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Librarianship has lagged far behind the corporate sector in how librarianship manages and supports employees with disabilities, this includes accommodations during the hiring process. This column will provide an autobiographical look into the hiring process for a person with a disability and give suggestions on how to make the hiring process more humane for all people, including those with disabilities. When did an institution of higher education get it right? Get it ok with good intentions? Or get it completely wrong? [ABSTRACT FROM AUTHOR]

Para sport classification aims to minimize the impact of impairments on the outcome of competition. The International Paralympic Committee requires classification systems to be evidence based and sport specific, yet the sport of goalball uses a structure that is not supported by evidence demonstrating its legitimacy for competition. This study aimed to establish expert opinions on how a sport-specific system of classification should be structured in the sport of goalball. Using a three-round Delphi survey, 30 international experts expressed their views across topics linked to goalball classification. Participants were divided as to whether the current system fulfills the aim to minimize the impact of impairment on competition. Most felt that less impairment should be required to compete but that the one-class structure should remain. Experts identified measures of visual function that should be considered and 15 core components of individual goalball performance. Findings constitute a crucial first step toward evidence-based classification in goalball. [ABSTRACT FROM AUTHOR]

The pandemic revealed the workings of biopower in relation to people with disabilities. In focusing on lives worth living, decisions were made based on metrics about the quality of life of various groups. Ultimately, the pandemic revealed the power structure lurking behind a rhetoric of "care and compassion." [ABSTRACT FROM AUTHOR]

This study explored severe malaria-related disability in children from the perspectives of their caregivers. The interpretive description qualitative approach was employed. The participants were selected using the purposive sampling technique considering the child's history of severe malaria, age (0–10 years), and location (urban/rural). Data were collected through face-to-face interviews with sixteen caregivers. Reflexive thematic data analysis was utilized. Through prolonged engagement, reflective journaling, an audit trail, and co-authors' review, trustworthiness was enhanced. The study generated five themes from the interviews: mitigators of disability, contributors of disability, impact on body function, impact on activities and participation, and uncertainties about future well-being. The findings revealed previously unstudied social components of disability and environmental factors. Furthermore, the research uncovered health-related quality of life aspects that are out of the scope of the current comprehensive disability framework. The study contributes to a deeper understanding of severe malaria-related disability in children from the biopsychosocial perspective. The findings could help policymakers, researchers, and clinicians who want to design rehabilitation interventions for the affected children or examine the components of disability on a large scale using quantitative methods. Various contextual factors interacted with severe malaria and influenced functioning either as facilitators or barriers, implying disability related to malaria can be prevented or created. The long-term impacts of severe malaria are not limited to functioning and disability but also affect the health-related quality of life of children who survive severe malaria. Rehabilitation professionals should consider applying comprehensive functioning and disability frameworks such as the ICF when designing (or applying) screening tools, planning interventions, and evaluating the outcomes of intervention for children with severe malaria-related disability. Rehabilitation interventions for children with severe malaria-related disability should consider patient– or caregiver–reported outcomes (components of disability). [ABSTRACT FROM AUTHOR]

Purpose: The Inclusive Society partnership research model aims to promote change in society for people with disabilities by supporting research teams composed of researchers and partner organizations. The objective of this article is to identify the strengths and limitations of this research model. Material and methods: An autoethnography approach was used. Thematic analysis of four methods was undertaken: semi-directed interviews with members of the research teams funded by Inclusive Society (researchers, partners), a focus group with the Inclusive Society's intersectoral collaboration agents, their logbooks, and Inclusive Society's annual reports. Results: Strengths and limitations of the Inclusive Society model were identified through their networking activities, the role and support of the intersectoral collaboration agents and the partnership research program. Conclusions: Networking activities are an essential element of Inclusive Society. They are indispensable for composing intersectoral research teams that will work on answering needs of people with disabilities. Intersectoral collaboration agents are also a strength of the model, but their role could be clarified to better frame what tasks are in their scope of practice and what the research teams could ask from them. Finally, the research program eligibility criteria could be improved to support, among others, the projects' appropriation phases. Networking activities stimulate the creation of intersectoral research teams centered on answering the needs of people with disabilities that are identified in the field Hired facilitators can play an important role in the emergence of research teams, merging the academic and non-academic worlds, and supporting the teams during their research project In participatory research projects, some funding should be reserved to support the partner organization's participation and the appropriation phase of the research projects [ABSTRACT FROM AUTHOR]

Post-ICL visual quality is influenced by disability glare. Factors such as preoperative mesopic pupil diameter, along with sphere and cylinder, serve as reliable predictors for postoperative glare occurrence. Purpose: To explore the influence of preoperative factors, including varying pupil sizes and refractive attributes, on postoperative glare disability in patients undergoing implantable collamer lens (ICL) implantation. Setting: Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China. Design: Prospective observational study. Methods: The preoperative ocular characteristics and 6-month postoperative glare status in eligible patients who underwent EVO-Visian ICL V4c (VICMO) implantation were analyzed. The glare disability criteria encompassed a glare symptom score >6 and glare sensitivity exceeding 1:2.7. Logistic regression analysis was used to explore the relationship between the preoperative ocular parameters and post-ICL glare. Results: The study included 95 patients (mean age, 26.04 ± 6.29 years), comprising 30 men (58 eyes) and 65 women (129 eyes). Multivariate analysis revealed a significant correlation between postoperative glare disability and increased spherical power in preoperative mesopic pupils (β = −0.124, P =.039), as well as elevated cylinder power in preoperative mesopic (β = −0.412, P =.009) and photopic pupils (β = −0.430, P =.007). Moreover, a larger preoperative mesopic pupil diameter (β = 0.561, P =.005) demonstrated a significant correlation with glare disability. Conclusions: Preoperative mesopic pupil dimensions and associated refractive parameters, such as sphere and cylinder, were correlated with glare disability, including the cylinder aspect in photopic pupils, which can assist clinicians in optimizing preoperative selection for ICL implantation, aiding in the anticipation of potential glare disability risks. [ABSTRACT FROM AUTHOR]

Introduction: The ObserVational survey of the Epidemiology, tReatment and Care Of MigrainE (OVERCOME) European Union (EU) is part of an overarching population-based study program that also includes the United States and Japan. Here, we report data on the migraine/severe headache burden and the use of acute medication and healthcare resources in Spain and Germany. Methods: OVERCOME (EU) was an online, non-interventional, cross-sectional survey conducted in adults in Spain and Germany between October 2020 and February 2021. A total migraine cohort was established based on health survey participants who reported headache/migraine in the last 12 months AND identified as having migraine based on modified International Classification of Headache Disorders, third edition criteria OR self-reported physician diagnosis. Data were analyzed for the total migraine cohort and the subcohort with moderate to severe headache attacks, with average pain severity ≥ 5 points, pain duration ≥ 4 h, and at least moderate disability due to migraine [Migraine Disability Assessment (MIDAS) score ≥ 11] over the past 3 months. Results: Pain of moderate or severe intensity was the most frequent symptom in the total migraine cohort (n = 19,103/20,756; 92.0%). Proportions of participants reporting severe disability (MIDAS Grade IV), poorer quality of life (QoL; Migraine-Specific QoL Questionnaire), and higher interictal burden (Migraine Interictal Burden Scale-4), generally increased with number of headache days (HDs)/month. Most participants (92.5%) reported current acute migraine/severe headache medication use, although only 39.0% were using triptans. In the moderate to severe attacks subcohort (n = 5547), 48.4% were using triptans, with nonsteroidal anti-inflammatory drugs the most common acute medication. The moderate to severe attacks subcohort also reported poorer QoL and greater pain and disability with increasing HDs/month, although severe interictal burden was reported for ~ 60% of participants regardless of HDs/month. Treatment satisfaction (six-item migraine Treatment Optimization Questionnaire) in those using triptans was generally poor in both total and subcohorts. Conclusion: High migraine-related burden levels were reported, despite use of acute medication. Although triptans are recommended for moderate to severe migraine attacks in Spanish and German guidelines, less than half of participants were using triptans; treatment satisfaction in those using triptans was generally poor. New tailored treatment options may help address unmet needs in current acute treatment. [ABSTRACT FROM AUTHOR]

Background: Participation in adventure as a recreational therapy intervention is well-recognized for its benefits for people with disabilities. Advances in technology and adaptive equipment have increased accessibility to adventure-based activities for those with physical disabilities. Climbing has long been established to facilitate the psychological state of flow; however, there is little research on the experience of flow in individuals with physical disabilities and adaptive climbing, specifically. Purpose: This study investigated if flow is experienced differently between individuals with and without physical disabilities who participated in climbing programs and to determine if there was a relationship between flow and intentions in future participation in climbing. Methodology: The Flow State Scale-2 was used to assess flow and additional questions measured participation. Findings: The global flow score on the FSS-2 indicated that climbers with and without disabilities both experienced a flow-like state. Climbers without disabilities reported a significantly higher sense of control, one of the nine dimensions of flow. Implications: With a better understanding of how people with physical disabilities experience flow, practitioners can better design interventions to facilitate this experience and should know how flow can best be used to promote an active leisure lifestyle. [ABSTRACT FROM AUTHOR]

To investigate the motor repertoire of infants diagnosed with spinal muscular atrophy Type I (SMA Type I) without administration of any disease-modifying agent. Motor Optimality Score-Revised (MOS-R) was calculated from videos recorded between post-term weeks 9–17 for 22 infants with SMA Type I. The MOS-R of infants with SMA Type I was compared with those of 22 infants with cerebral palsy (CP) and 22 infants with typical development. Of the infants with SMA Type I, 17 had absent fidgety movements (FMs) and 5 had sporadic FMs. Age adequate movement repertoire was absent, and the variety of movements in infants was very low. Movements were symmetrical but movements of four limbs remained on the surface level. Antigravity movements were very rare. Movement characterization was monotonous, slow speed, and small amplitude. The MOS-R of infants with SMA Type I was lower than those of infants with typical development but similar to those of infants with CP. Infants with SMA Type I had a motor repertoire similar to infants with CP, while they had a poorer motor repertoire than infants with typical development in the fidgety period as evidenced by MOS-R. Central nervous system involvement in these infants with SMA Type I with absent FMs and reduced MOS-R is unknown. Further studies are needed to determine the role of problems in the afferent and efferent pathways of spinal cord and muscle atrophy in the observation of normal FMs. [ABSTRACT FROM AUTHOR]

Children with congenital heart disease (CHD) have a higher prevalence of motor impairment secondary to brain injury, resulting in cerebral palsy (CP). The purpose of this study is to determine the prevalence of CP in CHD in a single-center cohort, stratify risk based on surgical mortality using Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) categories and identify risk factors. Retrospective cohort study of pediatric patients registered in the University of Florida (UF) Society of Thoracic Surgeons Congenital Heart Surgery database from 2006 to 2017 with a diagnosis of CHD who continued follow-up for more than two years at UF. A total of 701 children with CHD met inclusion criteria. Children identified to have CP were 54 (7.7%). Most common presentation was spastic hemiplegic CP with a Gross Motor Function Classification System of level 2. Analysis of surgical and intensive care factors between the two groups showed that children with CHD and CP had longer time from admission to surgery (P = 0.003), higher STAT categories 4 and 5 (P = 0.038), and higher frequency of brain injury and seizures (P < 0.001). Developmental disabilities and rehabilitation needs were significantly greater for children with CHD and CP when compared with those with CHD alone (P < 0.001). In our cohort, 7.7% children with CHD develop CP; this is significantly higher than the 2010 US population estimate of 0.3%. Our study suggests higher STAT categories, brain injury, and seizures are associated with developing CP in children with CHD. [ABSTRACT FROM AUTHOR]

This study describes the case of a student with congenital intestinal perforations and her experience with inclusive education in the Czech Republic. She is also a sister of an identical twin with cerebral palsy. The data were gained from semi-structured interviews and bio-graphical narratives of the student during her studies at the grammar school and from her parents. Van Manen's analyses of lived experiences was used to identify important themes for each participant. The overarching themes present in their narratives concerned Lucy's future and the choice of the most appropriate educational environment. The parents' narratives focused more on barriers to inclusive education, benefits of inclusive environments, medical and educational care and family support based on close cooperation with school. For Lucy, the dominant theme was being a sister with a less severe disability and caretaking of her sister. In addition to enhancing the understanding of different needs of a student with congenital malformations and her parents' experiences with inclusive education, it helped us to explore how the specific sibling's constellation within her family and school contexts impacts her personal perspective on life, driven strongly by a wish for independence. [ABSTRACT FROM AUTHOR]

This study aims to assess relationships between previous stroke diagnosis and demographic or disability status variables, stratified by U.S. citizenship status. The 2019 and 2021 National Health Interview Survey data were analyzed for both descriptive statistics and logistic regression models. Age, sex, income level, race/ethnicity, health insurance status, and indicators of disability common after stroke were predictor variables of interest. For each disability predictor variable, higher odds of having stroke were seen regardless of citizenship status, except for the 'difficulty remembering' variable. For U.S. citizens, increasing age corresponded with higher odds of stroke diagnosis. For noncitizens, odds ratios decreased from 40.3 (95% CI 38.88–41.82) for the 40–65 age group to 29.6 (95% CI 28.38–30.77) in the 80 + group, when compared with the 18–39 age reference group. Female noncitizens had higher odds of stroke, while male citizens had higher odds. Non-Hispanic Black citizens had higher odds of stroke, while the other racial/ethnic groups had higher odds for noncitizens. The results indicated the existence of several socio-demographic disparities in stroke. Notably, noncitizens experienced stroke at a younger age and reported more severe disability outcomes after stroke diagnosis than citizens. [ABSTRACT FROM AUTHOR]

Our different experiences of the world can alter how we carve our identities and sense of place within it. Thus, many have argued that writing and sharing our personal experiences in research can often help us give others a different understanding of the world. Having a personal experience of a phenomenon can also assist researchers in the formulation and conceptualisation of their different ideas during the research process. However, whilst valuable, researchers' different memories and recollections can negatively impact the research process as well. Sometimes different memories and recollections can alter what we see within our research and how we see what is happening in the real world. Therefore, this research note explores how our embodied experiences of a phenomenon can affect our research. It will centre around my own experiences of living with a disability, listening to those of other disabled people, my ever-changing professional and personal understanding of leisure, and how my own personal experiences have affected my interactions with disability and leisure research over the years. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the relationships among exercise engagement, psychosocial factors, and social participation for adults aging with physical disabilities (AAwPD). Design: A cross-sectional study within a community-based cohort study of participation among AAwPD was conducted. Setting: A comprehensive survey was administered online or via telephone. Participants: Participants were 474 individuals between the ages of 45-65, primarily living in the Midwestern United States, who reported living with a physical disability for at least 5 years. Method: Survey questions created based on prior consolidation of activity domains assessed exercise engagement. Psychosocial health and social participation were measured using the Patient Reported Outcomes Measurement Information System. Chi-square tests, t -tests, and a general linear model were used to examine differences between exercisers and non-exercisers. Results: Participants who exercised reported less pain (P <.001), fatigue (P <.001), and depression (P <.001) and greater self-efficacy for management of chronic conditions (P =.002), satisfaction with participation in social roles and activities (P <.001), and ability to participate in social roles and activities (P <.001) compared with non-exercising participants. Conclusions: AAwPD who exercised reported fewer secondary conditions and greater social participation. Although causal relationships cannot be drawn, and the frequency, duration, and intensity of exercise were not examined, this study lays important groundwork for future research to determine the health and participation benefits of exercise for AAwPD. Future studies should also focus on the development of exercise interventions to support successful aging with disability. [ABSTRACT FROM AUTHOR]

Purpose: People aging with disability may be limited in their ability to engage in healthy behaviors to maintain cardiometabolic health. We investigated the role of health promoting features in the neighborhood environment for incident cardiometabolic disease in adults aging with physical disability in the United States. Design: Retrospective cohort study. Setting: Optum's Clinformatics® Data Mart Database (2007-2018) of administrative health claims. Subjects: ICD-9-CM codes were used to identify 15 467 individuals with a diagnosis of Cerebral Palsy, Spina Bifida, Multiple Sclerosis, or Spinal Cord Injury. Measures: Cardiometabolic disease was identified using ICD-9-CM/ICD-10-CM codes over 3 years of follow-up. Measures of the neighborhood environment came from the National Neighborhood Data Archive and linked to individual residential ZIP codes over time. Covariates included age, sex, and comorbid health conditions. Analysis: Cox regression models estimated hazard ratios (HR) for incident cardiometabolic disease. Using a 1-year lookback period, individuals with pre-existing cardiometabolic disease were excluded from the analysis. Results: Net of individual risk factors, residing in neighborhoods with a greater density of broadband Internet connections (HR =.88, 95% CI:.81,.97), public transit stops (HR =.89, 95% CI:.83,.95), recreational establishments (HR =.89, 95% CI:.83,.96), and parks (HR =.88, 95% CI:.82,.94), was associated with reduced risk of 3-year incident cardiometabolic disease. Conclusion: Findings identify health-promoting resources that may mitigate health disparities in adults aging with disability. [ABSTRACT FROM AUTHOR]

Technology‐enabled recruitment and selection technologies, such as chatbots, assessment games, and asynchronous video interviews, are becoming more widely used. However, their impact on people with disabilities is frequently ignored; this has potentially significant implications for the perceived fairness of hiring decisions. We advance eight theoretical propositions on the positive and negative implications of technology‐enabled recruitment and selection technologies for applicant reactions of people with disabilities. Our propositions are based on three key design features of these technologies: separation in time and space, automated administration, and automated evaluation. We provide recommendations for future research and discuss practical implications for the use of advanced technology in recruitment and selection. Practitioner points: Organizations are increasingly using technology‐enabled recruitment and selection tools such as chatbots, assessment games, and asynchronous video interviews to recruit and select employees, without considering how these technologies can affect people with disabilities.We consider the positive and negative impacts of these technologies on the experiences of people with disabilities, with particular attention to applicant reactions.We offer guidance to vendors and users of these technologies in terms of how they can be used to provide better and more inclusive experiences for applicants. [ABSTRACT FROM AUTHOR]

Multiple Sclerosis (MS) is a chronic inflammatory autoimmune, neurodegenerative disease that affects regular mobility and leads predominantly to physical disability. Poor sleep quality, commonly reported in MS patients, impacts their physical activity (PA). Accelerometers monitor 24-h activity patterns, offering insights into disease progression in daily life. To test if the sleep quality variables of MS patients, as assessed with wrist-worn accelerometers, differ from those of controls and are associated with PA and disease severity variables. Seven-day raw accelerometer data collected from 40 MS patients and 24 controls was processed using an open-source GGIR package, from which variables of sleep quality (sleep efficiency, wake after sleep onset (WASO), sleep regularity index (SRI), intradaily variability (IV)) and PA (of different intensities: inactivity, light (LPA), moderate (MPA), vigorous (VPA)) were analyzed. The variables were compared between the two study groups and in MS patients, correlation tested associations among the variables of sleep quality, PA, and disease severity (assessed with the Expanded Disability Status Scale, EDSS). Sleep efficiency was the only variable that differed significantly between MS patients and controls (lower in MS, p = 0.01). Both SRI (positively) and IV (negatively) correlated with the time spent in LPA and MPA. WASO correlated negatively with inactivity. This is one of the few studies with a wrist-worn accelerometer that shows a difference in sleep efficiency between MS patients and controls and, in MS, an association of sleep quality variables with PA variables. • Sleep quality was measured in MS patients using wrist-worn motion sensors. • MS patients showed a lower sleep efficiency when compared to healthy controls. • Variables of sleep quality were associated with physical activity in MS patients. [ABSTRACT FROM AUTHOR]

Precise regulation of gene expression is important for correct neurodevelopment. 9q34.3 deletions affecting the EHMT1 gene result in a syndromic neurodevelopmental disorder named Kleefstra syndrome. In contrast, duplications of the 9q34.3 locus encompassing EHMT1 have been suggested to cause developmental disorders, but only limited information has been available. We have identified 15 individuals from 10 unrelated families, with 9q34.3 duplications <1.5 Mb in size, encompassing EHMT1 entirely. Clinical features included mild developmental delay, mild intellectual disability or learning problems, autism spectrum disorder, and behavior problems. The individuals did not consistently display dysmorphic features, congenital anomalies, or growth abnormalities. DNA methylation analysis revealed a weak DNAm profile for the cases with 9q34.3 duplication encompassing EHMT1, which could segregate the majority of the affected cases from controls. This study shows that individuals with 9q34.3 duplications including EHMT1 gene present with mild non‐syndromic neurodevelopmental disorders and DNA methylation changes different from Kleefstra syndrome. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONSupported decision-making (SDM) is an emerging and innovative alternative to substitute decision-making practices. While relationships are pivotal in establishing proper and effective SDM, scant research has examined these relationships in-depth. This study explores how decision-making supporters perceive relationships embedded in SDM for adults with disabilities. Furthermore, it compares the points of view of family and volunteer supporters on these relationships.Using a semi-structured interview guide, in-depth interviews were held with 16 family and 16 volunteer supporters of Israeli decision-makers with disabilities.Both family and volunteer supporters addressed the centrality of the support relationship. However, they differed in their perspectives on the ways such relationships should be formed and on their boundaries. We distinguish between families’ continuing relationships vs. volunteers’ emerging relationships to emphasize the identified differences.The findings highlighted the importance of relationships to SDM processes, highlighting the need to examine in greater depth whether and how “typical” family relationships differ from SDM relationships. Based on these findings, we recommend training and guidance for both family and volunteer supporters in developing and strengthening these relationships.Supported decision-making enhances quality of life as it helps persons with disabilities make and implement decisions.With proper supported decision-making, people with disabilities feel their wishes are recognized and respected.Focus on and awareness of relationship building is crucial and thus its various dimensions should explicitly be incorporated in any training program or policy for supported decision-makersGiven adequate training, both family and volunteers can develop positive relationships in supported decision-making schemes.Supported decision-making enhances quality of life as it helps persons with disabilities make and implement decisions.With proper supported decision-making, people with disabilities feel their wishes are recognized and respected.Focus on and awareness of relationship building is crucial and thus its various dimensions should explicitly be incorporated in any training program or policy for supported decision-makersGiven adequate training, both family and volunteers can develop positive relationships in supported decision-making schemes. [ABSTRACT FROM AUTHOR]

Introduction: People with disabilities (PwDs) constitute a large and diverse group within the global population, however, their sexual and reproductive health (SRH) needs are often neglected, particularly in low-and middle-income countries. This may result in adverse outcomes, such as sexually transmitted infections (STIs), unintended pregnancies, and experience of interpersonal violence (IV). This study aimed to assess the factors that influence the sexual lives of PwDs in two districts of Ghana. Methods: A sequential explanatory mixed-methods study design was used to collect data from PwDs. Quantitative data were obtained from 402 respondents using a pretested questionnaire, and qualitative data gathered from 37 participants using in-depth interviews. The quantitative data were analysed using descriptive and inferential statistics, while the qualitative data were analysed using inductive thematic analysis. Results: Most PwDs (91%) reported that they have ever had sex, which was associated with age, disability severity, and household size. The prevalence of poor SRH status, STIs, unintended pregnancy, pregnancy termination, and unsafe abortion were 10.5%, 5.7%, 6.4%, 21.6%, and 36.9% respectively. These outcomes were influenced by education, income, health insurance subscription, and proximity to a health facility. The prevalence of IV was 65%, which was related to disability type and severity. The qualitative data revealed five main themes: curiosity to engage in sexual activities, feelings of despair and insecurity with abled partners, preference for sexual relationships with other PwDs, IV and its perpetrators, and adverse SRH outcomes. Conclusion: The study findings indicate that most adult PwDs have ever had sex and they face various challenges in their sexual lives. They experience multiple forms of abuse and neglect from different perpetrators at different levels of society, which have negative impacts on their well-being. There is a need for comprehensive and inclusive interventions that address the SRH needs of PwDs, as well as the underlying social and structural factors that contribute to their vulnerability. Further research is recommended to explore the perspectives of stakeholders on how to improve the SRH outcomes of PwDs. Plain Language summary: People with disabilities make up 16 percent of the world population, but their sexual and reproductive health (SRH) needs are often unmet, especially in poorer countries, contributing to adverse outcomes. This study assessed factors influencing the sex lives of PwDs in two districts of Ghana. Quantitative data were collected from 402 respondents, while qualitative data were collected from 37 participants. The results showed that age, severity of disability, and household size influence sexual activity. Many respondents also reported adverse SRH issues including STIs and unintended pregnancies. Sixty-five percent reported experiencing violence or abuse, which is related to their disability type and severity. The study also found that PwDs encounter many challenges in their sexual lives, including abuse and neglect. The findings suggest the need to pay attention to the sexual health needs and the social issues that make PwDs vulnerable to various abuses. [ABSTRACT FROM AUTHOR]

Background: Challenging behaviors like aggression and self-injury are dangerous for clients and staff in residential care. These behaviors are not well understood and therefore often labeled as "complex". Yet it remains vague what this supposed complexity entails at the individual level. This case-study used a three-step mixed-methods analytical strategy, inspired by complex systems theory. First, we construed a holistic summary of relevant factors in her daily life. Second, we described her challenging behavioral trajectory by identifying stable phases. Third, instability and extraordinary events in her environment were evaluated as potential change-inducing mechanisms between different phases. Case presentation: A woman, living at a residential facility, diagnosed with mild intellectual disability and borderline personality disorder, who shows a chronic pattern of aggressive and self-injurious incidents. She used ecological momentary assessments to self-rate challenging behaviors daily for 560 days. Conclusions: A qualitative summary of caretaker records revealed many internal and environmental factors relevant to her daily life. Her clinician narrowed these down to 11 staff hypothesized risk- and protective factors, such as reliving trauma, experiencing pain, receiving medical care or compliments. Coercive measures increased the chance of challenging behavior the day after and psychological therapy sessions decreased the chance of self-injury the day after. The majority of contemporaneous and lagged associations between these 11 factors and self-reported challenging behaviors were non-significant, indicating that challenging behaviors are not governed by mono-causal if-then relations, speaking to its complex nature. Despite this complexity there were patterns in the temporal ordering of incidents. Aggression and self-injury occurred on respectively 13% and 50% of the 560 days. On this timeline 11 distinct stable phases were identified that alternated between four unique states: high levels of aggression and self-injury, average aggression and self-injury, low aggression and self-injury, and low aggression with high self-injury. Eight out of ten transitions between phases were triggered by extraordinary events in her environment, or preceded by increased fluctuations in her self-ratings, or a combination of these two. Desirable patterns emerged more often and were less easily malleable, indicating that when she experiences bad times, keeping in mind that better times lie ahead is hopeful and realistic. [ABSTRACT FROM AUTHOR]

The International Classification of Function, Disability, and Health (ICF—WHO, 2001) recognizes several dimensions of disability, such as body structure and function (and impairment thereof), activity (and activity restrictions) and participation (and participation restriction) and their interactions with contextual factor (personal and environmental). In this study, we map and analyse the relationship between the components of ICF in leprosy patients from two rural areas in Indonesia: Lewoleba (East Nusa Tenggara) and Likupang (North Minahasa). This study was part of a community outreach program by the KATAMATAKU team from Universitas Indonesia. The body structure was graded using the WHO hand and feet disability grade and the number of enlarged nerves, while the body function was measured by the Jebsen Taylor Hand Function Test (JTT) and Timed-up and Go (TUG). Activity limitation and participation restriction were measured using the Screening Activity Limitation Safety Awareness (SALSA) Scale and Participation Scale (P-scale), respectively. There were 177 leprosy patients from the two regions and 150 patients with complete data were included in the analysis. We found 82% (95% CI: 75.08%-87.32%) of subjects with multibacillary leprosy, 10.67% (95% CI: 6.67%-16.62%) of subjects with grade 2 WHO hand disability, and 9.33% (95% CI: 5.64%-15.06%) of subjects with grade 2 WHO foot disability. Assessment using the SALSA Scale showed 29.33% of subjects with limitation activity and 11.33% with participation restriction. Age was shown to have positive correlations with SALSA, JTT, and TUG. Inter-dimensional analysis showed that the SALSA scale had significant positive correlations with the number of nerve enlargements, P-scale, JTT, and TUG. SALSA scores of grade 2 WHO hand and foot disability were also significantly higher than grades 1 and 0. The participation scale also had a positive correlation with JTT but not TUG. Hand disability seemed to affect societal participation while foot did not. We used the ICF to describe and analyse dimensions of leprosy-related disability in Indonesia. Author summary: Disability is the long-term outcome of untreated leprosy or Hansen's disease, which is caused by peripheral nerve invasion of the Mycobacterium leprae. It is a serious and life-limiting complication for leprosy patients. Currently, seven regions in Indonesia have not yet achieved the state of disease elimination. In addition, Indonesia has not succeeded in achieving the sub-target of the rate of new cases with grade 2 disability in 2023. The concept of disability and health including the body structure, body function, personal and environmental domains, activity limitation, and participation restriction, is provided by the ICF. Through the framework, we could assess the aspects of disability and its relationship to one another in leprosy patients. Furthermore, the early detection, screening, and management programs for leprosy have not included aspects of disability and rehabilitative measures for restoration. Thus, the purpose of this study is to find the impact of leprosy-related disability on the patients' body function, activity, and participation. We reported 150 leprosy patients from two rural areas of Indonesia and found significant relationships between specific indicators, which would be useful for rehabilitative management programs in the future. [ABSTRACT FROM AUTHOR]

Purpose: In this study, it is aimed to determine personal wellbeing and social participation levels across different physical disability types and levels of mobility. Methods: A sample of 85 individuals with physical disabilities, excluding those with mental disabilities were included. Sociodemographics, mobility of the participants, cause, duration of disability were recorded. Personal Wellbeing Index-Adult (PWI-A) scale was used for the assessment of wellbeing and Keele Assessment of Participation (KAP) for social participation. Results: Female, single, unemployed subjects and individuals with neurologic disability showed significantly higher median KAP-scores(p = 0.009, p = 0.050, p<0.001, p = 0.050, respectively).The median KAP-score of the independently mobile group was significantly lower compared to the other two groups (p = 0.001). The factors affecting KAP were determined as employment, mobility level and personal wellbeing (p = 0.002, p = 0.024, p = 0.050, respectively). Conclusion: Mobility level, employment and personal wellbeing are the determinants of social participation in people with disabilities. Neurological disability, female gender, being single, unemployment and mobility limitations are factors that reduce social participation. [ABSTRACT FROM AUTHOR]

Objective: To analyze the perceptions of professionals, caregivers, children, and adolescents with disabilities regarding the implementation of the My Abilities First (MAF) tool in Specialized Child Rehabilitation Centers (CERs). Method: This is a qualitative research based on Reflexive Thematic Analysis (RTA). The study involved twenty-seven intentionally selected individuals, comprising 12 physiotherapists, 4 occupational therapists, 11 caregivers, 9 children and 2 adolescents. Participants completed sociodemographic and clinical questionnaires and took part in semi-structured online interviews, focusing on two themes: Positive health approaches and the MAF tool. The study was approved by the local ethics committee (opinion 4.779.175). Results: Reflexive Thematic Analysis of the interviews resulted in two themes: (1) Perceptions regarding the MAF tool as an educational and contributory process to enhance the inclusion and participation of children and adolescents with disabilities, and (2) Barriers and facilitators for the implementation process of the MAF tool. The implementation of MAF was identified as a driving factor in promoting equity and increased participation of children and adolescents with disabilities in various settings, including health, education, and leisure. Interviewees highlighted the need to confront attitudinal, communication, and social barriers that may hinder the implementation of the tool. Conclusion: The implementation of the MAF tool was perceived as an innovation due to its focus on the abilities of individuals with disabilities. However, there is a need to restructure it to broaden its scope and access to different contexts in order to confront barriers and enhance the inclusion and participation of children and adolescents with disabilities. [ABSTRACT FROM AUTHOR]

Education plays a central role in promoting social inclusion, respect and dignity and therefore contributes significantly to economic and social progress. The accessibility and quality of education are directly related to the development of any country. Therefore, ensuring equal access to quality education is crucial for sustainable economic growth, especially in developing countries. UNICEF’s ranking of Pakistan as the country with the second highest number of school dropouts in the world stimulated this study to address the alarming problem of large numbers of out-of-school children in marginalized communities such as Pakistan. The study aims to examine the multiple factors that stimulate dropout rates or out of school, including socioeconomic status, geographical location, child-related characteristics, child labor, skills and attitudes. Using data from MICS Wave 6 in Pakistan, this study proposes recommendations for educators and policymakers aimed at promoting equal educational opportunity and inclusive growth around the world. [ABSTRACT FROM AUTHOR]

ABSTRACT Children with disabilities are over‐represented in foster care and exposed to more disruptions. This is unfortunate because they need long‐term relationships and predictability, as well as access to special schools and health care. Disruption can be the result of a poor match between the child and the foster family. In this article, we focus on the matching process in relation to children with disabilities. Zeijlmans et al. describe matching as the process by which social workers move from principles of good matching to realistic matching, depending on existing premises. Using their model, we analyse the matching process for children with disabilities in Sweden. The study is based on 31 individual interviews and six group interviews with social workers and social work managers. They describe how they take into account the family climate, family composition and prior knowledge and/or experience of disability in the foster home. However, disruptions occur even when these conditions are met. Stable placements seem to be more related to the fostered child's progress when the family's efforts are rewarded. We also address the complex issue of what disability actually means in the context of foster care, given the interrelatedness of trauma, maltreatment and impairment. [ABSTRACT FROM AUTHOR]

Cerebral small vessel disease (cSVD) encompasses a heterogeneous group of age-related small vessel pathologies that affect multiple regions. Disease manifestations range from lesions incidentally detected on neuroimaging (white matter hyperintensities, small deep infarcts, microbleeds, or enlarged perivascular spaces) to severe disability and cognitive impairment. cSVD accounts for approximately 25% of ischemic strokes and the vast majority of spontaneous intracerebral hemorrhage and is also the most important vascular contributor to dementia. Despite its high prevalence and potentially long therapeutic window, there are still no mechanism-based treatments. Here, we provide an overview of the recent advances in this field. We summarize recent data highlighting the remarkable continuum between monogenic and multifactorial cSVDs involving NOTCH3, HTRA1, and COL4A1/A2 genes. Taking a vessel-centric view, we discuss possible cause-and-effect relationships between risk factors, structural and functional vessel changes, and disease manifestations, underscoring some major knowledge gaps. Although endothelial dysfunction is rightly considered a central feature of cSVD, the contributions of smooth muscle cells, pericytes, and other perivascular cells warrant continued investigation. [ABSTRACT FROM AUTHOR]

Study Design. Retrospective cohort. Objective. To examine the validity of the Oswestry Disability Index (ODI) in patients with adult spinal deformity (ASD) treated with surgery. Background. The ODI is a patient-reported outcome measure of low back pain and disability. Although nearly ubiquitous in ASD research, the measure has not been validated in this patient population. Patients and Methods. A registry of patients with ASD was queried for baseline and 1-year PROM data, including the ODI, the Scoliosis Research Society–22r (SRS-22r), and the Patient Reported Outcomes Measurement Information System–Pain Interference (PI) and Physical Function (PF) CATs. Internal reliability was assessed with Cronbach alpha, where values ≥ 0.7 are considered reliable. Validity was assessed with Spearman correlation coefficients calculated for the ODI against validated Patient-Reported Outcomes Measurement Information System (PROMIS)–PI and PF, and legacy measures SRS-Pain and SRS-Activity. Responsiveness to change was measured with the adjusted effect size. Results. A total of 325 patients were enrolled, with 208 completing baseline and 1-year patient-reported outcome measures. The majority (149, 72%) were females and White (193, 93%), median Charlson Comorbidity Index 0 (interquartile range: 0–2). The majority of cases included sagittal plane deformity [mean T1PA: 24.2° (13.9)]. Cronbach alpha showed excellent internal reliability (baseline = 0.89, 1 yr = 0.90). ODI was valid, with strong correlations between PROMIS-PI, PROMIS-PF, SRS-Pain, and SRS-Activity at baseline and 1-year follow-up. All measures were responsive to change, with the ODI showing greater responsiveness than PROMIS-PI, PROMIS-PF, and SRS-Activity. Conclusions. The ODI is a valid measure of disability as measured by pain and function in patients with ASD. It is responsive to change in a manner not different from validated PROMIS–CAT or the SRS-22r legacy measure. It is multidimensional, however, as it assesses both pain and function simultaneously. It does not measure disability related to self-image and may not account for all disease-related disability in patients with ASD. [ABSTRACT FROM AUTHOR]

Background: Disability is an important multifaceted construct. A brief, generic self-reported disability questionnaire that promises a broader and more comparable measure of disability than disease-specific instruments does not currently exist. The aim of this study was to develop and evaluate such a questionnaire: the Universal Disability Index (UDI). Methods: An online survey was used to collect general population data. Data were randomly divided into training and validation subsets. The dimensionality and structure of eight UDI questionnaire items were evaluated using exploratory factor analysis (EFA, training subset) followed by confirmatory factor analysis (CFA, validation subset). To assess concurrent validity, the UDI summed score from the full dataset was compared to the Groningen Activity Restriction Scale (GARS) and the Graded Chronic Pain Scale (GCPS) disability scores. Internal consistency and discriminant validity were also assessed. Bootstrapping was used to evaluate model stability and generalisability. Results: 403 participants enrolled; 364 completed at least one UDI item. Three single-factor versions of the UDI were assessed (8-item, 7-item, and 6-item). All versions performed well during EFA and CFA (182 cases assigned to each), but none met the RMSEA (Root Mean Square Error of Approximation) criterion (≤ 0.08). All versions of the UDI had high internal consistency (Cronbach's α > 0.90), were strongly correlated (Pearson's r > 0.7) with both GARS and GCPS disability scores, indicating concurrent validity, and could accurately discriminate between upper and lower quartiles of these comparators. Confidence intervals of estimates were narrow, suggesting model stability and generalisability. Conclusions: A brief, generic self-reported disability questionnaire was found to be valid and to possess good psychometric properties. The UDI has a single factor structure and either a 6-item, 7-item or 8-item version can be used to measure disability. For brevity and parsimony, the 6-item UDI is recommended, but further testing of all versions is warranted. [ABSTRACT FROM AUTHOR]

This study investigated inclusive and special education policy in Nepal. This paper employs social constructionism and discourse analysis as theoretical perspectives. This study is informed by the findings of the author’s doctoral research. Data were collected from a selected key policy document between 1970 and 2020. Discourses of disability was used as a methodology to examine how these policies construct the meaning of disability and inclusive education. The findings of this study demonstrated that Nepalese inclusive and special education policies have been influenced by the medical or deficit and social or human rights model discourse of disability. This article identified that the educational policies of Nepal were consistent and in variation between these two discourses of disability. This study found that inclusive education policies had rhetoric, contradictions and tensions within the policy documents. Limitations and recommendations of this research were also discussed. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the study was to explore characteristics of vaccine hesitancy and behaviors among college students with disabilities. Participants and Methods: Participants consisted of 105 college students with disabilities (Mage=26.82, SD = 8.42), and a majority of participants were female (69.5%) and Hispanic (85%). Results: No demographic differences were observed in vaccine hesitancy scores in this sample. Those who do not know where to get reliable information about COVID-19 vaccination had higher scores on vaccine hesitancy than those who know how to obtain reliable information; and participants who had a negative experience with a previous vaccination also had higher scores of vaccine hesitancy. Additionally, findings demonstrated COVID-19 vaccine hesitancy scores were negatively associated with openness to experience personality trait and COVID-19-related perceived stress. Conclusions: Implications provide additional insight into factors associated with vaccine hesitancy among college students with disabilities. [ABSTRACT FROM AUTHOR]

Brucellosis is an infection widely distributed around the world, and in some countries it is considered a public health problem. Brucellosis causes insidious symptoms that make it difficult to diagnose. Infection can also trigger chronic pain and neuropsychiatric complications. Antibiotics are not always effective to eradicate infection, contributing to chronicity. We aimed to investigate the effects of antibiotic treatment on proinflammatory cytokines, neurotransmitters, corticosterone, and behavior in a murine model of infecrion of B. abortus strain 2308. Four study groups were created: (a) control; (b) antibiotic control; (c) infected with B. abortus 2308; and (d) infected and treated with rifampicin and doxycycline. We determined B. abortus 2308 colony-forming units (CFUs), the count of dendritic cells, and macrophages in the spleen; serum levels of cytokines and corticosterone; levels of serotonin, dopamine, epinephrine, and norepinephrine in the brain; and equilibrium, physical strength, anxiety, and hopelessness tests. The infected and treated mice group was compared with the control and infected mice to assess whether treatment is sufficient to recover neuroimmunoendocrine parameters. Our results showed that despite the treatment of brucellosis with rifampicin and doxycycline, antibiotic-treated mice showed a persistence of B. abortus 2308 CFUs, an increased count in macrophage number, and higher circulating levels of corticosterone. Furthermore, the levels of IL-12, IL-6, and TNF-α remained higher. We found a decrease in muscular strength and equilibrium concomitant to changes in neurotransmitters in the hippocampus, cerebellum, and frontal cortex. Our data suggest that the remaining bacterial load after antibiotic administration favors inflammatory, neurochemical, and behavioral alterations, partly explaining the widespread and paradoxical symptomatology experienced by patients with chronic brucellosis. [ABSTRACT FROM AUTHOR]

This article arises in the context of the Research Project entitled: Inclusion of students with disabilities at the National University of Río Cuarto. From text to practice (Rector's Resolution No. 083/2020). The purpose of the writing is to explain theoretically some of the aspects identified in one of the categories of analysis that emerged from the empirical evidence collected. Understanding and explaining the reality in which the group of students with disabilities finds themselves involves delving into the views that the institution has regarding this reality. Therefore, particularly from this situated research and, on this occasion, we will start from understanding how the framework of disability is constituted by focusing the analysis on the concept of singularized educational trajectories reconstructed from the testimonies collected, in the in-depth interviews carried out with different actors who hold management positions in the institution. [ABSTRACT FROM AUTHOR]

Introduction: Cerebral Palsy as a health condition associated with disability in childhood requires comprehensive care and involves various actors, thus, rehabilitation is configured as a key health process in which knowledge and practices converge in daily life whose experience makes sense from the peculiarities. The objective was to analyze the comprehensions of the rehabilitation process in cerebral palsy from the perspectives of a group of health professionals, caregivers and people with cerebral palsy. Material and method: qualitative study, socio-constructionist design, focus groups were used. The sample was purposeful of homogeneous cases, the theoretical saturation of the data was used as a criterion for collecting information. The qualitative content analysis was streamlined through a categorization and coding process. Results: 3 people with cerebral palsy, 4 caregivers and 9 health professionals participated, relating their comprehensions about the phenomenon; the emerging categories were cerebral palsy as «Condition of life», functioning and disability from «Processes, tools and autonomy»; as well as contextual factors from «Barriers» and «Opportunities». Conclusions: although the comprehensions of the process are diverse and depend on life experiences, there are meeting points that configure the importance that both functionality and social inclusion acquire. [ABSTRACT FROM AUTHOR]

Background: This study reviewed migraine prevalence and disability gathered through epidemiologic survey studies in the United States conducted over the past three decades. We summarized these studies and evaluated changing patterns of disease prevalence and disability. Methods: We conducted a systematic review of US studies addressing the prevalence, disability, and/or burden of migraine, including both episodic migraine (EM) and chronic migraine (CM). A Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) protocol was used in conjunction with the PubMed search engine. Eligible studies were published before February 2022, were conducted in the United States, included representative samples, and used a case definition of migraine based on the International Classification of Headache Disorders (ICHD). The primary measure of disease burden was the Migraine Disability Assessment Scale (MIDAS). The MIDAS measures days lost due to migraine over 3 months in three domains and defines groups with moderate (Grade III) or severe disability (Grade IV) using cut‐scores. Results: Of the 1609 identified records, 26 publications from 11 US population‐based studies met eligibility criteria. The prevalence of migraine in the population has remained relatively consistent for the past 30 years: ranging from 11.7% to 14.7% overall, 17.1% to 19.2% in women, and 5.6% to 7.2% in men in the studies reviewed. CM prevalence is 0.91% (1.3% among women and 0.5% of men) in adults and 0.8% in adolescents. The proportion of people with migraine and moderate‐to‐severe MIDAS disability (Grades III–IV), has trended upward across studies from 22.0% in 2005 to 39.0% in 2012, to 43.2% in 2016, and 42.4% in 2018. A consistently higher proportion of women were assigned MIDAS Grades III/IV relative to men. Conclusion: The prevalence of migraine in the United States has remained stable over the past three decades while migraine‐related disability has increased. The disability trend could reflect changes in reporting, study methodology, social and societal changes, or changes in exacerbating or remediating factors that make migraine more disabling, among other hypotheses. These issues merit further investigation. Plain Language Summary: We reviewed 11 population‐based studies that adhered to the International Classification of Headache Disorders to examine the prevalence and burden of migraine in the United States. While the prevalence of migraine has remained stable at ~12% of adults for the past 30 years (with higher rates in women), the burden of migraine, including disability and impact on work, academics, and social life, appears to be increasing. The escalating burden of migraine may result from factors like increased headache frequency or changes in study methodology, indicating a need for more population studies. [ABSTRACT FROM AUTHOR]

Background: Older adults (OAs) with mild traumatic brain injury (OA-mTBI) are a growing population, but studies on long-term outcomes and quality of life are scarce. Our aim was to determine the health-related quality of life (HRQoL) in OA-mTBI one year after injury and to assess the early predictors of HRQoL. Methods: Data from a prospective follow-up study of 164 older (≥60 years) and 289 younger mTBI patients (<60 years) admitted to the emergency department were analyzed. Post-traumatic complaints, emotional distress and coping were evaluated 2 weeks post-injury using standardized questionnaires. At 12 months post-injury, HRQoL and functional recovery were determined with the abbreviated version of the World Health Organization Quality of Life scale and Glasgow Outcome Scale Extended (GOSE), respectively. Results: One year post-injury, 80% (n = 131) of the OA-mTBI rated their HRQoL as "good" or "very good", which was comparable to younger patients (79% (n = 226), p = 0.72). Incomplete recovery (GOSE <8) was present in 43% (n = 69) of OA-mTBI, with 67% (n = 46) reporting good HRQoL. Two weeks post-injury, fewer OA-mTBI had (≥2) post-traumatic complaints compared to younger patients (68% vs. 80%, p = 0.01). In the multivariable analyses, only depression-related symptoms (OR = 1.20 for each symptom, 95% CI = 1.01–1.34, p < 0.01) were predictors of poor HRQoL in OA-mTBI. Conclusions: Similar to younger patients, most OA-mTBI rated their HRQoL as good at one year after injury, although a considerable proportion showed incomplete recovery according to the GOSE, suggesting a disability paradox. Depression-related symptoms emerged as a significant predictor for poor HRQoL and can be identified as an early target for treatment after mTBI. [ABSTRACT FROM AUTHOR]

In university mathematics education, students do not simply learn mathematics but are shaped and shape themselves into someone new—mathematicians. In this study, we focus on the becoming of disabled mathematical subjects. We explore the importance of abilities in the processes of being and becoming in university mathematics. Our interest lies in how teaching and assessment practices provide students with ways to understand themselves as both able and disabled, as disabilities are only understood with respect to the norm. We analyse narratives of nine university students diagnosed with learning disabilities or mental health issues to investigate how their subjectivity is constituted in discourse. Our analysis shows how the students are shaped and shape themselves as disabled mathematicians in relation to speed in mathematical activities, disaffection in mathematics, individualism in performing mathematics, and measurability of performance. These findings cast light on the ableist underpinnings of the teaching and assessment practices in university mathematics education. We contend that mathematical ableism forms a watershed for belonging in mathematics learning practices, constituting rather narrow, "normal" ways of being "mathematically able". We also discuss how our participants challenge and widen the idea of an "able" mathematics student. We pave the way for more inclusive futures of mathematics education by suggesting that rather than understanding the "dis" in disability negatively, the university mathematics education communities may use dis by disrupting order. Perhaps, we ask, if university mathematics fails to enable accessible learning experiences for students who care about mathematics, these practices should indeed be disrupted. [ABSTRACT FROM AUTHOR]

Background and Objectives Perceived control is an important psychological resource for middle-aged and older adults. Aging in place may help foster feelings of control, yet many community-dwelling older adults must rely on others—whether family, friends, or professionals—for physical assistance. This study investigated how receiving home care from different sources was associated with two facets of perceived control (mastery and perceived constraints) among adults with varying levels of physical disability. Research Design and Methods Data were drawn from the 2012 and 2014 waves of the Health and Retirement Study. Community-dwelling adults aged 50 years and older receiving help for at least one activity of daily living (ADL) impairment (N  = 884) reported their relationship to each respective caregiver (formal professional and/or informal family or friend), level of ADL impairment, and ratings of perceived control. Ordinary least squares regression was used to examine the association between type of support and perceived control, as well as the moderating effect of physical disability on that relationship. Results Compared to receipt of informal support alone, receiving a combination of formal and informal support was related to perceptions of greater control over one's life, but only in terms of mastery. The level of one's ADL impairment did not have a moderating effect on the relationship between support type and perceived control. Discussion and Implications Findings suggested that the type of instrumental support adults receive in their home has implications for specific facets of perceived control. These findings can help inform home care program development. [ABSTRACT FROM AUTHOR]

Lipedema is a progressive connective tissue disease with enlargement of adipose tissue, fibrosis, fluid collection, and dermal thickening. Herein, we present a case of lipedema associated with skin hypoperfusion and ulceration in which soft tissue debulking with liposuction improved patients' symptoms. A 39-year-old female presented with asymmetric progressive initially unilateral lower limb swelling with severe pain with subsequent skin ulceration. Conservative management failed to improve her condition. After excluding other causes and detailed radiologic investigation, lipedema was diagnosed with an associated impaired skin perfusion. Trial of local wound care and compression therapy failed to improve the condition. Subsequent soft tissue debulking with circumferential liposuction and ulcer debridement and immediate compression showed dramatic improvement of the symptoms and skin perfusion. The unique nature of this case sheds light on lipedema as a loose connective tissue disease. Inflammation and microangiopathies explain the associated pain with hypoperfusion and ulceration being quite atypical and in part might be related to the large buildups of matrix proteins and sodium contents leading to fragility in microvessels with frequent petechiae and hematoma and subsequent tissue ischemia. Conservative measures like compression therapy plays a significant role in disease course. Surgical debulking with liposuction was shown to be efficacious in reducing the soft tissue load with improvement in limb pain, edema, circumference, and skin perfusion that was seen in our patient. Lipedema is a frequently misdiagnosed condition with disabling features. Skin involvement in lipedema with potential hypoperfusion was shown and it requires further investigation. [ABSTRACT FROM AUTHOR]

Although the literature on inclusive service learning generally reports positive outcomes for students with disabilities, it provides little insight into the process of inclusion that occurs when students with and without disabilities meet within a service-learning framework. This distinction between students with and without disabilities became less clear, especially as all students began to see that they have disabilities or that they lack something that the other has or vice versa, experience themselves without disabilities even if others have defined them that way. In this paper, we address this issue through a case study of a service-learning course that brought together students with and without disabilities. The course was based on a five-facet model for inclusive service learning that comprised theory, experiential learning, community projects, dialogue, and reflection. A qualitative analysis of the course illustrates that both students with and without disabilities experienced significant changes in perception of disability such that they no longer saw themselves as two separate groups. The paper looks at the processes that produced this change and suggests the idea of 'continuous mutual learning' (CML) as an important component in education for inclusion, arguing that CML can deepen the inclusiveness of inclusive service learning. [ABSTRACT FROM AUTHOR]

Background Chewing disability is associated with impaired quality of life, potentially leading to depression, and cognitive impairment. Although the chewing-ability-cognition relationship has been explored, examining whether depression mediates this relationship remains unclear. We investigated the association between chewing disability and cognitive impairment development and a potential mediation via depression among older persons. Methods Older persons without cognitive impairment at baseline (n  = 973) from the 3 waves of the Panel on Health and Ageing of Singaporean Elderly were investigated. The outcome was incident cognitive impairment by the end of the study, while the exposure was chewing disability over the study period. Time-varying depression was the mediator. Time-fixed confounders included sex, ethnicity, education, marital status, living arrangement, and housing type, and time-varying confounders included age, smoking, cardiovascular diseases, diabetes, number of teeth, and denture wearing. We used marginal structural modeling to evaluate the effect of chewing disability on cognitive impairment development. Results After 6 years, 11% developed cognitive impairment, and chewing disability was reported by 33%. Chewing disability was associated with higher odds of developing cognitive impairment (OR 1.43, 95% CI: 1.09, 1.87), of which 85.3% was explained by the controlled direct effect of chewing disability, whereas the remaining 14.7% could be eliminated if there was no depression. Conclusions Our findings indicate an association between chewing disability and cognitive impairment, while the role of depression could not be fully elucidated. Oral health should be incorporated as part of older persons' care for its potential to assess the risk for other systemic conditions. [ABSTRACT FROM AUTHOR]

Purpose: Motor deficits are widely documented among autistic individuals, and speech characteristics consistent with a motor speech disorder have been reported in prior literature. We conducted an auditory-perceptual analysis of speech production skills in low and minimally verbal autistic individuals as a step toward clarifying the nature of speech production impairments in this population and the potential link between oromotor functioning and language development. Method: Fifty-four low or minimally verbal autistic individuals aged 4–18 years were video-recorded performing nonspeech oromotor tasks and producing phonemes, syllables, and words in imitation. Three trained speech-language pathologists provided auditory perceptual ratings of 11 speech features reflecting speech subsystem performance and overall speech production ability. The presence, attributes, and severity of signs of oromotor dysfunction were analyzed, as were relative performance on nonspeech and speech tasks and correlations between perceptual speech features and language skills. Results and Conclusions: Our findings provide evidence of a motor speech disorder in this population, characterized by perceptual speech features including reduced intelligibility, decreased consonant and vowel precision, and impairments of speech coordination and consistency. Speech deficits were more associated with articulation than with other speech subsystems. Speech production was more impaired than nonspeech oromotor abilities in a subgroup of the sample. Oromotor deficits were significantly associated with expressive and receptive language skills. Findings are interpreted in the context of known characteristics of the pediatric motor speech disorders childhood apraxia of speech and childhood dysarthria. These results, if replicated in future studies, have significant potential to improve the early detection of language impairments, inform the development of speech and language interventions, and aid in the identification of neurobiological mechanisms influencing communication development. [ABSTRACT FROM AUTHOR]

The lived experiences of women with disabilities within their mothering role have received little attention in the literature. Even more scant is the perspective of women who become disabled after entering into motherhood. This ethnographic study documents the experiences of a mother, professional, and international researcher who is catapulted into the disableist world and is propelled to suddenly negotiate her newly appointed identities. This critical reflection leads to exposing the internalized ableist discourses and provides the terrain for a resistance identity based on character strengths, resiliency, and purpose. It centers around developing an identity based on mothering within an inter-dependency model. This study contributes to the fields of disability studies, mothering, and positive psychology. The scientific literature has a significant gap in research from the perspective of mothers with acquired disabilities. This article looks at the first author's journey adapting and accepting her new disability while being a single mother. Mothers who have a disability often face strong biased attitudes against their capacity to parent; often, those attitudes come from their own internal discourse. This is called internalized ableism. internalized ableism makes us believe that we may not be good enough because we do not compare to a certain standard; like the standard that mothers should be able to run after their child, which a mother with disability might not be able to do. The first author learned that reflecting on our own journeys can make us more empowered in our roles, such as our role of parent with a disability. [ABSTRACT FROM AUTHOR]

In the recent years, food delivery platforms in Southeast Asia have accepted people with disabilities as delivery workers, framing it as economic empowerment. This article examines this ambivalent bargain of economic rehabilitation in Singapore where Grab is headquartered. Drawing from historical records, it first traces the relations of "platform" to "access," demonstrating how the framework of curative intermediaries had historically shaped expectations around work. Access in the 1980s was envisioned as intermediating infrastructural connections that could provide disabled people with resources, transforming them from liabilities to productive personhoods. The second portion draws from interviews with disabled delivery workers to highlight the problems that constitute this investment in intermediaries and cure. Although accommodative platforms provide some degree of economic inclusion, these accommodations are often partial, resulting in precarity, attrition, and injury. "Curative platforms," therefore, signals the investment and twinning of cure and violence that subject the disabled to a compromised existence. [ABSTRACT FROM AUTHOR]

Introduction: Severe malaria often results in childhood disability. The prevalence of disability related to severe malaria is significant and is estimated to affect up to 53% of severe malaria survivors. In contrast, information is sparse about how healthcare providers in Africa think about or provide rehabilitation support in acute and post-acute phases respectively. Understanding the perceptions and behaviors of healthcare providers treating malaria could help inform malaria-related disability research, policy, and practice, aimed at the providers themselves. This study explored the perceptions and behaviors of healthcare providers towards rehabilitation for children with severe malaria-related disability. The Theoretical Domains Framework was used to describe the findings relative to wider literature on health provider behavior change. Methods: A qualitative descriptive approach was used to interview thirteen healthcare providers recruited purposively based on their clinical professions, roles, and settings. Data were analyzed using directed content analysis. We decided on the most prominent theoretical domains considering the frequency of specific perceptions and behaviors across the participants, the frequency of perceptions and behaviors in each domain, and evidence of strong perceptions and behaviors. Results: Nine out of fourteen theoretical domains were identified. These domains were: Beliefs about consequences, environmental context and resources, goals, knowledge, skills, optimism, reinforcement, social influences, and social or professional role and identity. Healthcare providers' beliefs about their roles in screening for disability or referring to rehabilitation were less positive. Conclusions: The findings of this study suggest the need for interventions to support healthcare providers in acute phases (prevention and control of severe malaria) and post-acute phases (disability screening, referral, and rehabilitation care). Recommended interventions should focus on developing clinical guidelines, training clinicians, addressing institutional factors, and modifying external social influences such as socio-cultural factors. [ABSTRACT FROM AUTHOR]

Antecedents: People with intellectual and developmental disability (IDD) with extensive support needs are more likely to live in segregated and highly institutionalized environments. The aim of this study was to analyze changes in functioning and quality of life for people with IDD and extensive support needs after transitioning to ordinary homes in the community. Method: The sample included 54 adults with IDD and extensive support needs, who were assessed at three time points: before transition, six months later, and one year after transition. The Resident Choice Scale, San Martin Quality of Life Scale, Active Support Participation Measure, and the Behavior Problem section of the Inventory for Client and Agency Planning were administered. Partial least squares-structural equation modeling (PLS-SEM) and t-tests for repeated measures were carried out. Results: There were significant improvements in decision-making, participation and independence in daily activities and quality of life, as well as a reduction in the presence and intensity of behavioral problems. Conclusions: The benefits found in this study support transformation processes towards more inclusive services and professional practices that foster people's rights and feeling of belonging to the community. [ABSTRACT FROM AUTHOR]

Despite the recognized benefits, access to assistive technology (AT) remains limited. Identifying the current usage patterns and unmet needs of AT users could help address the challenges of students with disabilities. Thus, this study aimed to investigate AT use and its associated factors. An institution-based cross-sectional mixed study was conducted on higher education students with disabilities in Ethiopia. An interviewer-administered questionnaire and an in-depth interview technique were used to collect data. Descriptive statistics and binary logistic regression models were used to analyse the quantitative data, while inductive thematic analysis was undertaken for the qualitative data. A total of 233 (74.68%) with (95% CI: 70%–80%) students with disabilities used at least one form of AT. Four themes emerged which include experiences of AT use and disability, benefits and challenges of using AT, perception of the community towards AT, and responsibility for the provision of AT. Students with vision problems or those with severe disability types were most likely to be AT users. A significant proportion of students with disabilities had unmet needs for AT. Capacity at universities or rehabilitation centres would enhance access, usage of AT, and the unmet needs of students with disabilities. Will help to solve the barriers to accessing assistive technology and associated factors in the access and provision of assistive technology. Will help policymakers and stakeholders to design evidence-based rehabilitation strategies in the provision of assistive technology to persons with disabilities. Provide insight into the role of assistive technology in an educational platform to engage people with disabilities in education, improve their quality of life and lead them to become part of a productive society. [ABSTRACT FROM AUTHOR]

Prior research indicates that the provision of assistive technology (AT) services positively predicts successful employment outcomes in vocational rehabilitation (VR) programs. While AT services can be promising, they are underutilized overall, and there are apparent disparities in AT service utilization. The purpose of this study was to identify sociodemographic factors which may act as barriers to receiving AT services in VR programs. Recognizing potential disparities is the first step in improving equity in access to beneficial services. This study is a retrospective analysis of national data collected by the Rehabilitation Service Administration's Case Service Report from fiscal years 2017–2019. The sample included 788,173 cases that reported having a disability, were aged ≥18 years old, was deemed eligible for VR services, and had a complete set of data. Less than 9% of VR clients received AT services. We ran a multiple logistic regression analysis to examine the independent effects of various sociodemographic variables on the likelihood of receiving AT services through VR programs. The following client characteristics were associated with a lower likelihood of receiving AT services: men, unemployed, minority, low income, significant disability, non-enrolled in post-secondary education, mental or cognitive disability, less education, and younger age (all p <.001). The findings emphasize the need for more research to identify underlying mechanisms and potential solutions to these apparent disparities in access to AT services for adults with disabilities. Future research and implications are provided. Increasing assistive technology (AT) training in counsellor education and offering more AT training for in-service rehabilitation counsellors to increase their competence to serve individuals with diverse disabilities, particularly those with cognitive and mental disabilities. Counsellors should be encouraged to use a team approach to ensure the most effective AT solutions are provided, and improve access to age-appropriate AT for younger individuals. Counsellors should identify alternative funding sources and refine eligibility criteria for low-income individuals, and develop effective means for educating less-informed individuals about the benefits of AT, and recognise the limited access of minority groups to receive services within vocational rehabilitation programs. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore and describe current trends in the augmentative and alternative communication (AAC) use and service delivery experiences of people with amyotrophic lateral sclerosis (PALS) in the U.S. Cross-sectional data were collected from 216 PALS via an anonymous online questionnaire in 2021. Over 70% of participants reported at least some detectable speech disturbance, and approximately half used aided communication during face-to-face interactions. Among respondents with severe speech impairment, over 90% reported using speech-generating devices, and just over half reported using low-tech AAC. Most participants had met with an SLP to discuss speech and communication, but varied in both timing of the initial intervention and frequency of ongoing intervention. Fewer than half reported that their family members or other important people had received education or support related to communication for PALS. Participants also shared their use of and experiences with telephone and video calls, access methods, mounting systems, word prediction and stored phrases, and message and voice banking. Results highlight the importance of early referral for AAC intervention, ongoing re-evaluation and treatment, involvement of communication partners and support for multimodal communication and adaptation to changing needs. Most people with amyotrophic lateral sclerosis (PALS) in this sample reported experiencing dysarthria, with 71.3% indicating at least some detectable speech disturbance (Revised ALS Functional Rating Scale [ALSFRS-R] speech rating ≤ 3) and 56.5% reporting reduced intelligibility (ALSFRS-R speech rating ≤ 2). Respondents used a wide variety of communication methods. Among respondents who were unable to meet their communication needs with speech alone, 84.6% used unaided methods (including speech), 52.3% used low-tech augmentative and alternative communication (AAC) and 90.8% used a speech-generating device. Service delivery improvements are needed to ensure timely, ongoing and comprehensive AAC education and intervention for PALS and their families. Communication over video calls (including virtual healthcare visits) is common among PALS and may be an important target for AAC intervention as the COVID-19 pandemic continues to limit in-person gatherings and appointments. [ABSTRACT FROM AUTHOR]