Zaccheus J Ahonle, Tianlan Wei, Phillip D Rumrill
et al.
Background State-Federal vocational rehabilitation (VR) services are available for eligible individuals with disabilities (IWD) who are interested in pursuing, obtaining, and maintaining gainful employment. Despite availability of VR services, employment outcomes of IWD compared to those without disabilities continue to be limited. Objective To examine effects of receipt of VR services on the employment outcomes of individuals with cognitive impairments (CI) compared to people with other impairments (i.e., physical and sensory impairments) while accounting for individual characteristics and patterns of VR service use. Methods Secondary data analysis using Rehabilitation Services Administration (RSA) 911 data covering cases in 2019. Hypothesized covariates and predictors of employment outcomes were divided into four groups: demographic variables, environmental/social variables, disability related variables, and receipt of VR services. The target outcome variables from the RSA 911 database were competitive integrated employment (CIE) employment outcome, hourly wage at case closure, and hours worked in a week at case closure. A hierarchical logistic regression analysis was performed using CIE as the criterion. Results Findings suggest that (a) the group including CI individuals was at a disadvantage in terms of CIE outcomes; (b) from the logistic regression, gender, education level, significance of disability, and receipt of some VR services were significantly associated with CIE outcomes (yes/no); and (c) when we examined the percentages of individuals receiving VR services, higher percentages of individuals with CI received varieties of VR services, but less assistive technology services. Conclusions Individuals with disabilities continue to experience disparate employment outcomes. The receipt of varieties of VR services facilitates IWDs to successfully obtain CIE. Receipt of VR services alone may not be the only factor that supports IWD in obtaining successful CIE. A critical investigation of the quality and type of these VR services, difference by impairment, and the economic impact of societal/environmental trends is warranted.
Kathlynne F. Eguia, Sum Kwing Cheung, Kevin K. H. Chung
et al.
Children with developmental coordination disorder (DCD) have motor difficulties that interfere with their daily functions. The extent to which DCD affects children in Hong Kong has not been established. In this study, we aimed to estimate the prevalence of children suspected of DCD (sDCD) in Hong Kong and to examine the relationship between motor performance difficulties and health-related functioning. We conducted a cross-sectional survey of parents of children aged 5 to 12 years across Hong Kong (<i>N</i> = 656). The survey consisted of the Developmental Coordination Disorder Questionnaire (DCDQ) and short forms on global health, physical activity, positive affect, and cognitive function of the Patient-Reported Outcome Measurement Information System (PROMIS<sup>®</sup>) parent-proxy report scales. We found that the total DCDQ score categorized 18.29% of the children as sDCD. Logistic regression revealed that household income (<i>OR</i> 0.776, <i>p</i> < 0.001) and child age (<i>OR</i> 1.012, <i>p</i> = 0.004) contributed to being categorized as sDCD. Children categorized as sDCD had lower global health (<i>p</i> < 0.001), less positive affect (<i>p</i> < 0.001), and more impaired cognitive function (<i>p</i> < 0.001) than children categorized as probably not DCD (nDCD). The findings of this study contribute to clarifying the extent to which DCD might affect Hong Kong children and serve as a basis to advocate for programs that address motor, health, affective, and cognitive outcomes. Further research is recommended to estimate the prevalence of a DCD diagnosis in Hong Kong.
Vocational rehabilitation. Employment of people with disabilities
Rehab Alhasani, Hadeil Almohaya, Bodor H. Bin Sheeha
et al.
Several neuropsychological assessments and self-reported cognitive measures have been used to ascertain cognitive decline. However, these tools may lack the ability to detect changes over an extended period or present challenges in practical applications in a clinical setting. Patient-Reported Outcomes Measurement Information System Cognitive Function Abilities (PROMIS CFA) short form 8a is a widely used patient-reported outcome measure for assessing self-perceived cognitive function in adults. This study aimed to evaluate the psychometric properties of the Arabic version of the PROMIS CFA short form 8a in the general population of Saudi Arabia. This cross-sectional methodological study involved a convenience sample of 351 healthy participants who completed the PROMIS CFA short form 8a. The items were rated on a Likert scale ranging from 1 (“not at all”) to 5 (“very much”). Data were analysed using Rasch analysis to assess category functioning, item fit, reliability indices, and item difficulty and to evaluate unidimensionality using WINSTEPS ® version 5.6.1. A total of 351 healthy individuals (85% women) participated in the study, with an average age of 37 years (±15.4 years). PROMIS CFA short form 8a met Linacre’s criteria for rating scale functioning. One item demonstrated slight overfitting values (infit mean square = 1.34). The person separation index was 2.85 (Cronbach’s α = 0.92). Therefore, the scale was sufficiently sensitive to distinguish between at least three different levels of cognitive ability. Meanwhile, participants’ abilities spanned 11.84 logits (mean 0.47) and item difficulty spanned 0.53 logits, which makes the targeting of items to participants poor. The unidimensionality of PROMIS CFA short form 8a was confirmed, and no local dependency was noted. The scale exhibited robust internal consistency and sensitivity, which facilitated discrimination across a range of cognitive ability levels. Despite the challenges in item targeting, the scale’s unidimensionality provides confidence in its ability to measure cognitive function abilities in diverse populations. This study offers a validated cognitive assessment tool for clinicians working with Arabic-speaking populations.
Vocational rehabilitation. Employment of people with disabilities
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.
Matthew Lamsey, Meredith D. Wells, Lydia Hamby
et al.
Robot-led physical therapy (PT) offers a promising avenue to enhance the care provided by clinical exercise specialists (ES) and physical and occupational therapists to improve patients' adherence to prescribed exercises outside of a clinic, such as at home. Collaborative efforts among roboticists, ES, physical and occupational therapists, and patients are essential for developing interactive, personalized exercise systems that meet each stakeholder's needs. We conducted a user study in which 11 ES evaluated a novel robot-led PT system for people with Parkinson's disease (PD), introduced in [1], focusing on the system's perceived efficacy and acceptance. Utilizing a mixed-methods approach, including technology acceptance questionnaires, task load questionnaires, and semi-structured interviews, we gathered comprehensive insights into ES perspectives and experiences after interacting with the system. Findings reveal a broadly positive reception, which highlights the system's capacity to augment traditional PT for PD, enhance patient engagement, and ensure consistent exercise support. We also identified two key areas for improvement: incorporating more human-like feedback systems and increasing the robot's ease of use. This research emphasizes the value of incorporating robotic aids into PT for PD, offering insights that can guide the development of more effective and user-friendly rehabilitation technologies.
This study proposes a novel method for detecting multiple sclerosis (MS) by integrating multi-modality data fusion techniques. Leveraging the complementary information from both health records and magnetic resonance imaging (MRI), our approach aims to enhance the accuracy and reliability of MS detection. We utilized DenseNet 201 to extract features from MRI scans, exploiting its capability to capture intricate patterns in brain images associated with MS pathology. Additionally, we employed bidirectional long short-term memory networks to extract temporal patterns from health records, capturing longitudinal patient data crucial for understanding disease progression. A feature fusion technique was then applied to integrate the extracted features from MRI and health records, combining the spatial information from imaging data with the temporal dynamics captured in health records. Finally, a multi-layer perceptron was employed to perform the final prediction task based on the fused features. The proposed model was experimented with in the Kaggle datasets, covering 271 individuals. Remarkably, our proposed model achieved an impressive accuracy of 99.2% in MS detection, highlighting its effectiveness in leveraging multi-modality data for diagnostic purposes. By combining information from both MRI scans and health records, our approach offers a comprehensive and holistic understanding of the disease, enabling more accurate and timely diagnosis. Additionally, further validation studies in clinical settings are warranted to assess our approach’s real-world utility and clinical impact in improving patient outcomes and facilitating better management of MS.
Vocational rehabilitation. Employment of people with disabilities
Background: One of the most common degenerative joint diseases is Osteoarthritis (OA) which involves the cartilage and other surrounding tissues. Progression of the disease is usually slow and increases with age but after a long time, it can lead to joint dysfunction with pain, affect quality of life, and cause disability. OA of the knees can lead to the greatest burden to the population often severe wear and tear leading to lifelong disability.
Objective: The main objective and aim of the study were to identify the frequency and related risk factors of Knee Osteoarthritis (KOA) in residents of Hayatabad Peshawar, and find a correlation to different aspects e.g., SEX, BMI, AGE, etc.
Method: A descriptive cross-sectional study was conducted in Hayatabad Peshawar. Data was collected from 409 residents who willingly participated by filling out a self-reported questionnaire that focused on the diagnosis of Knee Osteoarthritis and Associated Risk factors. The data was later analyzed using SPSS version 24.
Results: Among 409 participants 167 (40.83%) were suffering from knee Osteoarthritis. 75 (30.6%) of male and 92(56.1%) of female were suffering from KOA. Regarding risk factors aged>40 and obese participants were more prone to KOA than others such as age <40 and normal BMI.
Conclusion: KOA is a degenerative joint age-related disease that commonly affects females. Obesity shows a strong link in the development of KOA especially in those who are inactive. There is a significant relationship between KOA with age, BMI, and gender therefore proper attention and preventive measures should be taken into consideration.
Keywords: Knee Osteoarthritis, Frequency, risk factors, Hayatabad, Peshawar.
Vocational rehabilitation. Employment of people with disabilities, Therapeutics. Psychotherapy
Mehedi Masud, Abdulqader M. Almars, Mahmoud B. Rokaya
et al.
Alzheimer’s disease (AD) is a progressive neurological disorder that presents a significant public health concern. Early detection of Alzheimer’s has the potential to greatly improve patient care and treatment. Artificial intelligence (AI) has the potential to revolutionize healthcare by improving patient outcomes and empowering healthcare providers. In recent years, significant breakthroughs in medical diagnosis have occurred, thanks to the use of AI, particularly through the application of deep learning (DL) techniques. These advancements have the potential to greatly improve patient care and outcomes. Several proposals have been developed utilizing DL techniques to identify AD. This study proposes a DL model to classify individuals with AD using magnetic resonance imaging images. The study aims to evaluate DL’s effectiveness in predicting AD. The proposed model used a custom-weighted loss function, resulting in a 99.24% training accuracy, 96.95% test accuracy, a Cohen’s kappa score of 0.931, and a weighted average precision of 97%. The model is evaluated against several pre-trained models. Regarding accuracy findings and Cohen’s kappa score, the suggested model performs better than the others.
Vocational rehabilitation. Employment of people with disabilities
Background Multiple sclerosis (MS) is a complex immune-mediated disease with no currently known cure. There is growing evidence to support the role of diet in reducing some of the symptoms and disease progression in MS, and we previously developed and tested the feasibility of a digital nutrition education program for people with MS. Objective The aim of this study was to explore factors that influenced engagement in the digital nutrition education program, including features influencing capability, opportunity, and motivation to change their dietary behaviours. Methods Semi-structured interviews were conducted with people who MS who completed some or all of the program, until data saturation was reached. Interviews were analysed inductively using thematic analysis. Themes were deductively mapped against the COM-B behaviour change model. Results 16 interviews were conducted with participants who completed all (n=10) or some of the program (n=6). Four themes emerged: 1) Acquiring and validating nutrition knowledge; 2) Influence of time and social support; 3) Getting in early to improve health; and 4) Accounting for food literacy experiences. Discussion This is the first online nutrition program with suitable behavioural supports for people with MS. It highlights the importance of disease-specific and evidence-based nutrition education to support people with MS to make dietary changes. Acquiring nutrition knowledge, coupled with practical support mechanisms such as recipe booklets and goal-setting, emerged as crucial for facilitating engagement with the program. Conclusions When designing education programs for people with MS and other neurological conditions, healthcare professionals and program designers should consider flexible delivery and building peer support to address the needs and challenges faced by participants.
Madhuka Thisuri De Silva, Sarah Goodwin, Leona M Holloway
et al.
Actively participating in body movement such as dance, sports, and fitness activities is challenging for people who are blind or have low vision (BLV). Teachers primarily rely on verbal instructions and physical demonstrations with limited accessibility. Recent work shows that technology can support body movement education for BLV people. However, there is limited involvement with the BLV community and their teachers to understand their needs. By conducting a series of two surveys, 23 interviews and four focus groups, we gather the voices and perspectives of BLV people and their teachers. This provides a rich understanding of the challenges of body movement education. We identify ten major themes, four key design challenges, and propose potential solutions. We encourage the assistive technologies community to co-design potential solutions to these identified design challenges promoting the quality of life of BLV people and supporting the teachers in the provision of inclusive education.
Cedegao E. Zhang, Katherine M. Collins, Lionel Wong
et al.
People can evaluate features of problems and their potential solutions well before we can effectively solve them. When considering a game we have never played, for instance, we might infer whether it is likely to be challenging, fair, or fun simply from hearing the game rules, prior to deciding whether to invest time in learning the game or trying to play it well. Many studies of game play have focused on optimality and expertise, characterizing how people and computational models play based on moderate to extensive search and after playing a game dozens (if not thousands or millions) of times. Here, we study how people reason about a range of simple but novel Connect-N style board games. We ask people to judge how fair and how fun the games are from very little experience: just thinking about the game for a minute or so, before they have ever actually played with anyone else, and we propose a resource-limited model that captures their judgments using only a small number of partial game simulations and almost no look-ahead search.
Understanding how cooperation emerges in public goods games is crucial for addressing societal challenges. While optional participation can establish cooperation without identifying cooperators, it relies on specific assumptions -- that individuals abstain and receive a non-negative payoff, or that non-participants cause damage to public goods -- which limits our understanding of its broader role. We generalize this mechanism by considering non-participants' payoffs and their potential direct influence on public goods, allowing us to examine how various strategic motives for non-participation affect cooperation. Using replicator dynamics, we find that cooperation thrives only when non-participants are motivated by individualistic or prosocial values, with individualistic motivations yielding optimal cooperation. These findings are robust to mutation, which slightly enlarges the region where cooperation can be maintained through cyclic dominance among strategies. Our results suggest that while optional participation can benefit cooperation, its effectiveness is limited and highlights the limitations of bottom-up schemes in supporting public goods.
Visual icons provide immediate recognition of features on print maps but do not translate well for touch reading by people who are blind or have low vision due to the low fidelity of tactile perception. We explored 3D printed icons as an equivalent to visual icons for tactile maps addressing these problems. We designed over 200 tactile icons (TactIcons) for street and park maps. These were touch tested by blind and sighted people, resulting in a corpus of 33 icons that can be recognised instantly and a further 34 icons that are easily learned. Importantly, this work has informed the creation of detailed guidelines for the design of TactIcons and a practical methodology for touch testing new TactIcons. It is hoped that this work will contribute to the creation of more inclusive, user-friendly tactile maps for people who are blind or have low vision.
BACKGROUND Stroke is one of the leading causes of death and disability in the industrialized world and a large part of stroke survivors is of working age. A very important goal for these people is to return to work after stroke as it facilitates independent living and guarantees a high level of self-esteem and life satisfaction. AIM To find the main factors that facilitate and hinder the return to work (RTW) in people who suffered from stroke through an overview of systematic reviews. METHODS A systematic search using keywords and medical subject heading terms was conducted in January 2022, three electronic databases were searched: Medline (PubMed), Scopus and ISI Web. The articles that address the question of returning to work or maintaining employment of people of working age after stroke were included in the systematic review, as well as studies describing factors that facilitate and/or hinder RTW after stroke. Only systematic reviews written in English language were included in this overview. RESULTS The search revealed 180 records after removing duplicates, but only a total of 24 systematic reviews were included in the overview. This research shows that in people who have suffered from a stroke, individual abilities, socioeconomic factors, healthcare factors, and disabilities resulting from the stroke itself are the most critical factors influencing the RTW. Conclusion: Future research should focus on cognitive disabilities, as main RTW hindering factor, and vocational rehabilitation, as the more suitable factor for improving the RTW in stroke survivors.
Disabled people are at increased risk of violence, including physical, psychological, sexual, and financial abuse. We conducted a thematic analysis of discussion forum posts (<i>N</i> = 50) from the popular online platform, Reddit. Posts discussed personal experiences of domestic violence, most commonly referring to partner violence (<i>n</i> = 23) or abuse perpetrated by a parent (<i>n</i> = 16). We identified three primary themes associated with domestic violence: (i) Perpetrators Targeting Disability (e.g., withdrawing access to medication or assistive devices and verbal abuse focused on the disability), (ii) Isolation and Dependence (e.g., financial dependence on the perpetrator), and (iii) Accessibility of Support (e.g., inaccessibility of domestic violence shelters and bureaucracy of the benefits system). Findings highlight the relationship between disability and domestic violence. Greater societal recognition of this issue is required, and systems must be put into place to ensure that disabled victim-survivors of domestic violence can access the health and personal care required.
Vocational rehabilitation. Employment of people with disabilities
Patricia Flaherty-Fischette, Jenée Lee, Yvonne D'Uva-Howard
et al.
Individuals with intellectual and developmental disabilities (IDD) are a growing population. Considering the wide diversity in IDD and the financial burden of traditional treatment modalities, Animal-Assisted Interventions (AAI) has emerged as an innovative and non-traditional treatment for individuals with a range of disabilities, including individuals with IDD. To the authors’ knowledge, the present study was one of the first to explore a goat-assisted therapy experience for children with IDD. This study explored the experiences of 23 children with the All Abilities RAMble – a goat-assisted therapeutic activity offered by the Philly Goat Project (PGP). Key themes in our study included the RAMble activating joy, RAMble as a place to practice skills, RAMble as a unique service providing transferable skills, RAMble as a personalized and child-directed program, and RAMble providing a sense of community. This research provides valuable insight into the child’s experience with goat-assisted therapy, which can inform future goat-assisted therapy interventions for children with IDD. The results suggest there are several positive impacts from the All Abilities RAMble, further supported by the literature on AAI and IDD. Additionally, the emergence of social skill(s) and communication skill development, transferability of acquired skills, and sense of community prompted provided strength in this exploratory inquiry of this specific form of AAI. Goat-assisted therapeutic activities, such as the PGP All Abilities RAMble, is an opportunity to practice skills and develop relationships that are often under-examined in this specific population. This study demonstrates the need for more empirical research on goat-specific AAI with children with IDD, and their families. Future research recommendations include exploration of siblings and parents’ experience at the RAMble and further inquiry into what contributes to outdoor or nature-based programming beneficial to people with disabilities.
Vocational rehabilitation. Employment of people with disabilities, Special aspects of education
Attackers can exploit known vulnerabilities to infiltrate a device's firmware and the communication between firmware binaries, in order to pass between them. To improve cybersecurity, organizations must identify and mitigate the risks of the firmware they use. An attack graph (AG) can be used to assess and visually display firmware's risks by organizing the identified vulnerabilities into attack paths composed of sequences of actions attackers may perform to compromise firmware images. In this paper, we utilize AGs for firmware risk assessment. We propose MIRAGE (Multi-binary Image Risk Assessment with Attack Graph Employment), a framework for identifying potential attack vectors and vulnerable interactions between firmware binaries; MIRAGE accomplishes this by generating AGs for firmware inter-binary communication. The use cases of the proposed firmware AG generation framework include the identification of risky external interactions, supply chain risk assessment, and security analysis with digital twins. To evaluate the MIRAGE framework, we collected a dataset of 703 firmware images. We also propose a model for examining the risks of firmware binaries, demonstrate the model's implementation on the dataset of firmware images, and list the riskiest binaries.
BACKGROUND: Adequate, accessible public transportation is essential to fully address social and economic disparities that exist among individuals with disabilities. Despite removal of many physical barriers within transportation systems, significant barriers to public transportation for people with disabilities are still widespread. OBJECTIVE: Transportation is commonly cited as an obstacle to employment for individuals with disabilities, and as a result, a thorough analysis of specific factors influencing the use of public transportation by individuals with disabilities is necessary to fully understand patterns of use. METHOD: The current study used a national sample of individuals with disabilities in pursuit of employment to investigate characteristics that predict the receipt of transportation services by vocational rehabilitation personnel. RESULTS: Results indicate individuals who were not employed, who were receiving welfare and/or TANF, who were homeless, who were living in rehabilitation facilities, and/or who were living in substance abuse treatment centers were more likely to receive transit services from vocational rehabilitation programs. Also, individuals with substance use problems, mental health disorders, HIV/AIDS or other immune deficiency disorders, and/or people from racial or ethnic minority backgrounds were more likely to receive transit service support from vocational rehabilitation programs. CONCLUSION: Improvement in transportation services for individuals with disabilities is needed on a systems and individual level. State rehabilitation counselors can evaluate the extent high-risk clients identified in this study can benefit from transit services as well as other wrap around services that can improve their engagement in VR services leading to better employment outcomes.
James S. Krause, Clara E. Dismuke-Greer, Melinda Jarnecke
et al.
BACKGROUND: Joint studies of multiple sclerosis (MS) and spinal cord injury (SCI), both types of spinal cord dysfunction, have identified barriers and facilitators to employment and key outcomes including earnings and job benefits. However, there has been an absence of research on satisfaction with employment over one’s career. Such knowledge would help to establish the foundation for targeted vocational rehabilitation interventions. as well as differences in quality of employment outcomes, establishing the foundation for targeted vocational rehabilitation interventions. OBJECTIVE: Identify and quantify demographic, educational, vocational, and functional characteristics associated with career satisfaction, a quality employment outcome, among people with MS and SCI. METHODS: There were a total of 3,371 participants, 1,229 with MS and 2,142 with SCI, all of whom were in the traditional working age range (< 65 years old). Participants were identified from the Southeastern and Midwestern regions of the USA and data were collected, processed, and analyzed at a medical university in the Southeastern USA. Econometric modeling identified factors associated with career satisfaction, as defined by a five-item composite scale that was converted to Z-scores, integrating analysis using both diagnostic groups. RESULTS: Participants who were gainfully employed and those who had left the labor force (unemployed with no hopes to return to work), reported higher career satisfaction than those who were unemployed and hoping to return to work. Higher career satisfaction scores were associated with more formal education and having worked in management/professional, natural resources, or service occupations. Higher scores were also observed among those older, not single, and who had fewer functional deficits. No differences were identified as a function of diagnosis, race-ethnicity, sex, or time since injury/diagnosis. CONCLUSION: Career satisfaction was more strongly related to educational attainment, vocational history, and labor force participation, than to demographic and disability factors. Vocational counselors should target those still in the labor force for skills development, job retention, and reacquisition to promote career satisfaction.
Objectives: Sensory processing patterns refer to a person’s ability to receive and respond to sensory events which are important to succeed in daily routine activities. This study aims to determine the sensory processing patterns in infants/toddlers.
Methods: This is a cross-sectional study. A total of 518 infants/toddlers participated in this study. Their ages ranged from birth to 36 months. Parents completed the infant/toddler sensory profile for all participants.
Results: No significant difference was observed between girls and boys in sensory processing from birth to 6 months; however, there is a significant difference between girls and boys in low registration, sensory sensitivity, and sensory avoidance from 7-36 months. In addition, no significant difference was detected between children born by cesarean and those born through natural childbirth in terms of sensory processing (quadrants and scores) from birth to 6 months and 7-36 months. There is a significant difference between preterm and full-term children (birth to 6 months) in auditory processing. The findings also indicate only a significant difference in oral sensory processing between the preterm and full-term children (7-36 months).
Discussion: We discussed sensory processing patterns in children and their differences based on different factors. The results of this study can provide considerations for Iranian occupational therapists and psychologists.
Medicine, Vocational rehabilitation. Employment of people with disabilities