Background: Workplace inclusion for employees with chronic conditions such as multiple sclerosis (MS) remains a challenge because of the episodic and invisible nature of symptoms, leading to stigma, disclosure dilemmas and inadequate accommodations. Traditional approaches to disability inclusion often fail to address the lived realities of employees with MS, necessitating a deeper exploration of how individuals and organisations construct meaning around disability and inclusion.
Objectives: This study explores how employees with MS experience workplace inclusion, self-management and disclosure drawing on sensemaking theory and the Social Model of Disability. The study also employs a reflexive approach, centring the voices of employees to generate actionable insights for employers and disability advocates.
Method: An exploratory qualitative research design was adopted involving semi-structured interviews with 13 employees diagnosed with MS in South Africa. Thematic analysis was used to identify patterns related to workplace adaptability, disclosure and support structures. Researcher reflexivity was incorporated to acknowledge positionality and enhance the study’s depth.
Results: Workplace adaptability, including flexible work arrangements and empathetic leadership, play a critical role in ensuring inclusion for individuals with MS in the work environment. However, disclosure remains a complex decision influenced by stigma and workplace culture. Psychological safety and proactive organisational sensemaking significantly impact employees’ experiences.
Conclusion: For meaningful workplace inclusion, organisations must move beyond compliance-driven policies and foster an environment where employees with MS feel valued and supported.
Contribution: By integrating reflexivity, sensemaking theory and the Social Model of Disability, this study offers valuable contributions to the discourse on disability inclusion.
Vocational rehabilitation. Employment of people with disabilities, Communities. Classes. Races
Kristen Abrahams, Dellicia de Vos, Armand Bam
et al.
Background: Early communication supports are essential for development, learning and later employment. For children with visual impairments and blindness (VI and B), we argue that communication and its supports need to be considered outside of the normative ableist framework to best facilitate development.
Objectives: This study aimed to explore and describe how a home-based programme at a community-based organisation supported the communication development of children with VI and B by exploring and describing: (1) the organisation, its context and ethos; (2) the programme methodology including, role players, skills and activities; and (3) communication opportunities.
Method: A case study design was employed, and data were collected through interviews, document reviews and observations. Notably, one member of the research team has a VI, which provided additional context and understanding of the case and enhanced the analysis process.
Results: Key themes emerging from the data included the organisation’s history and context that shaped its ethos, the focus on a parent-led methodology and the support of communication through early multimodal opportunities.
Conclusion: The findings emphasise the importance of understanding communication and communication supports beyond the normative ableist framework, which creates opportunities to appreciate and support communication holistically. More specifically, for speech-language pathologists, this study can expand their understanding of communication and raises questions about the profession’s potential contribution.
Contribution: The study contributes to the literature within the South African context that demonstrates the value of communication and further captures how multimodal community support contributes to the health and wellbeing of people with disabilities.
Vocational rehabilitation. Employment of people with disabilities, Communities. Classes. Races
Malak Abedalthagafi, Eissa Faqeih, Nouf Alajaji
et al.
Early diagnosis of prenatal complications, particularly genetic disorders, can enable early intervention and improve outcomes for both mother and infant. However, the current gold-standard testing approaches, including amniocentesis and chorionic villi sampling, are expensive, require a tertiary-care setting, and can induce miscarriage. Advancements in genomic techniques, such as next-generation sequencing (NGS), combined with cell-free noninvasive prenatal testing (NIPT), can enable low-risk prenatal testing that requires only a single maternal blood sample. We expanded the design of an amplicon-based NGS assay that uses oligonucleotide probes designed to target and amplify specific regions of interest within a gene. This method requires only maternal peripheral blood, from which cell-free DNA (cfDNA) can be extracted. We then used NGS technology, a proprietary bioinformatics algorithm, and population-specific data to estimate autosomal recessive disease risk. We recruited pregnant women who were pursuing fetal diagnostic testing because they were known carriers of an autosomal recessive mutation, had a previous child with an autosomal recessive mutation, or had a family history of autosomal recessive mutations. A blood draw was obtained from each participant, and 50 samples passed quality control standards for advancement. We extracted cfDNA and genomic DNA from these samples for amplicon-based NGS. We obtained conclusive results for 38 of 50 samples, and the NGS results for 29 (76.3%) samples were concordant with the invasive testing results. Focusing on samples with heterozygous maternal cfDNA ( n = 20), we were able to predict the genotypes for 10 samples with high confidence and for 6 samples with low confidence, whereas the remaining 4 samples were incompatible with our approach. This novel NIPT method has the potential to improve prenatal care by offering expectant parents a noninvasive and accurate option for screening autosomal recessive conditions with minimal risks.
Vocational rehabilitation. Employment of people with disabilities
Michelle E. Kelly, Saoirse Byrne, Roisin Lacey
et al.
Dementia is recognised as a disability under the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). People with disabilities like dementia have the right to access specialised health and social care services, including interventions that support independence and community participation. Cognitive Stimulation Therapy (CST) is an evidence-based psychosocial intervention that improves cognition, communication, confidence, and quality of life for people living with dementia, but an implementation gap means that CST is often not available. This study examines whether trained CST practitioners implemented CST, their perceptions of the acceptability and efficacy of CST, whether the perceived acceptability and efficacy of CST predicted implementation, and practitioners’ opinions on the barriers and facilitators to CST implementation. A mixed-methods approach was used, with 62 participants (91.9% female). Although 95% of participants were trained to deliver CST, 45.2% did not facilitate CST groups. Statistical analysis showed that perceived efficacy significantly predicted both the likelihood of running CST groups (<i>p</i> = 0.006) and the number of groups delivered (<i>p</i> = 0.01). Thematic analysis of qualitative data identified the three key themes of ‘resources’, ‘awareness and education’, and ‘acceptability of CST’. Overall, the results show that while CST is acceptable and deemed highly effective, resources and staffing often impede implementation. The results are discussed in the context of prioritising the rights of people with disabilities and recommendations are made on improving access to evidence-based support.
Vocational rehabilitation. Employment of people with disabilities
Susanna F. Greyling, Suna M. Verhoef, Wilhelm G.d.V. Tempelhoff
Background: Disability-inclusive public green spaces are vital for universal accessibility and for enhancing accessible tourism. Integrating multisensory stimuli with information and communication technologies fosters inclusive, sustainable, interactive, and site-specific tourism experiences.
Objectives: The objective of this article is to present the development of the Braille Trail in the Karoo Desert National Botanical Garden (KDNBG), South Africa, highlighting how participatory design, inclusive multisensory gardens and locative literature foster accessible tourism experiences, while addressing gaps in the literature on sensory and wellbeing gardens from a Global South perspective.
Method: A qualitative, practice-based, and participatory approach was adopted, grounded in principles of collaborative, community-based research. Semi-structured interviews, guided by a thematic framework, elicited insights from participants directly involved in the project. The authors’ practice-based contributions complemented these findings.
Results: The design and establishment of the Braille Trail involved collaboration between Garden management and staff, visually impaired persons, service organisations, institutional partners, and creative contributors. This inclusive process ensured that the trail reflected the needs, experiences, and expectations of its intended users.
Conclusion: The Braille Trail integrates sensory garden design, accessibility, and diverse communication technologies – including digital platforms and locative literature – while incorporating indigenous elements to enrich visitor experiences. Continued community engagement, together with lessons drawn from successes and challenges, provides guidance for sustaining and extending inclusive design in future projects.
Contribution: This study offers insight into multisensory gardens and accessible tourism in a Global South context, demonstrating the application of universal and inclusive design, co-design, slow tourism, accessible communication technologies, and collaborative approaches to create engaging and accessible visitor experiences.
Vocational rehabilitation. Employment of people with disabilities, Communities. Classes. Races
Persons with disabilities in Kenya, like elsewhere in the world, struggle to find a decent job. Disability advocacy in Kenya is still at its infancy. Although the government of Kenya enacted the Persons with Disabilities Act (PDA) in 2003, individuals with disabilities are still struggling to compete for available jobs owing to prevailing negative attitudes toward them. This study examined attitudes toward employment of individuals with disability in a Kenyan higher education setting. Participants were a sample of 298 undergraduate students at the University of Nairobi (females = 186, male= 113, age range = 19 to 45). Data on attitudes toward employment were collected using the Attitudes Toward Organizational Policies and Procedures for Employees with Disabilities Scale of the ATEPD measure (Loo, 2002). Results indicate that Kenyan undergraduate students had positive attitudes toward employing individuals with disabilities. Implications for policy and research are discussed.
Background Compared to the general population, adults with disabilities often have poor employment rates. Apprenticeships offer one way to improve employment outcomes; yet, it is unclear whether apprenticeships have been effective among adults with disabilities. Objective Our objective was to explore apprenticeships among adults with disabilities. Method We conducted a systematic literature review of 19 studies which examined apprenticeships among adults with disabilities. Results The studies were inconsistent in their characterization of disability and/or the nature of the apprenticeship. Yet, overall, most studies reported that apprenticeships were effective for adults with disabilities. In spite of their effectiveness, stakeholders often have negative views of apprenticeships for adults with disabilities. Conclusion Implications for research and practice are discussed.
Background: Cerebral palsy is described as a permanent, non-progressive disorder related to neurodevelopmental abnormalities in an underdeveloped brain which leads to additional brain lesions resulting in secondary motor disturbances and postural abnormalities
Objective: To determine the effectiveness of treadmill training on gross motor function, spasticity and gait speed in ambulatory children with spastic cerebral palsy.
Methodology: It was a Randomized clinical trial, which was done in Bahria International Hospital, Lahore by convenient sampling technique. A sample size of 50 patients were divided into two groups. Patients in Group A underwent conventional physiotherapy, whereas those in Group B received a specialized treadmill training program tailored for children with spastic cerebral palsy, alongside their standard physical therapy sessions.
Result: Our data is normally distributed so wo applied Independent sample t test for between group analysis which shows that mean of group A at baseline is 5.40±0.49 and group B is 5.20±0.76, at 6th weeks group A is 4.80±0.48 and group B is 4.33±.0.88and at 12th weeks group A is 3.93±0.58 and group B is 2.13±0.68.p-value shows that there is no significant difference between two groups at baseline and at 6th weeks but at 12th weeks there is a significant differences as p-value is less than 0.00.Repeated measure ANOVA shows both groups shows significant results but meand difference of treadmill training group were more in all outcome.
Conclusion: - Our study concludes that treadmill training, along with physiotherapy, is beneficial for children with spastic cerebral palsy in improving gross motor function, spasticity, and gait speed.
Keywords: Treadmill exercise, Gait, Spasticity, cerebral palsy
Vocational rehabilitation. Employment of people with disabilities, Therapeutics. Psychotherapy
Ghadah Aldehim, Radwa Marzouk, Mohammed Abdullah Al-Hagery
et al.
Gestures are a vital part of our communication. It is a procedure of nonverbal conversation of data which stimulates great concerns regarding the offer of human–computer interaction methods, while permitting users to express themselves intuitively and naturally in various contexts. In most contexts, hand gestures play a vital role in the domain of assistive technologies for visually impaired people (VIP), but an optimum user interaction design is of great significance. The existing studies on the assisting of VIP mostly concentrate on resolving a single task (like reading text or identifying obstacles), thus making the user switch applications for performing other actions. Therefore, this research presents an interactive gesture technique using sand piper optimization with the deep belief network (IGSPO-DBN) technique. The purpose of the IGSPO-DBN technique enables people to handle the devices and exploit different assistance models by the use of different gestures. The IGSPO-DBN technique detects the gestures and classifies them into several kinds using the DBN model. To boost the overall gesture-recognition rate, the IGSPO-DBN technique exploits the SPO algorithm as a hyperparameter optimizer. The simulation outcome of the IGSPO-DBN approach was tested on gesture-recognition dataset and the outcomes showed the improvement of the IGSPO-DBN algorithm over other systems.
Vocational rehabilitation. Employment of people with disabilities
Reza Roozbehani, Amir Ali Fatemi, Zahra Zamani
et al.
Objectives: Considering the need of diabetic patients for accessing the care system and the role of modern media in health education and culture, we aimed to determine the effectiveness of educating via mobile SMS in controlling blood sugar. Moreover, the adherence to drug treatment of patients with type 2 diabetes was assessed.
Methods: This quasi-experimental study was conducted in Isfahan City, Iran in 2018. A total of 100 diabetic patients participated in the case (intervention) and control groups. The control group underwent conventional therapies and training. SMS training was applied for the intervention group in addition to the conventional therapies. Collecting the information and data to assess adherence to patients’ treatment was done using a researcher-made 18-item questionnaire. Analyzing data was performed in SPSS software, version 20 through the employment of the independent t test, paired t test, and multivariate analysis of covariance.
Results: Based on the independent t test results, no significant difference was detected between the two study groups at any time points (P>0.05) in terms of the mean fasting blood sugar. However, by analysis of covariance and adjusting the fasting blood sugar level before the intervention in the studied groups, the mean fasting blood sugar was recognized to be significantly lower in the intervention group compared to the control group in the second month (P=0.048) and the third month after the intervention (P=0.008).
Discussion: There is an association between SMS education and fasting blood sugar control and adherence to treatment in the studied patients. In the field of health care education, it is possible to use patient communication techniques and short message services to control follow-up and monitor interventions.
Medicine, Vocational rehabilitation. Employment of people with disabilities
Soniya Yaghoubi, Zahra Mosallanezhad, Hamid Reza Mokhtarinia
et al.
Objectives: A sonographic approach can be used to quantify joint movement, muscle thickness, and available joint space. This study aimed to compare the amount of mouth opening, joint articular distance, and both anterior and inferior translation of the mandibular condyle between healthy participants and individuals with temporomandibular joint (TMJ) disorders.
Methods: A cross-sectional study design was used with 52 participants (control: 26 healthy and TMJ: 26 symptomatic individuals) recruited using convenience sampling. The joint space distance and the anterior and inferior condylar translation on both sides were evaluated using sonography during maximum mouth opening and closing. Mouth opening was measured with a graduated ruler. Reliability was performed on a subgroup (n=10) with an interval of 3-7 days.
Results: The reliability was good to excellent (ICC=0.57-0.94). The highest reliability was related to the joint space distance. The mean values for mouth opening were 43.1 and 35.3mm, respectively for healthy and TMJ patients. The anterior condylar translation was 7.14-7.57mm, inferior condylar translation was 2.35-2.66mm, and the joint space distance was 49.4-0.44mm. No significant differences were found between the left and right sides in either group. The mouth opening and joint space values were significantly higher in the healthy group while the rate of anterior transition movement was higher but not significant. Furthermore, there was a significant negative relationship between pain, mouth opening, and joint distance.
Discussion: Sonography can be considered an accurate tool for the assessment of joint space and condylar translation in individuals with symptomatic TMJ disorders.
Medicine, Vocational rehabilitation. Employment of people with disabilities
Jalal Younesi, Javad Kazemi, Mohammad Saeed Khanjani
et al.
Objectives: This study aimed to determine the effects of Acceptance and Commitment Therapy (ACT) on the Sense of Coherence (SOC), Locus of Control (LoC), and Posttraumatic Growth (PTG) in patients with Multiple Sclerosis (MS). These factors were explored according to the prevalence of psychological problems in these patients.
Methods: This was a quasi-experimental study with a pre-test, post-test and a control group design. The study population included all patients with MS from Iran’s MS Association in Tehran City, Iran. The study sample included 30 patients (n=15/group) who were selected by purposive sampling technique and according to the study inclusion and exclusion criteria. The study participants were randomly assigned to the experimental and control groups. After obtaining necessary permissions and informed consent, a pre-test was initially performed. The instruments used in this study were the 29-item Antonovsky’s Sense of Coherence Scale; the 29-item Julian Rotter’s Locus of Control Scale, and the 21-item Tedeschi and Calhoun’s Posttraumatic Growth scale. Several studies supported the reliability and validity of these scales. The experimental group received 8 sessions (once a week, each session: 1.5 h) of group Acceptance and Commitment Therapy (ACT). However, the control group received no intervention. After the intervention, according to the instructions, the post-test was performed. Data analysis was conducted using SPSS V. 21. Multivariate Analysis of Covariance (MANCOVA) was performed to examine between-group differences data.
Results: The study findings indicated that ACT was effective on the SoC; however, it had no significant effect on the LoC and PTG (P=0.05).
Discussion: Participation in ACT sessions could enhance the SoC of patients with MS. Accordingly, it can be improved by accepting and enhancing these patients’ commitment to change through psychotherapy approach and increasing their SoC.
Medicine, Vocational rehabilitation. Employment of people with disabilities
Objectives: Juvenile delinquents are a group of people that is in dire need of psychosocial rehabilitation. In this research, we seek to assess the lived experience in two groups of delinquent adolescents: one group is repetitive delinquents, the second group successfully returned to society. We tried to understand the relevant and essential factors in making this difference.
Methods: This study is a qualitative research based on Grounded Theory. In this study, samples of adolescents with recurrent crimes and samples that have successfully returned to society without recidivism were reviewed. To do this, we should have investigated each case separately and the whole process that led to the recurrence of the crime. However, because the size of the statistical population is not sufficient to use quantitative and generalized methods, a case-experienced study has been conducted. This method assesses current phenomena in their real-life context, especially when the boundaries between a phenomenon and the context in which it occurs are not clearly defined. Several sources of evidence were used. After the coding of the gathered data and the formulation of the interviews in the form of concepts, the next step was to increase the level of abstraction of these concepts and propositions in the form of subcategories.
Results: Finally, of 222 propositions, we reached 100 concepts that were mainly associated with recurrent delinquency or regret and return to society. Some of the most important ones were family problems (such as parental quarrels, parental addiction, parental unemployment, and a history of a criminal conviction and parental imprisonment).
Discussion: Undoubtedly, one of the essential factors in the occurrence of crime is the environments in which the perpetrators deal with them. They are influenced by these environments whose personalities are shaped. Family, school, neighborhood, dropout, peer group, and general social determinants are influential in juvenile delinquency and its continuation or abandonment.
Medicine, Vocational rehabilitation. Employment of people with disabilities
Catherine E. Chambless, Sara McCormick, Catherine Ipsen
et al.
BACKGROUND: As one of the PROMISE projects, ASPIRE sought to enhance education and career outcomes to reduce long-term reliance on SSI. Self-determination training was offered to transition-age youth with disabilities receiving SSI as an evidence-based intervention to improve employment and post-secondary outcomes. OBJECTIVE: To investigate the implementation of self-determination training for transition-age youth with disabilities, and provide lessons learned to inform future programs. METHODS: Researchers used grounded theory and qualitative methods to obtain data on challenges encountered and successful strategies for delivering self-determination training to youth with disabilities. Informants were case managers and trainers in a six-state demonstration. RESULTS: Challenges encountered included low attendance and adapting training for groups with a range of disabilities. Successful strategies included scheduling other events in conjunction with the self-determination workshops and adapting the curriculum to be more interactive and relevant to the interests of teens. Youth outcomes were enhanced by increasing self-awareness and skills for disability disclosure. CONCLUSION: Considering the wide variety of training content and delivery formats, self-determination training can prepare youth with disabilities for post-secondary education and employment.
Background: Individuals with disabilities experience difficulty in using various everyday technologies such as computers and smartphones.
Objectives: To propose a conceptual framework that will lead to the development of practical and user friendly assistive technology.
Method: A literature review of challenges faced by individuals with physical disabilities was carried out. Interviews with adults with physical disabilities in Kampala, Uganda, and Port Elizabeth, South Africa, identified three main challenges with regard to using technology: using a mobile phone, controlling an electronic environment and using a computer.
Results: The challenges identified can be solved by taking into consideration the needs of individuals with disabilities. However, the design of new technologies and interaction techniques, such as natural hand gestures and voice, as input mechanisms has able-bodied individuals in mind. Individuals with disabilities are considered as an afterthought. The main reason for this is that individuals with a disability are a minority and hence it may not make economic sense for technology innovators to cater for their unique needs. A lack of practical guidelines on how to design for individuals with disabilities is another reason why designing for individuals with disabilities is often an afterthought.
Conclusion: This article proposes a conceptual framework that can be used by researchers and technology designers in order to design products that could cater for the unique needs of individuals with disabilities. The article also emphasises the importance of exploring alternative interaction techniques, as they could enable individuals with disabilities to fully utilise technologies such as smart phones, computers and smart home electronics.
Vocational rehabilitation. Employment of people with disabilities, Communities. Classes. Races
Objective: to relieve sacroiliac joint pain during third trimester of pregnancy in a quasi-experimental study of 39 pregnant women by giving physical therapy treatment like muscle stabilizing exercises, myofascial release and modifying activities of daily living.
Method: 39 pregnant women in Gynecology department of Jinnah Hospital, Lahore who fulfilled the criteria were included in the study. Pain intensity was rated on (0-10) numeric rating scale NRS.
Results: p>.05. Treatment was not much effective. Women with previous pregnancies were having more pain in sacroiliac joint. Socioeconomic status was a risk factor in pain. Women with low socioeconomic status were more diagnosed with sacroiliac joint pain than middle socioeconomic status.
Conclusion: Physical therapy treatment given for pregnancy related sacroiliac joint pain was not effective. May be because of not following treatment plan due to illiteracy.In order to obtain more knowledge about pregnancy related pelvic girdle pain and its treatment, it is necessary to perform a comprehensive study in which all features of the patients can be studied.
Keywords: Pelvic Girdle Pain, Pregnancy, Physical Therapy Exercises
Vocational rehabilitation. Employment of people with disabilities, Therapeutics. Psychotherapy