Hasil untuk "Vocational rehabilitation. Employment of people with disabilities"

Srikant Panda, Sourabh Singh Yadav, Palkesh Malviya

Vision-language models (VLMs) are increasingly deployed in socially sensitive applications, yet their behavior with respect to disability remains underexplored. We study disability aware descriptions for person centric images, where models often transition from evidence grounded factual description to interpretation shift including introduction of unsupported inferences beyond observable visual evidence. To systematically analyze this phenomenon, we introduce a benchmark based on paired Neutral Prompts (NP) and Disability-Contextualised Prompts (DP) and evaluate 15 state-of-the-art open- and closed-source VLMs under a zero-shot setting across 9 disability categories. Our evaluation framework treats interpretive fidelity as core objective and combines standard text-based metrics capturing affective degradation through shifts in sentiment, social regard and response length with an LLM-as-judge protocol, validated by annotators with lived experience of disability. We find that introducing disability context consistently degrades interpretive fidelity, inducing interpretation shifts characterised by speculative inference, narrative elaboration, affective degradation and deficit oriented framing. These effects are further amplified along race and gender dimension. Finally, we demonstrate targeted prompting and preference fine-tuning effectively improves interpretive fidelity and reduces substantially interpretation shifts.

Rui Chen, Firman Isma Serdana, Domenico Chiaradia et al.

Hand impairment following neurological disorders substantially limits independence in activities of daily living, motivating the development of effective assistive and rehabilitation strategies. Soft robotic gloves have attracted growing interest in this context, yet persistent challenges in customization, ergonomic fit, and flexion-extension actuation constrain their clinical utility. Here, we present a dual-action fabric-based soft robotic glove incorporating customized actuators aligned with individual finger joints. The glove comprises five independently controlled dual-action actuators supporting finger flexion and extension, together with a dedicated thumb abduction actuator. Leveraging computer numerical control heat sealing technology, we fabricated symmetrical-chamber actuators that adopt a concave outer surface upon inflation, thereby maximizing finger contact area and improving comfort. Systematic characterization confirmed that the actuators generate sufficient joint moment and fingertip force for ADL-relevant tasks, and that the complete glove system produces adequate grasping force for common household objects. A preliminary study with ten healthy subjects demonstrated that active glove assistance significantly reduces forearm muscle activity during object manipulation. A pilot feasibility study with three individuals with cervical spinal cord injury across seven functional tasks indicated that glove assistance promotes more natural grasp patterns and reduces reliance on tenodesis grasp, although at the cost of increased task completion time attributable to the current actuation interface. This customizable, ergonomic design represents a practical step toward personalized hand rehabilitation and assistive robotics.

Anthony LoBianco, Chithra Adams, Calisa Fitzpatrick

Background Earlier research has focused on the immediate impacts of the COVID-19 pandemic on persons with spinal cord injury (SCI). Objective The present study revisits lessons learned from the previous study and assesses the longer-term effects of the pandemic. Methods We used a community conversation method to inform our analysis. The themes examined include adapting to a “new normal” way of interacting with the world, employment, social isolation, and physical and mental health. Results We found that a person's ability to adapt to changing circumstances is a major predictor of how one will respond to the aftermath of a pandemic, and that this adaptability is heightened for persons with SCI. Conclusion Service providers, healthcare professionals, employers, and persons with SCI should be attuned to the impact of an individual's adaptation skills when dealing with long term societal social upheavals. This is particularly relevant for the SCI community, and continued inclusive research is necessary to understand these effects.

David John Musendo, Blessings Chirwa, Chisomo Kamata et al.

This paper describes the co-design of a participatory group intervention developed to promote and enhance parental involvement in supporting the education of children with disabilities in Malawi. The intervention was developed through participatory co-design workshops and consensus meetings involving 23 stakeholders, including parents, teachers, and community leaders. The Behaviour Change Wheel framework and the Delphi technique guided the intervention development process, ensuring theoretical robustness and contextual relevance. The proposed intervention, Tiyanjane (‘Let Us Unite’), includes facilitator and participant training and practical face-to-face sessions over 12 weeks. The intervention targets four key areas: developing family action plans, holding regular meetings, providing ongoing support at home and school, and facilitating training and information exchange. This participatory approach, involving a wide range of local stakeholders, offers valuable insights into the process and outcomes of co-developing culturally relevant and theoretically grounded interventions to address the needs of families with children with disabilities in low-resource settings. Future research should include an evaluation of the feasibility and acceptability of the intervention and examine its applicability in diverse sociocultural settings within LMICs (low- and middle-income countries).

Dianne Michaeli, MD, Vadim Bluvshtein, MD, Haitham Gazawi, MD et al.

Objective: To assess the employment rates, rates of return to work (RTW) in Israel, and factors affecting these rates after the onset of traumatic and nontraumatic spinal cord lesions (SCLs). Design: Longitudinal retrospective cohort study, collecting demographic, clinical, and employment data from hospital records and by phone interviews. Setting: A rehabilitation medical center. Participants: Inpatients with SCLs (N=487) and no comorbidities, aged 43±14 years at SCL onset, 72% men, 45% traumatic, admitted to rehabilitation between 2010 and 2022. Interventions: Not applicable. Main Outcome Measures: Rates of employment and RTW, and factors affecting them. Results: Patients’ American Spinal Injury Association Impairment Scale grades at discharge from rehabilitation were A, B, C, D, and E (normal according to the International Standards for Neurological Classification of Spinal Cord Injury(in 16.2%, 2.9%, 16.6%, 64.1%, and 0.2% of cases, respectively. The mean discharge Spinal Cord Independence Measure III score was 68±19). Before SCL onset, 79% of the patients had been employed. At any time after SCL onset, one-third (33.1%; 95% CI, 28.9%-37.2%) of the sample were employed; 29.7% and 35.8% for traumatic vs nontraumatic SCL. The RTW rate for those previously employed was 36.9% (95% CI, 32.0%-41.9%); 29% and 43.9% for traumatic vs nontraumatic SCL. Employment was independently related to former employment, education, and higher discharge Spinal Cord Independence Measure III scores (P<.01). The level of injury, American Spinal Injury Association Impairment Scale grade, and SCL etiology had no independent association with employment or RTW. Factors perceived as assisting employment after SCL onset (catalysts) were motivation, rehabilitation process, and support of family, friends, or colleagues. Reported reasons for not working (obstacles) were disability, pain, older age, sleep disturbances, mental condition, studying, and inaccessibility. Conclusions: Employment and RTW rates after SCL were low compared to those of people with other disabilities nationwide and to people with SCL in Western countries. The main catalysts were patient motivation and rehabilitation, and the main obstacles were disability and pain. To enhance employment after SCL, rehabilitation and an adequate national policy should be implemented. Rehabilitation should include vocational training and management of complications, pain, and patients’ motivation.

Mohd Saeed, Munazzah Tasleem, Ashanul Haque et al.

Muscular dystrophies (MDs) are an array of inherited disorders characterized by progressive muscle weakness and degeneration. This review explores the genetic foundation, pathophysiological mechanisms, current treatments, and therapeutic potential of medicinal plants for MDs. Although gene therapy, exon-skipping, and stem cell therapies are substantial advancements, they encounter obstacles regarding immune responses, long-term efficacy, and delivery efficiency. A promising complementary approach to conventional MD therapies is presented by natural compounds from medicinal plants. Recent studies and historical use underscore the multi-targeted effects of phytochemicals, such as resveratrol, withaferin A, ginsenosides, curcumin, and epigallocatechin gallate, on muscle regeneration, oxidative stress, and inflammation. These compounds have demonstrated potential in pre-clinical studies to enhance muscle function, reduce inflammation, and reduce oxidative stress. Despite their potential, the utilization of medicinal plants in MD treatment is impeded by regulatory hurdles, potential side effects, variability in bioactive compound concentration, and standardization issues. To address these challenges, it is necessary to implement rigorous clinical trials, standardization protocols, and comprehensive quality control measures. Future research should focus on elucidating the molecular mechanisms of plant-derived compounds, improving biotechnological production techniques, and integrating these treatments into personalized, comprehensive treatment plans. Advances in synthetic biology, genomics, metabolomics, and nanoformulations have the potential to improve the efficacy and safety of phytomedicine in the treatment of MD. Implementing evidence-based integrative approaches can enhance holistic care, improve patient outcomes, and facilitate acceptance of medicinal plant-based therapies in clinical practice.

Hien Nguyen, June Alexander, Michelle Bellon

Despite advancements in legal protections for people with disabilities in Vietnam, significant barriers to employment persist. This qualitative phenomenological study explored the employment experiences of people with physical disabilities in Vietnam. Semi-structured interviews with 15 participants employed across different sectors were thematically analysed, with the ecological systems theory applied as a guiding framework to interpret the findings and implications. Three primary themes were revealed: accessibility, vulnerability, and discrimination and ableism. The results also emphasised the importance of positive attitudes and interactions from co-workers and supervisors in fostering inclusive workplaces. Recommendations include policy reforms for attitudinal shifts, focus on equity to improve workplace culture, and the involvement of people with disabilities in organisational decision making. These actions are essential for creating more diverse and inclusive workplaces in Vietnam, where employees with physical disabilities feel included, valued, and empowered.

Shorena Sadzaglishvili, Ketevan Makashvili, Ketevan Gigineishvili et al.

This study explores the attitudes of university administrative staff toward disability and their perceptions of the potential for inclusive environments in higher education institutions across Georgia. Using the Attitudes to Disability Scale (ADS), a cross-sectional survey was conducted with 63 staff members from a Tbilisi-based and a regional university. The findings reveal generally positive attitudes, especially among younger and female staff, but expose persistent hierarchies in disability perception—particularly skepticism toward intellectual and psychosocial impairments. While the participants expressed support for inclusion, their recommendations for occupational roles reflected narrow and often custodial views of employability. Urban–rural and tenure-based divides further underscored structural and cultural barriers to full inclusion. This study concludes with actionable recommendations for inclusive training, policy reform, and participatory approaches to shift Georgian universities toward genuine inclusion.

Gonçalo Mesquita, Ana Rita Cóias, Artur Dubrawski et al.

The growing demands of stroke rehabilitation have increased the need for solutions to support autonomous exercising. Virtual coaches can provide real-time exercise feedback from video data, helping patients improve motor function and keep engagement. However, training real-time motion analysis systems demands frame-level annotations, which are time-consuming and costly to obtain. In this work, we present a framework that learns to classify individual frames from video-level annotations for real-time assessment of compensatory motions in rehabilitation exercises. We use a gradient-based technique and a pseudo-label selection method to create frame-level pseudo-labels for training a frame-level classifier. We leverage pre-trained task-specific models - Action Transformer, SkateFormer - and a foundation model - MOMENT - for pseudo-label generation, aiming to improve generalization to new patients. To validate the approach, we use the \textit{SERE} dataset with 18 post-stroke patients performing five rehabilitation exercises annotated on compensatory motions. MOMENT achieves better video-level assessment results (AUC = $73\%$), outperforming the baseline LSTM (AUC = $58\%$). The Action Transformer, with the Integrated Gradient technique, leads to better outcomes (AUC = $72\%$) for frame-level assessment, outperforming the baseline trained with ground truth frame-level labeling (AUC = $69\%$). We show that our proposed approach with pre-trained models enhances model generalization ability and facilitates the customization to new patients, reducing the demands of data labeling.

Vladimir Martirosyan, Rachit Kamdar

Online reviews shape impressions across products and workplaces. Employer reviews combine narratives and ratings that reflect culture. Glassdoor permits fully anonymous posts; Blind requires employment verification while preserving anonymity. We ask how verification changes reviews. Evidence suggests verified reviews can be more trustworthy, yet verification can also erode authenticity when expectations are unmet. We use the Competing Values Framework (clan, adhocracy, hierarchy, market) and the CultureBERT model by Koch and Pasch, 2023 to over 300k ratings. We find that Blind reviews emphasize clan and hierarchy while Glassdoor skews positive and highlights clan and market. Verification on its own does not remove bias but shifts how culture is represented. Job seekers using different platforms receive systematically different signals about workplace culture, affecting application decisions and job-matching.

Md Minhazul Islam Munna, Al Amin, Xin Wang et al.

Augmented Reality (AR) technology holds immense potential to transform the lives of blind and disabled individuals by offering enhanced interaction with their surroundings and providing real-time, accessible information. Globally, AR applications are being developed with features such as audio descriptions of environments, object recognition, and navigational aids, specifically designed to support the visually impaired. These innovations are paving the way for increased independence, mobility, and overall quality of life for millions of people worldwide. In Bangladesh, the adoption of AR technology for the blind and disabled is still in its early stages, primarily due to limited accessibility resources and infrastructure challenges. However, with the growing penetration of smartphones and continuous advancements in AR technologies, there is a promising opportunity for these solutions to be adapted, localized, and scaled within the country. This paper reviews the current state of AR technologies for the visually impaired on a global scale, explores their potential application in Bangladesh, and delves into the challenges and opportunities for broader implementation in this context.

Sara H. Rotenberg, Calum Davey, Emily McFadden

Background: Quality maternal health care is central to the Sustainable Development Goals efforts to reduce maternal mortality, yet there remain limited quantitative data on maternal care inequities for women with disabilities in sub-Saharan Africa. Objectives: This study aims to understand the differences in maternal care providers for women with and without disabilities. Method: We used Multiple Indicator Cluster Surveys from 13 sub-Saharan African countries conducted between 2017–2020. We used logistic and multinomial logistic regression to examine the relationship between disability (Washington Group definition) and antenatal care attendance and the type of care provider for antenatal care, skilled birth attendance, and postnatal and postpartum checks. All analyses were adjusted for age, wealth, country, and location. Results: The sample included 10 021 women, including 306 (3.1%) women with disabilities. There were small absolute and no relative differences in antenatal care attendance, qualified antenatal care provider, postnatal, and postpartum checks, for disabled and women without disabilities. Women with disabilities had some evidence of higher odds of having a doctor at their birth compared to women without disabilities (aOR = 1.52, 95% CI: 0.99–2.33). Conclusion: This study shows small absolute and no relative differences between women with and without disabilities for antenatal access and provider types for maternal care, though these findings are limited by a small sample and no data on care quality, acceptability, or outcomes. More research on care quality and outcomes is needed. Contribution: This study is the first quantitative, multi-country study in sub-Saharan Africa to examine maternal care seeking patterns, demonstrating important data on maternal health indicators for women with disabilities.

John S. Russo, Tim Mahoney, Kirill Kokorin et al.

Multiple Sclerosis (MS) is a severely disabling condition that leads to various neurological symptoms. A Brain-Computer Interface (BCI) may substitute some lost function; however, there is a lack of BCI research in people with MS. To progress this research area effectively and efficiently, we aimed to evaluate user needs and assess the feasibility and user-centric requirements of a BCI for people with MS. We conducted an online survey of 34 people with MS to qualitatively assess user preferences and establish the initial steps of user-centred design. The survey aimed to understand their interest and preferences in BCI and bionic applications. We demonstrated widespread interest for BCI applications in all stages of MS, with a preference for a non-invasive (n = 12) or minimally invasive (n = 15) BCI over carer assistance (n = 6). Qualitative assessment indicated that this preference was not influenced by level of independence. Additionally, strong interest was noted in bionic technology for sensory and autonomic functions. Considering the potential to enhance independence and quality of life for people living with MS, the results emphasise the importance of user-centred design for future advancement of BCIs that account for the unique pathological changes associated with MS.

Huiyuan Xie, Felix Steffek, Joana Ribeiro de Faria et al.

This paper explores the intersection of technological innovation and access to justice by developing a benchmark for predicting case outcomes in the UK Employment Tribunal (UKET). To address the challenge of extensive manual annotation, the study employs a large language model (LLM) for automatic annotation, resulting in the creation of the CLC-UKET dataset. The dataset consists of approximately 19,000 UKET cases and their metadata. Comprehensive legal annotations cover facts, claims, precedent references, statutory references, case outcomes, reasons and jurisdiction codes. Facilitated by the CLC-UKET data, we examine a multi-class case outcome prediction task in the UKET. Human predictions are collected to establish a performance reference for model comparison. Empirical results from baseline models indicate that finetuned transformer models outperform zero-shot and few-shot LLMs on the UKET prediction task. The performance of zero-shot LLMs can be enhanced by integrating task-related information into few-shot examples. We hope that the CLC-UKET dataset, along with human annotations and empirical findings, can serve as a valuable benchmark for employment-related dispute resolution.

Alexandre L. Ratschat, Rubén Martín-Rodríguez, Yasemin Vardar et al.

Object properties perceived through the tactile sense, such as weight, friction, and slip, greatly influence motor control during manipulation tasks. However, the provision of tactile information during robotic training in neurorehabilitation has not been well explored. Therefore, we designed and evaluated a tactile interface based on a two-degrees-of-freedom moving platform mounted on a hand rehabilitation robot that provides skin stretch at four fingertips, from the index through the little finger. To accurately control the rendered forces, we included a custom magnetic-based force sensor to control the tactile interface in a closed loop. The technical evaluation showed that our custom force sensor achieved measurable shear forces of +-8N with accuracies of 95.2-98.4% influenced by hysteresis, viscoelastic creep, and torsional deformation. The tactile interface accurately rendered forces with a step response steady-state accuracy of 97.5-99.4% and a frequency response in the range of most activities of daily living. Our sensor showed the highest measurement-range-to-size ratio and comparable accuracy to sensors of its kind. These characteristics enabled the closed-loop force control of the tactile interface for precise rendering of multi-finger two-dimensional skin stretch. The proposed system is a first step towards more realistic and rich haptic feedback during robotic sensorimotor rehabilitation, potentially improving therapy outcomes.

Min-Sik Kim, Young-Ran Kim

This study focuses on experience of Job Coach in Occupational Rehabilitation Support Projects that is offered by the field at the Field-Centric Occupational Rehabilitation Centers. The purpose of the study is to present better support to field training customized for people with severe disabilities. For this purpose, the researchers employed qualitative case methodology, conducted an in-depth interview with 6 Job Coaches to collect data, and analyzed collected data through constant comparison and analysis. The findings were as follows: training assistants began their work with no previous experiences with the vocational training of people with severe disabilities, but they witnessed changes to trainees and felt rewarded through their experiences of supporting the trainees. During the training sessions implemented at the establishment where trainees would be employed, the Job Coach worked together with them by their side and supported them through repetitions and praises. The Job Coach put greater importance on sociality than vocational training and spent four hours from the start to the end of their daily work on inducing the trainees to engage in conversations or having educational talks on detailed topics such as manners, hygiene, attitude, and sexuality. They had a relationship of trust with trainees, a relation of cooperation with the participant workplaces, and a relation of mutual need with trainees’ caregivers, but their employment relationship with the employed agency was ambiguous, which raises a need for institutional and administrative supplementation. Finally, Job Coach had difficulties with excessive workload, poor benefits, unclear work boundaries, difficult recruitment of trainees, and unrealistic performance goals. These difficulties can be resolved by supporting the greater professionalism of training assistants, improving their benefits, and rearranging their identity and job assignment.

Yukiya Yamada, Kazuaki Maebara

Background: Leisure activities contribute to the quality of life and continuation of employment for individuals with disabilities. However, education related to leisure activities is inadequate in special needs schools in Japan. Purpose: This study aimed to clarify which components of leisure guidance are considered important by vocational rehabilitation practitioners in Japan. Methods: An online survey was conducted in 337 branches of the Support Center for Employment and Livelihood of Persons with Disabilities in Japan. Results: Employment support practitioners recognized the importance of teaching students how to use their leisure time outside of working hours and helping them cultivate skills necessary to engage in leisure activities, regardless of whether they were still in school or had already graduated. In school, importance was placed on providing activities aimed at expanding leisure opportunities after graduation. For the period after graduation, the emphasis shifted to acquiring specific abilities necessary for engaging in leisure activities with other people, such as money management and securing means of transportation. Conclusion: This study provides a direction for optimizing the quality of leisure guidance for individuals with special needs. The findings can help improve teaching practices in special needs schools and enhance the effectiveness of transition support for students with disabilities.

P. Rumrill, Judiann McCrone Romeo, Kimberly Wickert et al.

BACKGROUND: With incidence and prevalence rates of asthma diagnoses steadily increasing in the United States and worldwide over the past 30 years, people with asthma are an emerging vocational rehabilitation (VR) consumer population. OBJECTIVE: This article describes the job acquisition and return to work considerations facing employees with asthma. METHODS: Following an overview of the etiology, incidence, prevalence, and career development implications of this chronic respiratory disease, the authors present career preparatory and return to work recommendations to meet the needs of Americans with asthma across the phases of the VR process. RESULTS: The importance of access to quality healthcare, lifestyle, and environmental modifications to promote respiratory health, employer consultation, workplace accommodations and universal design, and interface with medical and mental health professionals is emphasized throughout the article. CONCLUSION: Asthma is an emerging disability that disproportionally affects people of color and people who live in poverty. Rehabilitation professionals must be prepared to meet the needs of this growing and diverse clientele as people with asthma seek assistance from the VR program in acquiring, maintaining, and advancing in meaningful, satisfying employment.

Jamshaid Haider Malik, Maryam Nadir Kiyani

Background: The human voice is a prominent feature and the most susceptible to environmental changes, lifestyle, and age. Voice problems tend to be significantly under-reported and consequently less likely to be clinically treated. It is yet to be established if the cause lies in the lack of awareness or the impermanent nature of most voice disorders. Objective: To evaluate the patterns and perceptions about vocal use and misuse among young adults in Pakistan. Method: The study used a cross-sectional survey design. A convenient sampling technique was employed to collect the data from n=242 healthy young adults aged 18-25 years studying in colleges and universities of Rawalpindi and Islamabad. A 32-item survey questionnaire titled “patterns and Perceptions about voice use and Misuse” was employed, with a portion for demographic data and five sections dedicated to general awareness, self-perception about voice, and habits of vocal use and misuse. Results: The results regarding the perception and patterns of vocal use and misuse reflects that 88.3% of the participants agreed that precautionary measure would help them to avoid voice disorder. In contrast, 83.3% of the participants reported screaming and yelling as part of their vocal pattern. Participants showed a strong association with the positive attributes related to their voice such as beautiful as 82.2% of the participants reported their voice as pleasant. Conclusion: The study concluded that the outcome of participants’ perceptions and their patterns of vocal behavior were significantly atypical. Screaming and smoking were the most frequently reported response by adults but on the other hand, they did not seek professional help and did not perceive their voice as unpleasant voice. Keywords: speech therapy; voice disorder; vocal misuse; young adults

Arnengsih Nazir

Objectives: This review aimed to explore inspiratory muscle training (IMT) use in patients with mechanical ventilation (MV). The topics were related to its effect on the duration of MV or weaning, respiratory symptoms or lung function, inspiratory muscle strength (IMS) or endurance, functional ability, and quality of life (QoL). Methods: Articles published in the last ten years were reviewed narratively to obtain data about how inspiratory muscle training (IMT) can affect breathing muscle strength in prolonged mechanically ventilated patients. Results: Eleven articles were relevant to the topic, including seven original articles and four systematic reviews. We also found one practical guide on IMT in intensive care unit (ICU) patients. Discussion: Inspiratory muscle weakness is found in most intensive care unit (ICU) patients which further causes difficulty in weaning from MV. No standard protocol exists for the use of IMT in patients who failed to wean from MV. The use of IMT was found to be safe with the incidence of side effects or unexpected events was very rare. Several studies found various effects on the success of weaning after IMT administration, such as decreased MV and weaning duration or no effect on these parameters. Studies also found various effects on IMS or endurance although most investigators found increased IMS after IMT administration. These effects vary with exercise intensity and baseline maximum inspiratory pressure (MIP). The IMT program improves lung function thereby reducing symptoms, leading to improved functional abilities and QoL.improved functional abilities and quality of life (QoL). Coresponding author: Arnengsih Nazir, E-mail: arnengsih@unpad.ac.id You can also search for this author in:  Google Scholar