Search results for: neuro disability
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 837

Search results for: neuro disability

657 Multiscale Model of Blast Explosion Human Injury Biomechanics

Authors: Raj K. Gupta, X. Gary Tan, Andrzej Przekwas

Abstract:

Bomb blasts from Improvised Explosive Devices (IEDs) account for vast majority of terrorist attacks worldwide. Injuries caused by IEDs result from a combination of the primary blast wave, penetrating fragments, and human body accelerations and impacts. This paper presents a multiscale computational model of coupled blast physics, whole human body biodynamics and injury biomechanics of sensitive organs. The disparity of the involved space- and time-scales is used to conduct sequential modeling of an IED explosion event, CFD simulation of blast loads on the human body and FEM modeling of body biodynamics and injury biomechanics. The paper presents simulation results for blast-induced brain injury coupling macro-scale brain biomechanics and micro-scale response of sensitive neuro-axonal structures. Validation results on animal models and physical surrogates are discussed. Results of our model can be used to 'replicate' filed blast loadings in laboratory controlled experiments using animal models and in vitro neuro-cultures.

Keywords: blast waves, improvised explosive devices, injury biomechanics, mathematical models, traumatic brain injury

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656 Differentiated Instruction for All Learners: Strategies for Full Inclusion

Authors: Susan Dodd

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This presentation details the methodology for teachers to identify and support a population of students who have historically been overlooked in regards to their educational needs. The twice exceptional (2e) student is a learner who is considered gifted and also has a learning disability, as defined by the Individuals with Disabilities Education Act (IDEA). Many of these students remain underserved throughout their educational careers because their exceptionalities may mask each other, resulting in a special population of students who are not achieving to their fullest potential. There are three common scenarios that may make the identification of a 2e student challenging. First, the student may have been identified as gifted, and her disability may go unnoticed. She could also be considered an under-achiever, or she may be able to compensate for her disability under the school works becomes more challenging. In the second scenario, the student may be identified as having a learning disability and is only receiving remedial services where his giftedness will not be highlighted. His overall IQ scores may be misleading because they were impacted by his learning disability. In the third scenario, the student is able to compensate for her ability well enough to maintain average scores, and she goes undetected as both gifted and learning disabled. Research in the area identifies the complexity involved in identifying 2e students, and how multiple forms of assessment are required. It is important for teachers to be aware of the common characteristics exhibited by many 2e students, so these learners can be identified and appropriately served. Once 2e students have been identified, teachers are then challenged to meet the varying needs of these exceptional learners. Strength-based teaching entails simultaneously providing gifted instruction as well as individualized accommodations for those students. Research in this field has yielded strategies that have proven helpful for teaching 2e students, as well as other students who may be struggling academically. Differentiated instruction, while necessary in all classrooms, is especially important for 2e students, as is encouragement for academic success. Teachers who take the time to really know their students will have a better understanding of each student’s strengths and areas for growth, and therefore tailor instruction to extend the intellectual capacities for optimal achievement. Teachers should also understand that some learning activities can prove very frustrating to students, and these activities can be modified based on individual student needs. Because 2e students can often become discouraged by their learning challenges, it is especially important for teachers to assist students in recognizing their own strengths and maintaining motivation for learning. Although research on the needs of 2e students has spanned across two decades, this population remains underserved in many educational institutions. Teacher awareness of the identification of and the support strategies for 2e students is critical for their success.

Keywords: gifted, learning disability, special needs, twice exceptional

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655 A High Efficiency Reduced Rules Neuro-Fuzzy Based Maximum Power Point Tracking Controller for Photovoltaic Array Connected to Grid

Authors: Lotfi Farah, Nadir Farah, Zaiem Kamar

Abstract:

This paper achieves a maximum power point tracking (MPPT) controller using a high-efficiency reduced rules neuro-fuzzy inference system (HE2RNF) for a 100 kW stand-alone photovoltaic (PV) system connected to the grid. The suggested HE2RNF based MPPT seeks the optimal duty cycle for the boost DC-DC converter, making the designed PV system working at the maximum power point (MPP), then transferring this power to the grid via a three levels voltage source converter (VSC). PV current variation and voltage variation are chosen as HE2RNF-based MPPT controller inputs. By using these inputs with the duty cycle as the only single output, a six rules ANFIS is generated. The high performance of the proposed HE2RNF numerically in the MATLAB/Simulink environment is shown. The 0.006% steady-state error, 0.006s of tracking time, and 0.088s of starting time prove the robustness of this six reduced rules against the widely used twenty-five ones.

Keywords: PV, MPPT, ANFIS, HE2RNF-based MPPT controller, VSC, grid connection

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654 Working With Accessibility in Latvian Contemporary Art: Research, Barriers, and Implementation From a Curator’s and Production Manager’s Perspective

Authors: Agnese Zviedre

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In 2010 Latvia ratified the United Nations Convention on the Rights of Persons with Disabilities, which states that the state will recognize the importance of accessibility to the physical, social, and cultural environment. Nevertheless, accessibility of art and culture in Latvia has become a focal point only since 2020. A study on the impact of cultural consumption and participation done by the Latvian Academy of Culture and the research center “SKDS” results show that art and cultural institutions lack knowledge and understanding of needs and required accessibility measures for people with disabilities to participate in cultural and art events. At the same time, even if art institutions want to create accessible events for people with diverse bodies and minds, many barriers exist, such as budget, lack of time, and lack of knowledge. Even though disability is still largely invisible in the public space, due to recent public campaigns and awareness of the need for accessibility, the media and society are starting to speak about disability as a social issue, not a medical one. Thus, this paper focuses on the first-hand experience of implementing different Western accessibility guidelines and working with communities as a production manager for the multidisciplinary exhibition project “Invisible Lives” in Riga and curator of the education program of Riga Photography Biennial’s 2022 Central Event - Exhibition “Screen Age III: Still Life”. Analyzing two events from the Disability studies perspective, this paper focuses on working with existing knowledge and budget to achieve accessibility.

Keywords: accessibility, contemporary art, curatorial practices, disability studies

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653 The Physically Handicapped in the City

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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652 A Comparative Study on ANN, ANFIS and SVM Methods for Computing Resonant Frequency of A-Shaped Compact Microstrip Antennas

Authors: Ahmet Kayabasi, Ali Akdagli

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In this study, three robust predicting methods, namely artificial neural network (ANN), adaptive neuro fuzzy inference system (ANFIS) and support vector machine (SVM) were used for computing the resonant frequency of A-shaped compact microstrip antennas (ACMAs) operating at UHF band. Firstly, the resonant frequencies of 144 ACMAs with various dimensions and electrical parameters were simulated with the help of IE3D™ based on method of moment (MoM). The ANN, ANFIS and SVM models for computing the resonant frequency were then built by considering the simulation data. 124 simulated ACMAs were utilized for training and the remaining 20 ACMAs were used for testing the ANN, ANFIS and SVM models. The performance of the ANN, ANFIS and SVM models are compared in the training and test process. The average percentage errors (APE) regarding the computed resonant frequencies for training of the ANN, ANFIS and SVM were obtained as 0.457%, 0.399% and 0.600%, respectively. The constructed models were then tested and APE values as 0.601% for ANN, 0.744% for ANFIS and 0.623% for SVM were achieved. The results obtained here show that ANN, ANFIS and SVM methods can be successfully applied to compute the resonant frequency of ACMAs, since they are useful and versatile methods that yield accurate results.

Keywords: a-shaped compact microstrip antenna, artificial neural network (ANN), adaptive neuro-fuzzy inference system (ANFIS), support vector machine (SVM)

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651 Early Metastatic Cancer: A Review of Its Management and Outcomes

Authors: Diwei Lin, Amanda Jia Hui Tan

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In 2012, testicular cancer was estimated to account for 940 disability adjusted life years in Australia; of these, 450 were years lost due to premature death and 500 were years of healthy life lost due to disease, disability or injury. Testicular choriocarcinoma is one of the rarest variants of testicular germ cell tumours, accounting for less than 1% of testicular germ cell tumours and only about 0.19% of all testicular tumours. Management involves radical orchiectomy followed by chemotherapy. Even then, the prognosis is extremely poor. This case report describes a 20-year-old male with pure testicular choriocarcinoma with pulmonary metastases.

Keywords: testicular cancer, choriocarcinoma, cryptorchidism, chemotherapy, metastatic testicular cancer

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650 Evaluation of the Self-Organizing Map and the Adaptive Neuro-Fuzzy Inference System Machine Learning Techniques for the Estimation of Crop Water Stress Index of Wheat under Varying Application of Irrigation Water Levels for Efficient Irrigation Scheduling

Authors: Aschalew C. Workneh, K. S. Hari Prasad, C. S. P. Ojha

Abstract:

The crop water stress index (CWSI) is a cost-effective, non-destructive, and simple technique for tracking the start of crop water stress. This study investigated the feasibility of CWSI derived from canopy temperature to detect the water status of wheat crops. Artificial intelligence (AI) techniques have become increasingly popular in recent years for determining CWSI. In this study, the performance of two AI techniques, adaptive neuro-fuzzy inference system (ANFIS) and self-organizing maps (SOM), are compared while determining the CWSI of paddy crops. Field experiments were conducted for varying irrigation water applications during two seasons in 2022 and 2023 at the irrigation field laboratory at the Civil Engineering Department, Indian Institute of Technology Roorkee, India. The ANFIS and SOM-simulated CWSI values were compared with the experimentally calculated CWSI (EP-CWSI). Multiple regression analysis was used to determine the upper and lower CWSI baselines. The upper CWSI baseline was found to be a function of crop height and wind speed, while the lower CWSI baseline was a function of crop height, air vapor pressure deficit, and wind speed. The performance of ANFIS and SOM were compared based on mean absolute error (MAE), mean bias error (MBE), root mean squared error (RMSE), index of agreement (d), Nash-Sutcliffe efficiency (NSE), and coefficient of correlation (R²). Both models successfully estimated the CWSI of the paddy crop with higher correlation coefficients and lower statistical errors. However, the ANFIS (R²=0.81, NSE=0.73, d=0.94, RMSE=0.04, MAE= 0.00-1.76 and MBE=-2.13-1.32) outperformed the SOM model (R²=0.77, NSE=0.68, d=0.90, RMSE=0.05, MAE= 0.00-2.13 and MBE=-2.29-1.45). Overall, the results suggest that ANFIS is a reliable tool for accurately determining CWSI in wheat crops compared to SOM.

Keywords: adaptive neuro-fuzzy inference system, canopy temperature, crop water stress index, self-organizing map, wheat

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649 Stability Enhancement of a Large-Scale Power System Using Power System Stabilizer Based on Adaptive Neuro Fuzzy Inference System

Authors: Agung Budi Muljono, I Made Ginarsa, I Made Ari Nrartha

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A large-scale power system (LSPS) consists of two or more sub-systems connected by inter-connecting transmission. Loading pattern on an LSPS always changes from time to time and varies depend on consumer need. The serious instability problem is appeared in an LSPS due to load fluctuation in all of the bus. Adaptive neuro-fuzzy inference system (ANFIS)-based power system stabilizer (PSS) is presented to cover the stability problem and to enhance the stability of an LSPS. The ANFIS control is presented because the ANFIS control is more effective than Mamdani fuzzy control in the computation aspect. Simulation results show that the presented PSS is able to maintain the stability by decreasing peak overshoot to the value of −2.56 × 10−5 pu for rotor speed deviation Δω2−3. The presented PSS also makes the settling time to achieve at 3.78 s on local mode oscillation. Furthermore, the presented PSS is able to improve the peak overshoot and settling time of Δω3−9 to the value of −0.868 × 10−5 pu and at the time of 3.50 s for inter-area oscillation.

Keywords: ANFIS, large-scale, power system, PSS, stability enhancement

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648 Use of Virtual Reality to Manage Anxiety in Patients on Neuro-Rehabilitation Unit

Authors: Anthony Cogrove, Shagun Saikia, Pradeep Deshpande

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Introduction: Management of anxiety in rehabilitation setting often is a challenge and is usually done by using medication. The role of psychology and the creation of a quite environment in order to reduce stimulation helps in the process. We have a hypothesis that feedback from a calm visual imagery with soothing music help in reducing anxiety in these setting Aim-To explore the possibility of using virtual reality in the management of anxiety in a setting of neuro-rehabilitation unit. Method: Six patients in an inpatient rehabilitation unit with acquired brain injury subjected to a low stimulation calming visual motion picture with calm music. Six sessions were conducted over 6 weeks. All sessions were performed in a separate purpose built room in the unit. . A cohort of 6 people with various neurological conditions were involved in 6 sessions of 30 minutes during their inpatient rehabilitation. They reported benefit from using the virtual reality environment in reducing their anxiety. Results: All reported improvement in their anxiety levels. They felt there was a calming effect of the session. There was a sense of feeling of self empowerment on direct questioning. Conclusion: Virtual reality environment can aid the traditional rehabilitation techniques used to manage the levels of anxiety experienced by people with acquired brain injury undergoing inpatient rehabilitation.

Keywords: neurological rehabilitation, virtual reality, anxiety, calming environment

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647 Hopes of out of School Children with Disabilities for Educational Inclusion

Authors: Afaf Manzoor, Abdul Hameed

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Hopes to attend school is the most effective means to overcome the burden of disability and become a self-reliant, productive citizen. The objectives of the study were to develop a valid and reliable scale to measure hopes of out of school children with disabilities and find an association between hopes and various demographic factors such as type of disability, gender, socio-economic status, and locale, etc. Child Hope theory by Snyder (2003) was used as a framework to develop a measure for the hopes of children. According to this theory, hope is defined as a set of cognition that includes self- perception which establish routes to achieve desired goals (pathways) and motivation for achieving the goals (agency). By applying this theory, inclusion hope scale was developed and validated. The data were collected from 361 out of school children with disabilities living in three districts (Lahore, Sheikupura, Kasur) of Lahore Division by using the cluster sampling technique. Findings of the study indicated that children with intellectual challenges were more hopeless as compared to other types of disabilities. Similarly, children living in urban areas have better hopes for inclusion in school. However, no gender disparity was found in terms of being hopeful to attend schools. The study also includes recommendations to improve hopes for educational inclusion among out of school children with disabilities.

Keywords: out of school children, disability, hopes, inclusion

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646 Disability, Technology and Inclusion: Fostering and Inclusive Pedagogical Approach in an Interdisciplinary Project

Authors: M. Lopez-Pereyra, I. Cisneros Alvarado, M. Del Socorro Lobato Alba

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This paper aims to discuss a conceptual, pedagogical approach that foster inclusive education and that create an awareness of the use of assistive technology in Mexico. Interdisciplinary understanding of disabilities and the use of assistive technology as a frame for an inclusive education have challenged the reality of the researchers’ participation in decision-making. Drawing upon a pedagogical inquiry process within an interdisciplinary academic project that involved the sciences, design, biotechnology, psychology and education fields, this paper provides a discussion on the challenges of assistive technology and inclusive education in interdisciplinary research on disabilities and technology project. This study is frame on an educational action research design where the team is interested in integrating, disability, technology, and inclusion, theory, and practice. Major findings include: (1) the concept of inclusive education as a strategy for interdisciplinary research; (2) inclusion as a pedagogical approach that challenges the creation of assistive technology from diverse academic fields; and, (3) inclusion as a frame, problem-focused, for decision-making. The findings suggest that inclusive pedagogical approaches provide a unique insight into interdisciplinary teams on disability and assistive technology in education.

Keywords: assistive technology, inclusive education, inclusive pedagogy, interdisciplinary research

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645 Seven Brothers and Sisters of Severely Disabled Children Speak up about Their Everyday Challenges and Needs : A Multiple Case Study

Authors: Myriam Castonguay, Florence Vinit

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This study aims to gain a better understanding of the lived experience of seven children growing up in a family where another child is severely disabled, informed by family systems theory and the socio-ecological model of development. In depth semi-structured interviews were conducted with seven children who described they everyday life since their brother’s or sister’s diagnosis. Thematic analysis revealed four themes : struggling with loneliness inside the family, supporting the disabled child through its journey, accommodating to a changing routine and keeping a “bubble” for oneself. Brothers and sisters depict a family life characterized by much loneliness, with severe disabilities requiring ongoing care and prolonged hospitalizations. In the midst of adversity, siblings describe themselves as highly committed to supporting the disabled child and to preserve family cohesion, even if that means getting exposed to emotionally challenging situations and adjusting their daily routine frequently. Children recount that keeping up with schoolwork and leisure activities of their own is central to their well-being. Having a space where one can reconnect with his ordinary life as a kid is also deemed very important. This study reminds us that more needs to be done to counteract the loneliness experienced by siblings through the family experience of disability. Family members and clinicians need to be extra vigilant to ensure siblings’ needs don’t go unnoticed or dismissed, as it may be difficult for this population of children to voice their own experience and needs. Family, school and other actors in the community may help brothers and sisters pursue their personal dreams, goals and projects, to continue experiencing well-being despite adverse life circumstances.

Keywords: sibling’s lived experience of disability, sibling’s needs at various levels of the ecosystem, family adjustment to the disability experience, supporting family wellness through the disability experience

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644 Motivation for Higher Education: An Exploration of Lived Experiences of Students with Disabilities in a Ghanaian University

Authors: Yaw Akoto

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The social construction of disability in a Ghanaian society has created a restriction on the development of the academic potentials of persons with disabilities. Ghanaian societal perceptions position persons with disabilities as needy, evil, feeble and 'abnormal' that a person with disability cannot contribute anything meaningful to their own development, society, and the nation as well. Almost all Ghanaian cultures believe the Gods visit evil people with disability as such they erect barriers that limit them to select and enroll in education. The few people with disabilities who gain admission to schools drop out due to these barriers erected by the society and institutions. However, there are very few of these students who are able to pursue their education at the higher education level despite these challenges. This qualitative study explores the motivation of students with disabilities to select and enroll in a Ghanaian university. The study used semi-structured interview to solicit information from students with disabilities in a Ghanaian university. Although the quality of students with disabilities experience was affected by culture, discrimination, marginalisation, and lack of support, the prospect of using themselves as role models, employment opportunities and family impingement were among others that pushed them to embark on their educational journey. The findings of this study have implications for societal and institutional levels for restructuring and refining societal perception and institutional policies on disabilities.

Keywords: beliefs, Ghanaian university, social construction, students with disabilities

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643 The Identification of Instructional Approach for Enhancing Competency of Autism, Attention Deficit Hyperactivity Disorder and Learning Disability Groups

Authors: P. Srisuruk, P. Narot

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The purpose of this research were 1) to develop the curriculum and instructional approach that are suitable for children with autism, attention deficit hyperactivity disorder and learning disability as well as to arrange the instructional approach that can be integrated into inclusive classroom 2) to increase the competency of the children in these group. The research processes were to a) study related documents, b) arrange workshops to clarify fundamental issues in developing core curriculum among the researchers and experts in curriculum development, c) arrange workshops to develop the curriculum, submit it to the experts for criticism and editing, d) implement the instructional approach to examine its effectiveness, e) select the schools to participate in the project and arrange training programs for teachers in the selected school, f) implement the instruction approach in the selected schools in different regions. The research results were 1) the core curriculum to enhance the competency of children with autism, attention deficit hyperactivity disorder and learning disability , and to be used as a guideline for teachers, and these group of children in order to arrange classrooms for students with special needs to study with normal students, 2) teaching and learning methods arranged for students with autism, attention deficit, hyperactivity disorder and learning disability to study with normal students can be used as a framework for writing plans to help students with parallel problems by developing teaching materials as part of the instructional approach. However, the details of how to help the students in each skill or content differ according to the demand of development as well as the problems of individual students or group of students. Furthermore; it was found that most of target teacher could implement the instructional approach based on the guideline model developed by the research team. School in each region does not have much difference in their implementation. The good point of the developed instructional model is that teacher can construct a parallel lesson plan. So teacher did not fell that they have to do extra work it was also shown that students in regular classroom enjoyed studying with the developed instructional model as well.

Keywords: instructional approach, autism, attention deficit hyperactivity disorder, learning disability

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642 The Deprivation of Human Rights Experienced by African Children with Disabilities

Authors: Anna Wiltshire, Rebecca Markham

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Over the last decade, a growing body of evidence has indicated that children with disabilities are often amongst the most excluded and vulnerable in society. The World Bank estimates that 20% of those living in poverty in developing countries are disabled which means that those with the least bear the greatest burden. Furthermore, children with disabilities in Africa have to face a multitude of difficulties ranging from the physical to the psychological. Misconceptions and cultural beliefs are used to justify violence against, or complete shunning of these individuals and their families. In addition, discrimination can prevent access to both education and health services, further compromising these individuals. All children, irrespective of their disability should be able to enjoy human rights without discrimination, but this is often not the case. This poster explores how and why children with disabilities in Africa are subject to violations of their human rights, and suggests ways of addressing these problems.

Keywords: Africa, children, disability, discrimination, human rights

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641 The Effect of Proprioceptive Neuromuscular Facilitation and Lumbar Stabilization Exercises on Muscle Strength and Muscle Endurance in Patients with Lumbar Disc Hernia

Authors: Mustafa Gulsen, Mitat Koz

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The aim of this study is to investigate the effect of lumbar stabilisation and proprioceptive neuromuscular facilitation (PNF) training on muscle strength and muscle endurance. The participants were 64 between the ages of 15-69 (53.04 ± 14.59), who were graded protrusion and bulging lumbar herniation according to 'Macnab Classification'. The participants were divided into four groups as each group had 16 participants: lumbar stabilitation training, PNF training, physical therapy and control groups. Sociodemographic features were recorded. Then their muscle strength tests (by isokinetic dynamometer (Cybex 770 Norm Lumex Inc, Ronkonkoma, NY, USA) were recorded. Before and after applications; visual analogue scale (VAS), Oswestry Disability İndex were applied by a physical therapist. The participants in lumbar stabilisation group performed 45 minutes, 5 days in a week for 4 weeks strength training with a physical therapist observation. The participants in PNF group performed 5 days in a week for 4 weeks with pelvic patterns of PNF by a physiotherapist. The participants in physical therapy group underwent Hotpack, Tens and Ultrasound therapy 5 days in a week for 4 weeks. The participants in control group didn’t take any training programme. After 4 weeks, the evaluations were repeated. There were significant increases in muscle strength and muscle endurance in lumbar stabilization training group. Also in pain intensity at rest and during activity in this group and in Oswestry disability index of patients, there were significant improvements (p < 0.05). In PNF training group likewise, there were significant improvements in muscle strength, muscle endurance, pain intensity at rest and with activity and in Oswestry disability index (p < 0.05). But improvements in the Lumbar Stabilization group was better than PNF Group. We found significant differences only in pain intensity at rest and with activity and in Oswestry disability index (p < 0.05). in the patients in Physical Therapy group. We think that appropriate physiotherapy and rehabilitation program which will be prepared for patients, to protect the waist circumference of patients with low muscle strength and low muscle endurance will increase muscle strength and muscle endurance. And it is expected that will reduce pain and will provide advances toward correcting functional disability of the patients.

Keywords: disc herniation, endurance, lumbar stabilitation exercises, PNF, strength

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640 The Participation of Refugee Children with Disabilities in Educational Options in Turkey: A Systematic Review

Authors: Robert L. Williamson, Baris Çetin

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Turkey, due to its geographic location, finds itself the world’s largest host to refugees worldwide, and this nation has done much to educate their refugee population. Turkey’s considerable experience can inform other nations educating refugee children. This systematic review of the literature examined the context, barriers, and responses to successfully educating refugee children in Turkey. Additionally, because some refugee children may have an identified or unidentified disability, the educational experiences of refugee children with disabilities in Turkey were an ancillary focus. Results indicated that while some educational challenges have been successfully met within Turkey, others remain. Additionally, the education of children with disabilities in Turkey is largely unexamined.

Keywords: disability, education, refugee, systematic review, Turkey

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639 Accessing Single Parenting and Disabled Children: A Case Study of Ghana

Authors: Edwina Owusu Panin

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Families may face significant obstacles as a result of single parenting and disabilities. The amenities and support those single parents need to give their children with disabilities the care they need are frequently out of their reach. These can include financial hardship, limited access to health and education, and social isolation. In addition, cultural attitudes toward disability can worsen these challenges, making it difficult for families to get the support and resources they need. Despite these challenges, many single parents have shown resilience and strength to overcome these difficulties and defend the rights of their children; some, too, have failed in taking care of their disabled children in Ghana. The study traces the developmental process of how single parents cope with disabled children. There is a discouraging fact that single father’s face a much more dreadful task in taking care of their disabled children in Ghana, which is later highlighted in the article. Additional research and support are needed to address the unique needs of families facing these challenges. This case study explores the experiences of single parents raising children with disabilities in Ghana. Using a qualitative approach, the study examines the challenges facing lone parents in caring for children, including access to healthcare, education and social support. In addition, the study examines the impact of cultural disability attitudes on the experiences of single parents and their children and what causes it in Ghana. Findings indicate that single parents in Ghana face significant challenges in accessing resources and support for their children and that cultural attitudes toward disability may aggravate these challenges. However, the study recommends the tenacity and strengths of how to create awareness, protect the welfare and also by encouraging single parents to face these challenges and protect the rights of their children, swaying away influences of bad cultural attitudes.

Keywords: disability, single parenting, case study, assessing

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638 The ‘Othered’ Body: Deafness and Disability in Nina Raine’s Tribes

Authors: Nurten Çelik

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Under the new developments in science, medicine, sociology, psychology and literary theories, body studies has gained huge importance and the body has become a debatable issue. There has emerged, among sociologists and literary theorists, an overwhelming consensus that body is socially, politically and culturally perceived and constructed and thus, the position of an individual in the society is determined in accordance with his/her body image. In this regard, the most complicated point is the theoretical views propounded upon disability studies, where the disabled body is considered to be a site upon which social and political restrictions as well as repressions are inscribed. There has been the widely-accepted view that no matter what kind of disability it is, those with physical, mental or learning impairments face varied social, political and environmental obstacles that prevent them from being an active citizen, worker, lover and even a family member. In parallel with these approaches, the matter of the sufferings of disabled individuals attains its place in cinema and literature as well as in theatre studies under the category of disability theatre. One of the prominent plays that deal with physical disability came from the contemporary British playwright Nina Raine. In her awarded play Tribes, which premiered at the Royal Court Theatre in 2010, Raine develops the social strata where her deaf protagonist, Billy, caught up between two tribes – namely his family and his lover Slyvia, a member of the deaf community– experiences personal and social hardships due to his hearing impairment. In the play, intransigent and self-opinionated family members foster no sense of empathy towards Billy, there are noisy talking and shouting, but no communication, love, compassion or mutual understanding, and language becomes just a tool for the expression of rage and oppression. In the disordered atmosphere of the family life, Billy experiences isolation and loneliness. Billy’s hopes for success and love are destroyed when Slyvia, troubled between hearing and deafness, rejects him because she does not utterly grasp what Billy is experiencing. Drawing upon the hardships, Billy undergoes in his relationships with his family and his girlfriend, Tribes problematizes the concept of deafness and explores to what extent a deaf person can find a place in the hearing world. Setting ‘the disabled’ bodies against ‘the abled’ bodies in a family, a microcosm of the society where bodies are socially shaped and constructed, Tribes dramatizes how the disabled bodies are disenfranchised, stigmatised, marginalized and othered on the grounds that they are socially misfit. Tribes, with a specific focus on the dysfunctional family, shows that the lack of communication and empathy numbs the characters to the feelings of each other and thereby, they become more disabled than Billy. In conclusion, this paper, with the reference to the embodiment of disability and social theories, aims to explore how disabled bodies are socially marked and segregated from family and society.

Keywords: body, deafness, disability, disability theatre, Nina Raine, tribes

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637 Correlative Study of Serum Interleukin-18 and Disease Activity, Functional Disability and Quality of Life in Rheumatoid Arthritis Patients

Authors: Hamdy Khamis Korayem, Manal Yehia Tayel, Abeer Shawky El Hadedy, Emmanuel Kamal Aziz Saba, Shimaa Badr Abdelnaby Badr

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The aim of the current study was to demonstrate whether serum Interleukin-18 (IL-18) is increased in rheumatoid arthritis (RA) and its correlation with disease activity, functional disability and quality of life in RA patients. The study included 30 RA patients and 20 healthy normal control subjects. The RA patients were diagnosed according to the 2010 ACR/EULAR classification criteria for RA with the exclusion of those who had diabetes mellitus, endocrine disorders, associated rheumatologic diseases, viral hepatitis B or C and other diseases with increased serum IL-18 level. All patients were subjected to clinical evaluation of the musculoskeletal system. Disease activity was assessed by disease activity score 28 with 4 variables (DAS 28). Functional disability was assessed by health assessment questionnaire disability index (HAQ-DI). The quality of life was assessed by Short form-36 (SF-36) questionnaire. Radiological assessment of both hands and feet by Sharp/van der Heijde (SvH) scoring method. Laboratory parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) were assessed in patients and serum level of IL-18 in both patients and control subjects. There was no statistically significant difference between patient and control group as regards age and sex. Among patients, 29 % were females and the age range was between 25 to 55 years. Extra-articular manifestations were presented in 56.7% of the patients. The mean of DAS 28 score was 5.73±1.46 and that of HAQ-DI was 1.22±0.72 while that of SF-36 was 40.03±13.96. The level of serum IL-18 was significantly higher in patients than in the control subjects (P= 0.030). Serum IL-18 was correlated with ACPA among the patient group. There were no statistically significant correlations between serum IL-18 and DAS28, HAQ-DI, SF-36, total SvH score and the other laboratory results. In conclusion, IL-18 is significantly higher in RA patient than in healthy control subjects and positively correlated with ACPA level. IL-18 is associated with extra-articular manifestations. However, it is not correlated with other laboratory parameters, disease activity, functional disability, quality of life nor radiological severity.

Keywords: disease activity score, Interleukin-18, quality of life assessment, rheumatoid arthritis

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636 Benefits of Occupational Therapy for Children with Intellectual Disabilities in the Aspects of Vocational Activities and Instrumental Activities of Daily Life

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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635 On ‘Freaks’ and the Feminine in Margaret Atwood’s ‘Lusus Naturae’

Authors: Shahd Alshammari

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This paper considers one of Margaret Atwood’s short stories ‘Lusus Naturae'. Through a critical lens that makes use of Julia Kristeva’s work on Powers of Horror and abjection, this paper suggests that the monstrous girl is the disabled woman, the abject in society. The monster is used as a metaphor for the unknown, the misunderstood, and the ‘different’ woman. Culturally Relevant Teaching (CRT) is a pedagogy that calls for making course material accessible and relevant to students. Through the study of literary texts, we are able to help create agency inside and outside the classroom. Stories are a necessary part of establishing connections across borders and boundaries. Stories are meant to raise awareness both inside and outside the classroom. The discussion is equally important, and the text is meant to facilitate relevant questions that the students need to consider when it comes to identity. Questions to consider are: what does it mean to be a ‘girl’ today, and what implications and consequences are at hand when you fail to perform this gendered identity? Gender is sometimes a fatal bond in the Middle East, and even more so, is the disability. In the case of our unnamed protagonist, she undergoes a process of un-becoming, a non-linear process of growing up. In a sense, it is a counter-Bildungsroman. The reading of this text emphasizes that a non-linear narrative is sometimes necessary for the female protagonist’s self-awareness and development. Discussion in class facilitates this sense of agency and questioning of gender and disability.

Keywords: disability, gender, literature, pedagogy

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634 Vocational Rehabilitation for People with Disabilities: Employment Rates, Job Persistence and Wages

Authors: Hester Fass, Ofir Pinto

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Research indicates gaps in education, employment rates and wages between people with disabilities and those without disabilities. One of the main tools available to reduce these gaps is vocational rehabilitation. In order to examine the effects of vocational rehabilitation, a follow-up study, based on comprehensive administrative data, was conducted. The study included 88,286 people with disabilities who participated in vocational rehabilitation of the National Insurance Institute of Israel (NII), and completed the process between 1999 and 2012. Research variables included: employment rates, job persistence and wage levels. This research, the first of its kind in Israel, has several unique aspects: a)a long-range follow-up study on people who completed vocational rehabilitation; b) examination of a broad population spectrum, including also people that are not eligible to disability pensions ; c) a comparison among those with work-related injuries, those injured in hostile acts and those injured in other circumstances; and finally d) the identification of the characteristics of those who are entitled to vocational rehabilitation but who do not participate in any vocational rehabilitation plan. The most notable results include: 1. Vocational rehabilitation contributed to employment, job persistence and wage levels. Participation in vocational rehabilitation resulted in an employment rate of 65% within two years after completing the program, and 73% eventually. Participation in a vocational rehabilitation plan also contributed to job persistence and wage levels. 2. Vocational rehabilitation plans aimed at integration in universal frameworks increased the chances of being employed, persisting at the job and receiving a higher wage than did the vocational rehabilitation aimed at selective frameworks (such as sheltered workshops). 3. The type of disability affected the chances of integration in a vocational rehabilitation plan and in the labor market. People with a disability from birth had greater chances of integration in a vocational rehabilitation plan, while the type of disability and its severity affected the chances of the person with disabilities to find employment.

Keywords: vocational rehabilitation, employment, job persistence, wages

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633 Challenges of Teaching Physical Education to Students With Special Needs in Regular School Settings

Authors: Christine Okello

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Physical Education (PE) curriculum provides school age students to explore issues that are likely to impact on health, safety, and well-being. The current curriculum includes the physical activity component, intended to improve physical fitness, social skills as well as building confidence. While this viewpoint is vital, there are challenges and stigma attached when specific issues are either ignored, inadequately addressed, or not seen to be important. The department stipulates that students attend a school that is closest to their home, to access available government transportation to and from school. Equivalently, parents of students with a disability decide where their children attend school. A choice between a regular classroom, mainstream Special Unit classroom, or a School for Specific Purposes (SSP). Parents who take their children to regular schools may be oblivious of the details of the curriculum. Physical Education outcomes does not stipulate the extent to which a student must perform or expected to perform. It is therefore due to the classroom teacher to adjust their teaching goals or outcomes to suit all students in their classroom. A student who can run a hundred meters race in 20 seconds may belong in the same classroom as a student in a wheelchair. While these students are challenged because of a lack of performance, teachers are challenged to effectively teach successful PE lessons, and on the other hand students without a disability may not be able to attain their optimum. This paper will identify areas of need, address the challenges, and explore a possible solution.

Keywords: special needs, disability, challenges, physical education

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632 Access to Justice for Persons with Intellectual Disabilities in Indonesia: Case and Problem in Indonesian Criminal Justice System

Authors: Fines Fatimah, SH. MH.

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Indonesia is one of the countries that has ratified the UNCRPD (United Nations Convention on the Rights of Persons with Disabilities). The ratification of this convention brings consequences on the adjustment of national legislation with the UNCRPD convention, where this ratification at the same time is a measure in the eyes of the international community that a state party could be consistent with the issues and problems of disability. Persons with disabilities often have little access to justice when they are forced to deal with the criminal justice system. Pursuit of justice through litigation are often not in their favor, therefore without any awareness of law enforcement/awareness of disability will further complicate access to justice for persons with disabilities. Under Article 13 of the UNCRPD, it appeared that the convention requires ratifying states to guarantee equal opportunity and treatment in justice for persons with disabilities. The States should also ensure that any judicial rules must be adapted to the circumstances of persons with disabilities so that people with disabilities can fully participate in all stages of the trial court and, for example, as a witness. Finally, the state must provide training to understand these persons with disabilities (for those who work in the judiciary institution such as police or prison officials). Further, this paper aims to describe problem faced by persons with intellectual disabilities to access justice in Indonesian Criminal Justice System. This paper tries to find and propose the alternative solutions to promote the quality of law enforcement in Indonesia, especially for persons with intellectual disabilities.

Keywords: access to justice, Indonesian criminal justice system, intellectual disability, ratifying states

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631 'It Is a Sin to Be in Love with a Disabled Woman': Stigma, Rejection and Intersections of Womanhood and Violence among Physically Disabled Women Living in South Africa

Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries

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Background: Commonly, womanhood is defined as the qualities considered to be natural to or characteristic of a woman. However, womanhood is not a static concept; it is contextual and negotiable. For women with disabilities, gender roles or ‘qualities’ of womanhood are often overstated or contradicted because of assumptions of weakness, passivity, asexuality and infertility. Currently, little is known about how disability stigma intersects with notions of womanhood to make women with disabilities vulnerable to violence, or how women navigate this intersection to prevent or protect themselves from violence. Objective: To describe how the stigmatized constructions of womanhood and disability promote women with physical disabilities’ exposure to or protection from violence. Methods: Qualitative data for this paper comes from a doctoral study involving women with disabilities living in Cape Town, South Africa. It presents data from repeat in-depth interviews with 30 women with a range of physical impairments. Women attending protective workshops, rehabilitative centers and residential care facilities for people living with disabilities were invited to participate. Consent procedures and interviews were conducted by the first author (who is herself a woman living with a physical disability), and a female research assistant/translator who is a qualified occupational therapist. Reasonable accommodation is central to the methodology and the study as a whole. Findings: Descriptive and thematic analyses reveal how stigma and local constructions around womanhood, as well as women’s self-image and physical limitations, promotes women’s exposure to psychological, physical and sexual violence. It reveals how disabled women feel they are presumed incapable of living up to expectations of a ‘proper’ woman. This plays out as psychological violence, with women reporting that they feel ‘devalued,' ‘rejected’ and deprived of lasting intimate relationships. Furthermore, forms of psychological violence perpetuate physical and sexual violence. Women also discuss using strategies to prevent violence; by refusing to date, avoiding certain places or avoiding isolation, creating awareness, hiding their physical impairments, and exaggerating their ‘femininity.' Implications: Service providers need to be made aware of women’s violence experiences, and provide a range of accessible psychological and mental health services to women living with disabilities, as well as raising awareness around disability, and violence prevention, among caregivers, men, and women. Violence awareness and prevention interventions need to involve disability experts, researchers and people with disabilities.

Keywords: disability, gender, stigma, violence awareness and prevention interventions

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630 Auditory and Language Skills Development after Cochlear Implantation in Children with Multiple Disabilities

Authors: Tamer Mesallam, Medhat Yousef, Ayna Almasaad

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BACKGROUND: Cochlear implantation (CI) in children with additional disabilities can be a fundamental and supportive intervention. Although, there may be some positive impacts of CI on children with multiple disabilities such as better outcomes of communication skills, development, and quality of life, the families of those children complain from the post-implant habilitation efforts that considered as a burden. OBJECTIVE: To investigate the outcomes of CI children with different co-disabilities through using the Meaningful Auditory Integration Scale (MAIS) and the Meaningful Use of Speech Scale (MUSS) as outcome measurement tools. METHODS: The study sample comprised 25 hearing-impaired children with co-disability who received cochlear implantation. Age and gender-matched control group of 25 cochlear-implanted children without any other disability has been also included. The participants' auditory skills and speech outcomes were assessed using MAIS and MUSS tests. RESULTS: There was a statistically significant difference in the different outcomes measure between the two groups. However, the outcomes of some multiple disabilities subgroups were comparable to the control group. Around 40% of the participants with co-disabilities experienced advancement in their methods of communication from behavior to oral mode. CONCLUSION: Cochlear-implanted children with multiple disabilities showed variable degrees of auditory and speech outcomes. The degree of benefits depends on the type of the co-disability. Long-term follow-up is recommended for those children.

Keywords: children with disabilities, Cochlear implants, hearing impairment, language development

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629 Gender-Based Violence among Women and Girls with Disability in Nepal

Authors: Manita Pyakurel, Ram Chandra Silwal, Padam Simkhada, Edwin van Teijlingen, Bikesh Bajracharya, Sushila Sapkota, Tina Gorkhali, Salita Gurung

Abstract:

Introduction: Gender-based violence (GBV) has been identified as a social and personal security concern for women with disabilities who are at increased risk for various types of abuse. This study aims to determine the prevalence rates of physical, psychological, and sexual violence among women and girls with disability in Nepal. Methods: This cross-sectional study was conducted in 28 municipalities, 14 districts, and 7 provinces representing all three ecological regions of Nepal from January to March 2021. Study respondents were girls and women with disabilities, aged between 15 and 59 years, at the study sites. Face-to-face semi-structured interviews were conducted among 1294 respondents using the KoBo toolbox application on a smartphone or tablet. Results: Among the total study population, 35.3% shared lifetime violence experience. Only 4.8% formally reported violence experienced. Among the violence experienced participants maximum (92.6%) of women and girls identified no change in violence before and after the COVID-19 pandemic. Women who were married had protective odds of 0.71 for violence experienced in their lifetime [aOR-0.71, CI (0.56-0.90)]. Conclusion: More than one-third experienced violence in their lifetime. Intimate partner violence was the most common violence experienced by women and girls with disability in Nepal. Sexual violence was the least type of violence experienced. The most common perpetrator of violence includes the mother or father-in-law. Most of the women and girls never reported violence.

Keywords: gender-based violence, prevalence, girls, women

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628 Muslim Social Workers and Imams’ Recommendations in Marital and Child Custody Cases of Persons with Intellectual or Mental Disability

Authors: Badran Leena, Rimmerman Arie

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Arab society in Israel is undergoing modernization and secularization. However, its approach to disability and mental illness is still dominated by religious and traditional stereotypes, as well as folk remedies and community practices. The present study examines differences in Muslim social workers' and Imams' recommendations in marriage/divorce and child custody cases of persons with intellectual disabilities (ID) or mental illness. The study has two goals: (1) To examine differences in recommendations between Imams and Muslim social workers; (2) To explore variables related to their differential recommendations as observed in their responses to vignettes—a quantitative study using vignettes resembling existing Muslim religious (Sharia) court cases. Muslim social workers (138) and Imams (48) completed a background questionnaire, a religiosity questionnaire, and a questionnaire that included 25 vignettes constructed by the researcher based on court rulings adapted for the study. Muslim social workers tended to consider the religious recommendation when the family of a person with ID or mental illness was portrayed in the vignette as religious. The same applied to Imams, albeit to a greater extent. The findings call for raising awareness among social workers and academics regarding the importance of religion and tradition in formulating professional recommendations.

Keywords: child custody, intellectual and developmental disability, marriage/divorce, mental illness, sharia court, social workers

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