petrochemical industry have been seriously concerned in the environmental and occupational health field. Considering assessing workers’ health risks and their resultant economical and health losses requires the establishment of long-term VCM exposure data for any similar exposure group (SEG) of interest, the development of suitable technologies has become an urgent and important issue. In the present study, VCM exposures for petrochemical industry workers were determined firstly based on the database of the 'Workplace Environmental Monitoring Information Systems (WEMIS)' provided by Taiwan OSHA. Considering the existence of miss data, the reconstruction of historical exposure techniques were then used for completing the long-term exposure data for SEGs with routine operations. For SEGs with non-routine operations, exposure modeling techniques, together with their time/activity records, were adopted for determining their long-term exposure concentrations. The Bayesian decision analysis (BDA) was adopted for conducting exposure and health risk assessments for any given SEG in the petrochemical industry. The resultant excessive cancer risk was then used to determine the corresponding loss of quality-adjusted life expectancy (QALE). Results show that low average concentrations can be found for SEGs with routine operations (e.g., VCM rectification 0.0973 ppm, polymerization 0.306 ppm, reaction tank 0.33 ppm, VCM recovery 1.4 ppm, control room 0.14 ppm, VCM storage tanks 0.095 ppm and wastewater treatment 0.390 ppm), and the above values were much lower than that of the permissible exposure limit (PEL; 3 ppm) of VCM promulgated in Taiwan. For non-routine workers, though their high exposure concentrations, their low exposure time and frequencies result in low corresponding health risks. Through the consideration of exposure assessment results, health risk assessment results, and QALE results simultaneously, it is concluded that the proposed method was useful for prioritizing SEGs for conducting exposure abatement measurements. Particularly, the obtained QALE results further indicate the importance of reducing workers’ VCM exposures, though their exposures were low as in comparison with the PEL and the acceptable health risk.

Keywords: exposure assessment, health risk assessment, petrochemical industry, quality-adjusted life years, vinyl chloride monomer

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Authors: Farjina Malek, Julie King, Niki Edwards

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Across the globe more than a billion people live with a disability and a further billion people, mostly carers, are indirectly impacted. While prevalence data is problematic, it is estimated that more than 15% of the population in Bangladesh live with a disability. Disability service infrastructure in Bangladesh is under-developed; and consequently, the onus of care falls on family, especially on mothers. Within the caring role, mothers encounter many challenging experiences which are not only due to the lack of support delivered through the Bangladeshi health care system but also related to the existence of stigma and perception around disability in the Bangladeshi society. Within this perception, the causes of disability are mostly associated with 'God’s will'; 'possession of ghosts on the disabled person'; and 'karma or the result of past sins of the family members especially the mothers'. These beliefs are likely to have a significant impact on the well-being of mothers and their caring experience of children with disability. This is an ongoing qualitative study which is conducting in-depth interviews with 30 mothers from five districts (Dhaka, Mymensingh, Manikganj, Tangail, and Gazipur) of Bangladesh with the aim to explore the impact of social perception and stigma around physical disability on the caring role of the mothers of children with physical disability. The major findings of this study show that the social perception around disability and the social expectation from a mother regarding her caring role have a huge impact on the well-being of mothers. Mothers are mostly expected to take their child on their lap to prove that they are ‘good mother’. These practices of lifting their children with physical disability and keeping them on the lap for a long time often cause chronic back pain of the mothers. Existing social beliefs consider disability as a ‘curse’ and punishment for the ‘sins’ of the family members, most often by the mother. Mothers are blamed if they give birth to ‘abnormal’ children. This social construction creates stigma, and thus, the caring responsibility of mothers become more challenging. It also encourages the family and mothers to hide their children from the society and to avoid seeking accessible disability services. The mothers also compromise their careers and social interaction as they have to stay with their children at home, and that has a significant impact on personal wellbeing, income, and empowerment of the mothers. The research is informed by intersectional theory and employed an interpretive phenomenological methodology to explore mothers’ experience of caring their children with physical disability, and the contribution and impact of key relationships within the family and the intersection with community and services.

Keywords: mother, family carer, physical disability, children, social stigma, key relationship

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Authors: Farah Al-Shatti, Elsayed El-Khamisi, Nabel Suleiman

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The study aimed at identifying the relationship between self-injury behavior and social skills among children with mild intellectual disability (ID) in the state of Kuwait. The sample of the study consisted of 65 males and females with ID; their ages ranged between 8 to 12 years. The study used a measure for rating self-injury behavior designed by the researcher; and a measure for rating social skills was designed. The results of the study showed that there was an increase in the percentages of the two dimensions of the self-injury behavior for children with ID; the self-injury behavior by child’s own body was higher than the self-injury behavior by environmental tools, additionally the results showed that there were statistically significant differences between males and females on the dimensions and total scorer of self-injury scale favor the males, and there were statistically significant differences between them on the dimensions of the social skills and total score favor the females, It also indicated that there was statistically significant negative relationship between the dimensions of the self-injury and the dimensions of the social skills for children with intellectual disability.

Keywords: mild intellectual disability, self injury behavior, social skills, state of Kuwait

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Authors: Alison Wilde, Stephen Millett

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The cultural value of disabled people has largely been overlooked within forms of media and cultural analysis until the 1980s, when disabled people and disability studies highlighted the cultural misrecognition of disabled people and called for improved forms of cultural recognition and representation. Despite an increase in cultural analysis of representations of disabled people, much has been assumed about how images are read, and little work has been done on the value attributed to disabled people by media audiences and the viewing interests and encounters of film audiences. In particular, there has been little work on film reception, or on the way that young people interpret images of disability. We set out to understand some of the ways that young people read disability imagery, by showing small groups of young people different types of film featuring impairments, chosen from three different eras in film. These were Freaks, Rear Window (remake), and Finding Nemo. The discussions after these films allowed them to explore their own experiences of disability alongside the evolution of cultural representations; in so doing they discussed significant themes of cultural value and reflected on their own identities, e.g. in/dependency, autonomy, and competency and the ways these intersected with self-identity, and attitudes to disabled people.

Keywords: film, audience, identity, disability

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Authors: Charles Masulani Mwale

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Background: It is argued that 85% of children with the disability live in resource-poor countries where there are few available disability services. A majority of these children, including their parents, suffer a lot as a result of the disability and its associated stigmatization, leading to a marginalized life. These parents also experience more stress and mental health problems such as depression, compared with families of normal developing children. There is little research from Africa addressing these issues especially among parents of intellectually disabled children. WHO encourages research on the impact that child with a disability have on their family and appropriate training and support to the families so that they can promote the child’s development and well-being. This study investigated the parenting experiences, mechanisms of coping with these challenges and psychosocial needs while caring for children with intellectual disabilities in both rural and urban settings of Lilongwe and Mzuzu. Methods: This is part of a larger Mixed-methods study aimed at developing a contextualized psychosocial intervention for parents of intellectually disabled children. 16 focus group discussions and four in-depth interviews were conducted with parents in catchments areas for St John of God and Children of Blessings in Mzuzu and Lilongwe cities respectively. Ethical clearance was obtained from COMREC. Data were stored in NVivo software for easy retrieval and management. All interviews were tape-recorded, transcribed and translated into English. Note-taking was performed during all the observations. Data triangulation from the interviews, note taking and the observations were done for validation and reliability. Results: Caring for intellectually disabled children comes with a number of challenges. Parents experience stigma and discrimination; fear for the child’s future; have self-blame and guilt; get coerced by neighbors to kill the disabled child; and fear violence by and to the child. Their needs include respite relief, improved access to disability services, education on disability management and financial support. For their emotional stability, parents cope by sharing with others and turning to God while other use poor coping mechanisms like alcohol use. Discussion and Recommendation: Apart from neighbors’ coercion to eliminate the child life, the findings of this study are similar to those done in other countries like Kenya and Pakistan. It is recommended that parents get educated on disability, its causes, and management to array fears of unknown. Community education is also crucial to promote community inclusiveness and correct prevailing myths associated with disability. Disability institutions ought to intensify individual as well as group counseling services to these parents. Further studies need to be done to design culturally appropriate and specific psychosocial interventions for the parents to promote their psychological resilience.

Keywords: psychological distress, intellectual disability, psychosocial interventions, mental health, psychological resilience, children

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Authors: N. Tal-Alon, O. Shapira-Lishchinsky

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Disability disclosure is one of the most complicated dilemmas that people with invisible disabilities face. There are only a few research studies that have focused on the difficulties and dilemmas of teachers who have different disabilities. In addition, there are currently no research studies focusing specifically on the different aspects of disability disclosure, which are unique to teachers. This research has, therefore, broadened the knowledge base and understanding of the dilemma of disability disclosure among teachers with invisible physical disabilities. In addition, it has shed light on the ways this issue is perceived by different groups: the perspective of school principals, the perspective of colleagues, and the perspective of teachers with physical disabilities themselves. The study sample included 12 teachers with invisible physical disabilities, 10 school principals who employ at least one teacher with an invisible physical disability, and 10 professional colleagues of at least one teacher with an invisible physical disability. This particular research study was conducted using a qualitative approach through the Narralizer computer program based on a series of in-depth interviews. The data analysis was carried out by grouping major points of interest into specific categories and sub-categories. The findings of this research suggest that teachers with disabilities struggle with the dilemma of whether or not to reveal their disability to the school staff and to their students. It was found that there were considerable differences between the issues that faculty members considered regarding this dilemma and the ones that teachers with disabilities considered. While the principals and professional colleagues focused solely on their own interests, the teachers with a disability emphasized more on the ways that they might have a positive influence on their students, as well as their own individual interests. In addition, school principals on a whole tended to view negatively the option of disclosing the disability to the students and were often critical towards teachers who concealed their disability from the school staff. The importance of this research is in its potential to influence policy decisions that can be implemented by the Ministry of Education regarding the support system for teachers with invisible physical disabilities.

Keywords: education, employment, invisible disabilities, teachers

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Authors: Meng-Huan Wu, Wei-Er Wang, Tsu-Nai Wang, Wei-Jian Hsu, Vincent Chin-Hung Chen

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Objective: Studies have reported a strong link between asthma and bipolar disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and bipolar disorder during adolescence and early adulthood. Methods: A total of 162,766 participants aged 11–16 years were categorized into asthma and non-asthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant’s gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and bipolar disorder. Results: Our findings revealed that asthma increased the risk of bipolar disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.31, 95% CI: 1.12-1.53). Hospitalizations or visits to the emergency department for asthma exhibited a dose–response effect on bipolar disorder (adjusted HR: 1.59, 95% CI: 1.22-2.06). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for bipolar disorder (adjusted HR: 3.10, 95% CI: 1.29-7.44). Conclusions: Patients newly diagnosed with asthma had a 1.3 times higher risk of developing bipolar disorder. Smoking during late childhood or adolescence increases the risk of developing bipolar disorder in patients with asthma.

Keywords: adolescence, asthma, smoking, bipolar disorder, early adulthood

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Authors: Erin C. Rodenburg, Jennifer McWhirter, Andrew Papadopoulos

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Support workers for adults with developmental disabilities promote the care and wellbeing of a historically underserved population. Poor employment training and low work satisfaction for these disability support workers are linked to low productivity, poor quality of care, turnover, and intention to leave employment. Therefore, to improve the lives of those within disability support homes, both client and caregiver, it is vital to determine where improvements to training and support for those providing direct care can be made. The current study aims to explore disability support worker’s perceptions of the training received in their employment at the residential homes, how it prepared them for their role, and where there is room for improvement with the aim of developing recommendations for an improved training experience. Responses were collected from 85 disability support workers across 40 Ontario group homes. Findings suggest most disability support workers within the 40 support homes feel adequately trained in their responsibilities of employment. For those who did not feel adequately trained, the main issues expressed were a lack of standardization in training, a need for more continuous training, and a move away from trial and error in performing tasks to support clients with developmental disabilities.

Keywords: developmental disabilities, disability workers, support homes, training

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Authors: Amrin Moger, Sagar Bhalerao, Martin Mathew

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Advertisements play a vital role in dissemination of information regarding products and services. Advertisements as Mass Media tool is not only a source of entertainment, but also a source of information, education and entertainment. It provides information about the outside world and exposes us to other ways of life and culture. Public service advertisements (PSA) are generally aimed at public well-being. Aim of PSA is not to make profit, but rather to change public opinion and raise awareness in the Society about a social issue.’ Start with the boys’ is one such PSA aims to create awareness about issue of ‘gender bias’ that is taught prevalent in the society. Persons with disabilities (PWDs) are also consumers of PSA in the society. The population of persons with disability in the society also faces gender bias and discrimination. It is a double discrimination. The advertisement selected for the study gives out a strong message on gender bias and therefore must be accessible to everyone including PWDs in the society. Accessibility of PSA in the digital format can be done with the help of Universal Design (UD) in digital media application. Features of UD inclusive in nature, and it focus on eliminating established barriers through initial designs. It considers the needs of diverse people, whether they are persons with or without disability. In this research two aspects of UD in digital media: captioning and Indian sign language (ISL) is used. Hence a short survey study was under taken to know the effects of a multimedia on gender bias, in accessible format on persons with and without disability. The result demonstrated a significant difference in the opinion, on the usage accessible and non-accessible format for persons with and without disability and their understanding of message in the PSA selected for the study.

Keywords: public service advertisements, gender, disability, accessibility

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Authors: Fadzayi M.Maruza

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The conversation about diversity in the African academy focuses on the need for an international and ethnically diverse population of scholars and students. Operationalising the concept of cognitive diversity offers us an opportunity to broaden our conception of who can know and who can proclaim knowledge by availing new understandings of what knowledge is and how it is made. Limited attention is paid to the value of diversity generated by cognitive disabilities in the African academy. The inclusion of persons with minds labelled disabled in African academia requires an epistemology of disability to reform the still dominant notion of the expert and scholar as an able-bodied and hyper-rational in African academia. This review wants to explore how cognitive disabilities have been represented in higher education research in Africa or has the African academy reinforced ignorance by promoting an able-bodied academia. The review aims to tackle its exploratory objective by using Malcom Tights framework. The main questions this paper would focus on are: (I)What are the major disability themes and concerns discussed in the disability-related articles? (II)What are the major methods or methodologies used to address the topic in the papers? (III)What are the levels of analysis the papers focus on? (IV)How do higher education researchers define and represent cognitive disabilities in higher education research in Africa? To answer the exploratory questions that are aimed at mapping the disability-related higher education research landscape, Malcolm Tights’ framework is seen as most appropriate. In addition to a thematic categorization, that shall be made after reviewing of published empirical studies on disability in African higher education from the period 2010 – 2017. A synthesis of the findings and implications of African disability studies relating to students with cognitive disabilities in the African Academy will be provided using the categories suggested by Tight as a benchmark. Data for the proposed work shall be taken from well-reputed higher education journals between 2010 and 2017.Using the keyword ‘Disability’ in the titles, abstracts and keywords section of journal articles, a selection of disability-focused higher education articles shall be compiled for analysis regarding cognitive disability. It has to be noted as a limitation that the word Disability might not be sufficient to investigate the topic for there can be many more specific disabilities concerns the researchers would discuss. Therefore, the paper is only intended to give a bird’s eye view of cognitive disability in higher education research and therefore is not comprehensive. The paper is expected to shed some light for me, as a beginning researcher, and other researchers like myself as to what has been the focus of higher education researchers about cognitive disability in the African academy. Keywords: Cognitive diversity, cognitive disability, disability, higher education.

Keywords: cognitive disability, cognitive diversity, disability, higher education

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Authors: Shakhawath Hossain, Tazkia Tahsin

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Introduction/Background: Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. Vocational education is a multi-professional approach that is provided to individuals of working age with health-related impairments, limitations, or restrictions with work functioning and whose primary aim is to optimize work participation. Instrumental Activities of Daily Living activities to support daily life within the home and community. Like as community mobility, financial management, meal preparation, and clean-up, shopping. Material and Method: Electronic searches of Medline, PubMed, Google scholar, OT Seeker literature using the key terms of intellectual disability, vocational rehabilitation, instrumental activities of daily living and Occupational Therapy, as well as a thorough manual search for relevant literature. Results: There were 13 articles, all qualitative and quantitative, which are included in this review. All studies were mixed methods in design. To take the Occupational Therapy services, there is a significant improvement in their children's various areas like as sensory issues, cognitive abilities, perceptual skills, visual, motor planning, and group therapy. After taking the vocational and instrumental activities of daily living training children with intellectual disabilities to participate in their daily activities and work as an employee different company or organizations. Conclusion: The persons with intellectual disability are an integral part of our society who deserves social support and opportunities like other human beings. From the result section of the project papers, it is found that the significant benefits of Occupational Therapy services in the aspects of vocational and instrumental activities of daily living.

Keywords: occupational therapy, daily living activities, intellectual disabilities, instrumental ADL

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Authors: Sidra Jawed

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The accessibility constructs and the body privilege discourse has been a major problem while dealing with health inequities and inaccessibility. The inherent problem in this arbitrary view of disability is that disability would never be the productive way of living. For past thirty years, disability activists have been working to differentiate ‘impairment’ from ‘disability’ and probing for more understanding of limitation imposed by society, this notion is ultimately known as the Social Model of Disability. The vulnerable population as disability community remains marginalized and seen relentlessly fighting to highlight the importance of social factors. It does not only constitute physical architectural barriers and famous blue symbol of access to the healthcare but also invisible, intangible barriers as attitudes and behaviours. Conventionally the idea of ‘disability’ has been laden with prejudiced perception amalgamating with biased attitude. Equity in contemporary setup necessitates the restructuring of organizational structure. Apparently simple, the complex interplay of disability and contemporary healthcare set up often ends up at negotiating vital components of basic healthcare needs. The role of society is indispensable when it comes to people with disability (PWD), everything from the access to healthcare to timely interventions are strongly related to the set up in place and the attitude of healthcare providers. It is vital to understand the association between assumptions and the quality of healthcare PWD receives in our global healthcare setup. Most of time the crucial physician-patient relationship with PWD is governed by the negative assumptions of the physicians. The multifaceted, troubled patient-physicians’ relationship has been neglected in past. To compound it, insufficient work has been done to explore physicians’ perspective about the disability and access to healthcare PWD have currently. This research project is directed towards physicians’ perspective on the intersection of health and access of healthcare for PWD. The principal aim of the study is to explore the perception of disability in family medicine physicians, highlighting the underpinning of medical perspective in healthcare institution. In the quest of removing barriers, the first step must be to identify the barriers and formulate a plan for future policies, involving all the stakeholders. There would be semi-structured interviews to explore themes as accessibility, medical training, construct of social model and medical model of disability, time limitations, financial constraints. The main research interest is to identify the obstacles to inclusion and marginalization continuing from the basic living necessities to wide health inequity in present society. Physicians point of view is largely missing from the research landscape and the current forum of knowledge with regards to physicians’ standpoint. This research will provide policy makers with a starting point and comprehensive background knowledge that can be a stepping stone for future researches and furthering the knowledge translation process to strengthen healthcare. Additionally, it would facilitate the process of knowledge translation between the much needed medical and disability community.

Keywords: disability, physicians, social model, accessibility

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Authors: Anna Mirczak

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Introduction: In connection with the aging of the population and the increase in the number of people with chronic illnesses, the priority objective for public health has become not only lengthening life, but also improving quality of life in older persons, as well as maintenance of their relative independence and active participation in social life. The most important determinant of a person’s quality of life is health. According to the literature, older people with chronic illness who live in rural settings are at greater risk for poor outcomes than their urban counterparts. Furthermore research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban citizens. It is dictated by the overlapping certain specific socio-economic factors typical for rural areas which include: social and geography exclusion, limited access to health care centers, and low socioeconomic status. Aim of the study: The objective of this study was to recognize health status and needs of older people living in selected rural areas in Poland and evaluate the impacts of working in the farm on their health status. Material and methods: The study was performed personally, using interviews based on the structural questionnaires, during the period from March 2011 to October 2012. The group of respondents consisted 203 people aged 65 years and over living in selected rural areas in Poland. The analysis of collected research material was performed using the statistical package SPSS 19 for Windows. The level of significance for the tested the hypotheses assumed value of 0.05. Results: The mean age of participants was 75,5 years (SD=5,7) range from 65 to 94 years. Most of the interviewees had children (89.2%) and grandchildren (83.7) and lived mainly with family members (75.9%) mostly in double (46.8%) and triple (20.8%) household. The majority of respondents (71,9%) were physical working on the farm. At the time of interview, each of the respondents reported that they had been diagnosed with at least one chronic diseases by their GP. The most common were: hypertension (67,5%), osteoarthritis (44,8%), atherosclerosis (43,3%), cataract (40,4%), arrhythmia (28,6%), diabetes mellitus (19,7%) and stomach or duodenum ulcer diseases (17,2%).The number of diseases occurring of the sample was dependent on gender and age. Significant associations were observed between working on the farm and frequency of occurrence cardiovascular diseases, the gastrointestinal tract dysfunction and sensory disorders. Conclusions: The most common causes of disability among older citizens were: chronic diseases, malnutrition and complaints about access to health services (especially to cardiologist and an ophthalmologist). Health care access and health status are a particular concern in rural areas where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas than is the case in urban areas.

Keywords: ageing, health status, older people, rural

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Authors: Doctor Akanle Florence Foluso

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Access to health care and people’s ability to having a responsible, satisfying and safe sexual life is clearly a defined human right of people with hearing impairment and others with disabilities this paper looks at disability and sexuality: a human right approach to sexual and reproductive health of the hearing impaired adolescents in developing countries. This paper investigates the extent to which the hearing impaired has a satisfying, safe sexual life and whether their human right in regards to information education is violated. The study population consists of all hearing impaired adolescents and young adults aged 10-24 years who are currently enrolled in the primary and secondary schools in Nigeria. A sample of 389 hearing impaired adolescents was selected, an adapted version of the illustrative questionnaire for interview – survey by Johncleland was used to collect the data. A correlation of 0.80 was obtained at p<0.05 level of significance. Teachers in the schools of the deaf who used sign language were used in the administration of the questionnaire. The data generated were analyzed using Frequency Counts, Percentages, Means and Standard Deviation to give a Summary on responses on access to information, education, voluntary testing and counselling and other reproductive services. This is to investigate if the sexual and reproductive right violated or protected. Findings show that a gap exists in the level of knowledge of SRH services, voluntary counselling because more than half the respondents are not aware of these services in their community. Access to information, education and health services are rights denied the hearing impaired. So their SRH rights are violated.

Keywords: sexual right diability, family planning, pregnancy, diability

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