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BACKGROUND Aging workers constitute a growing population in many countries and form an indispensable and qualified resource, especially in the context of the labor shortage. Despite work’s many benefits for individuals, organizations, and societies, it also presents several risks and challenges that may lead to occupational injuries. Thus, rehabilitation professionals and managers working with this emerging and unique clientele during their return to work after an absence often lack the tools and skills to support them, especially in the changing world of work that includes the rise of telework. Indeed, as an increasingly present work arrangement, telework has the potential to be used as an accommodation modality that can facilitate inclusion and healthy participation in the workplace. However, the implications of this topic for aging workers require study. OBJECTIVE This paper presents the protocol of a study that aims to develop a reflective telework application guide to support the accommodation, inclusion, and health of aging workers after an absence from work. Specifically, this study will (1) explore the experience of aging workers, managers, and rehabilitation professionals regarding telework and its impact on accommodation, inclusion, and health; (2) use a validated logic model to design a reflective application guide; and (3) test and evaluate the guide. METHODS Following a 3-phase developmental research design, individual interviews with aging teleworkers, managers, and rehabilitation professionals will enable the collection of qualitative data to be used in generating a logic model of levers and good practices, leading to the creation of a reflective application guide. Validation of this guide by workers and managers to measure its acceptability and applicability in daily life will precede its implementation. RESULTS Data collection began in spring 2023 and initial results are expected in fall 2023. This study aims to generate a concrete tool—namely, the reflective telework application guide—that rehabilitation professionals could use to support managers and aging workers during their return to work through the healthy use of telework. All phases of the study include conducting dissemination activities to share the results of the project and increase its sustainability potential (ie, publication through social networks, podcasts, conferences, and scientific publications). CONCLUSIONS As the first of its kind, this project aims to produce innovative impacts at several levels, including practical, scientific, and societal impacts. In addition, the results will provide healthy solutions to the labor shortage in a changing world of work, where digital and teleworking are becoming increasingly important. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/46114

This article analyses and compares disability policies for working-age individuals in Canada with a focus on the mode of policy provision and type of measure to determine the degree to which direct funding is used in this country. To consider policy diversity in this federal system, policies are compared using a mixed-methods approach. Using quantitative methods, federal, provincial and territorial policies are first compared using hierarchical cluster analysis. This provides evidence of three distinct clusters in Canada according to policy provision and measure type. In a second, qualitative analysis, the disability strategies of four provinces’ (British Columbia, Ontario, Newfoundland and Labrador and Quebec) are compared, to determine over arching policy orientations. Findings indicate that policy provision in Canada largely favours money over services. Furthermore, most provinces emphasize either health or integration measures over substantive measures. Despite these commonalities, significant variation persists across Canada. This extends to poverty and disability reduction strategies with two of the four provinces having a broader orientation while the other two provinces focus specifically on employment as a means of social inclusion. The article concludes with a discussion on the state of employment policies for individuals with a disability in Canada.

The COVID-19 pandemic has led to numerous changes in work environments. Thousands of workers quickly found themselves having to telework without being prepared, which had consequences on their work experience and health. Authors proposed telework practices that promote the healthy work experience of workers in a pandemic context, but less attention has been paid to consider the realities and needs of individuals with physical disabilities. Purpose This study aimed to explore the influence of telework during the pandemic on the work experience of people with physical disabilities. Methods Following an interpretive descriptive research design, interviews were conducted with 16 workers with physical disabilities (i.e., motor, or sensory). The data were analyzed using a thematic analysis strategy. Results The results revealed 15 factors that influence the work experience of teleworkers with physical disabilities. These factors are related to interactions between three spheres of the worker's life: the individual, the organization, and the environment. Ten recommendations are proposed to consider the reality and needs of individuals with physical disabilities in the telework practices. Conclusion Given that telework has expanded since the onset of the COVID-19 pandemic and will likely continue to remain a widespread modality of work delivery, it becomes even more important to expand knowledge about it, to benefit the work experience of teleworkers with physical disabilities.

The COVID-19 pandemic has led to numerous changes in work environments. Thousands of workers quickly found themselves having to telework without being prepared, which had consequences on their well-being. Authors proposed telework practices that promote the well-being of workers in a pandemic context, but less attention has been paid to consider the needs of disabled workers. Purpose. This study aimed to explore the effects of telework during the pandemic on the well-being of people with disabilities. Methods. Following an interpretive descriptive research design, interviews were conducted with 16 workers with disabilities (i.e., motor, or sensory). The data were analyzed using a thematic analysis strategy. Results. The results revealed 15 factors that influence the well-being of teleworkers with disabilities. These factors are related to interactions between three spheres of the worker's life: the individual, the organization, and the environment. Ten recommendations are proposed to consider the reality of disabled individuals in the telework practices. Conclusion. Given that telework has expanded since the onset of the COVID-19 pandemic and will likely continue to remain a widespread modality of work delivery, it becomes even more important to expand knowledge about it, to benefit the well-being of disabled teleworkers.

Resume Cet article presente les enjeux epistemologiques lies a la mise en place et a l’exploitation de donnees produites dans le cadre d’un projet transdisciplinaire sur de jeunes drepanocytaires en Guadeloupe. Le recours au modele theorique du MDH-PPH vise a apprehender les interactions reciproques entre effets biomedicaux de la pathologie et habitudes de vie, en rompant avec les lectures medicales du handicap. Fonde sur une approche inclusive, ce modele considere les facteurs individuels en interaction avec l’environnement physique et social dans l’etude de la realisation d’activites courantes et roles sociaux. La reflexion sur la transdisciplinarite qui en decoule porte sur l’operationnalisation du protocole d’enquete et sur les modalites de traitement des donnees de recherche. Comment eviter la dispersion ou la simple coexistence de ces dernieres ? En contribuant a leur integration, le MDH-PPH offre un cadre susceptible de favoriser les applications et retombees pour les patients. La demarche transdisciplinaire vise donc ici des retombees societales et inclusive des jeunes drepanocytaires dans toutes les spheres de leur vie sociale, et questionne les fondements epistemologiques d’une etude transdisciplinaire de la drepanocytose privilegiant une approche socio-anthropologique.

Cette étude vise à explorer la manière dont les personnes victimes de brûlures graves s’adaptent au changement identitaire en lien avec l’image corporelle. Des entrevues semi-dirigées ont été réalisées avec dix adultes (de 27 à 65 ans) ayant subi des brûlures graves et qui ont terminé leur réadaptation. Les participants sont sept hommes et trois femmes, qui sont majoritairement mariés et occupent un emploi. On note que 9 % à 83 % de la surface corporelle est atteinte et que la principale cause est attribuable aux flammes. Les analyses révèlent l’existence d’un processus complexe animé par une forme de mise en scène autour de l’apparence physique et de la différenciation où s’entrecroisent des stratégies de camouflage, d’exposition et de dissimulation des cicatrices, génératrices de sens tant dans le rapport au corps que dans le rapport aux autres vis-à-vis de leurs attitudes. Ces résultats mettent en lumière aussi le rôle clé de facteurs comme les ressources internes révélant la capacité de résilience et l’entourage significatif, le regard d’autrui tant dans le processus de réadaptation que lors du retour dans la communauté. Ils soulèvent des interrogations quant aux pratiques de suivi à long terme et à l’importance d’accroître les interventions psychosociales auprès des proches significatifs., This study aims to explore how burn survivors adapt to identity changes related to their body image. Semi-directed interviews have been carried out with 10 adults (from 27 to 65 y.o.) with severe burns, after their rehabilitation. The participants are 7 men and 3 women, most of whom are married and employed. We note that 9% to 83% of the body surface is affected and that the main cause is attributable to flames. The analysis reveals the existence of a complex process animated by a kind of staging around physical appearance and differentiation where strategies of camouflage, exposure and concealment of the scars are intertwined, generating meaning in relation to their bodies as well as in relation to others vis-à-vis their attitudes. These results reveal also the key role played by some factors such as internal resources of resilience and significant relatives, the way others look at them during the rehabilitation process and on their return to community. The results raise questions related to long term follow up practices and the importance of increasing psychosocial interventions with significant relatives.

Norms and values embedded in what is referred to as 'institutionalised gender,' defined by the distribution of power between genders in the political, educational, religious, medical, cultural or social institutions of a society, exist even today. The above mentioned influential institutions shape societal norms that define, reproduce and justify differing expectations and opportunities for women, men, girls and boys. Using qualitative methods, 41 semi-structured interviews among employed people with deafness/hard of hearing (DHH), blindness/low vision, motor disabilities, or chronic pain from three administrative regions of Québec (Montréal, Outaouais, and Montérégie) were analysed. The results show that while gender is omnipresent in participants' remarks, it is not necessarily associated with exclusion from employment, but most certainly with perpetuating some forms of inequity in work situations. Solutions to raise awareness among ergonomists working with people with disabilities are suggested.

Objectives To evaluate nasal soft and hard tissue changes immediately post–rapid maxillary expansion (RME) and to assess the stability of these changes using cone beam computed tomography (CBCT). Materials and Methods A total of 35 treatment group (TG) patients (18 girls, 17 boys; 9.39 ± 1.4) had a pre-RME CBCT and a post-RME CBCT approximately 66 days after expansion, and 25 patients had a follow-up CBCT 2.84 years later. A total of 28 control group (CG; no RME) patients (16 girls, 12 boys; 8.81 ± 1.6) had an initial CBCT and a CBCT an average of 2.25 years later. Soft and hard tissue nasal landmarks were measured in transverse, sagittal, and coronal planes of space on CBCT scans. Differences within the same group were evaluated by paired t-tests or Wilcoxon signed-rank tests. Long-term comparisons between TG and CG were evaluated by independent-sample t-tests or Wilcoxon rank-sum tests. Results Immediately post-RME, there were statistically significant mean increases of 1.6 mm of alar base width, 1.77 mm of pyriform height, and 3.57 mm of pyriform width (P < .05). CG showed the significant increases over 2.25 years (P < .001). Compared with CG, the long-term evaluation of TG demonstrated only pyriform height and pyriform width showed a statistically significant difference (P < .01). Conclusions Although RME produced some significant increase on the nasal soft tissue immediately after expansion, it regressed to the mean of normal growth and development over time. However, long-term evaluation of TG compared with CG showed only pyriform height and pyriform width to be affected by RME.

In this article, we illustrate how Australia’s new National Disability Insurance Scheme (NDIS) extends the active citizenship of people with disabilities. This is done by examining how the NDIS changes their relation between persons with disabilities and to the welfare state, and through an analysis of its eligibility criteria and needs assessment planning. The support provided and the way in which it is provided reproduce a particular understanding of disability that has a direct influence on the roles assigned to people with disabilities in society as well as on their opportunities to exercise their rights as active citizens. This is important because the implementation of NDIS in Australia is likely to influence the development of disability policy on a global level. Understanding how its mechanisms restricts or facilitates citizenship is therefore crucial.

Cet article explore les représentations sociales à l’égard des usagers ayant des différences, fonctionnelles ou non, de « l’environnement » et du « territoire » des différents acteurs que sont les usagers du transport en commun et les chauffeurs de bus. L’analyse de ce matériau riche et complexe, provenant d’entrevues, lève le voile sur les significations de ces notions pour les participants mais aussi sur l’existence de représentations sociales variant selon différents sous-groupes. Ces résultats vont enfin permettre d’identifier les enjeux qui sont liés au développement d’un transport collectif inclusif sur le territoire de la Ville de Québec., This article explores the social representations which public transit users and bus drivers have of users with or without disabilities, the environment and, ultimately, the territory. The analysis of rich and complex material drawn from interviews reveals what these concepts mean for participants, and also shows the way in which attitudes vary among different subgroups. These research results allow us to identify important issues related to the development of inclusive public transit in the Quebec Metropolitan Community.

BACKGROUND Patients with hemifacial microsomia (HFM) may undergo unilateral mandibular distraction osteogenesis (MDO) before skeletal maturity in an effort to improve facial symmetry. Mandibular distraction osteogenesis's effect on airway volumes have been studied in the past, though to our knowledge, none have accounted for the effect of head and neck posture on airway morphology. This study aimed to tackle this shortcoming, using imaging to analyze the upper airway of patients with HFM before and after surgical intervention with MDO. METHODS/DESCRIPTION The authors retrospectively reviewed patients with a diagnosis of unilateral HFM whom underwent unilateral MDO with an oblique vector at age 4 to 14 years at a single institution from 2004 to 2019. Patients with pre- and post-MDO three-dimensional computed tomography scans of the upper airway within 12 months of distractor placement and removal, respectively, were included. Head and neck postures were determined by craniocervical, pitch, roll, and yaw angles. Pre- and post-operative pharyngeal airway volumes, pharyngeal surface area, minimum retropalatal cross-sectional areas (RP CSA) and retroglossal (RG) CSA and associated anteroposterior distances were measured using Mimics 22.0 (Materialise; Leuven, Belgium). Comparison was done using Kruskal-Wallis tests and linear mixed-effects models controlling for head and neck postures. RESULTS Ten patients met inclusion criteria. Mean age at pre-distractor placement computed tomography scan was 99 ± 35 months, and mean duration between pre- and post-surgery scans was 220 ± 90 days. Head and neck posture were found to be significant predictors of all airway dimensions. After controlling for significant factors with fixed effects linear modeling, surface area was found to be significantly smaller in patients after MDO by 189.48 mm2 (F[10.8] = -3.47, P = 0.0053), compared to their preoperative measurements. Surgery was not a significant predictor of changes in airway volume (F[11.6] = 0.52, P = 0.61), minimum RP CSA (F[12.2] = -0.64, P = 0.53), minimum RG CSA (F[12.6] = -1.64, P = 0.13), RP anteroposterior distance (F[14.0] = 0.30, P = 0.77), or RG anteroposterior distance (F[20.0] = -0.04, P = 0.97). CONCLUSIONS Oblique vector MDO in patients with HFM is associated only with statistically significant changes in the surface area of the upper airway, and is not associated with statistically significant changes in dimensions like volume, CSA, or anteroposterior dimension. This is an important finding, as it may guide discussions surrounding risk/benefit ratio for MDO in childhood.

This paper provides methodological insights into the development of design guidelines for accessible pedestrian infrastructure for individuals with physical disabilities (IPD) in Quebec’s municipal...

CBCT imaging has the potential to increase the scope and accuracy of orthodontic diagnosis in several ways. The convergence of digital technologies makes this possible. Intraoral scanners generate digital models that, when merged with CBCT, allow the orthodontic diagnostician to generate virtual treatment objectives which not only target the position of dental crowns but also dental roots. Tooth movement decisions become periodontally driven. CBCT images change orthodontic diagnosis, from a two-dimensional process to a more comprehensive three-dimensional process, potentially identifying maxillary transverse deficiencies. CBCT imaging enhances the diagnosis of dento-skeletal asymmetry. CBCT imaging allows the orthodontist to render a diagnosis on the status of the temporomandibular joints. CBCT imaging is a screening tool for impaired airways.

Objectives To evaluate the presence of dehiscences and changes in alveolar bone height and width in the area of the mandibular central incisors pre- and post-orthodontic treatment. Materials and Methods In 60 skeletal Class II patients, cone-beam computed tomographic (CBCT) images were obtained and the patients were divided into four groups based on the presence of dehiscences at pre- and post-orthodontic treatment. The alveolar bone height and width were measured on CBCT in cross section along the long axis of the teeth. Lateral cephalograms were analyzed. Results The changes in L1-NB and IMPA appeared to be correlated with vertical bone loss and dehiscence. Alveolar bone height appeared to follow a segmented relationship with these two variables, with changes below a threshold (L1-NB = 0.71 mm, IMPA = 3.02°) having relatively minimal or no effect on bone loss but with changes beyond the threshold correlated with extensive bone loss. Similarly, increases in L1-NB or IMPA correlated with decreases in alveolar bone width (L1-NB: −0.25 mm/mm, IMPA: −0.07 mm/°) and increased the probability of developing dehiscences, with an estimated 50% probability of vertical bone loss at a L1-NB change of 2.00 mm or, equivalently, an IMPA change of 8.02° was estimated. Conclusions When treating skeletal Class II patients, the limits of incisor proclination/protraction are less than previously thought. To prevent undesired periodontal outcomes, careful three-dimensional diagnosis is advisable. Furthermore, when excessive protrusion and/or proclination is planned, additional treatment modalities, including orthognathic surgery, tooth extraction, and corticotomy with bone graft, should be considered.

Les personnes malentendantes rencontrent des obstacles de communication dans leur vie courante. S’appuyant sur une approche communautaire visant l’autodétermination, l’étude décrit l’apport d’ateliers de partage de savoirs expérientiels sur l’utilisation des TIC entre personnes malentendantes. Plusieurs aspects de ces ateliers ont été appréciés ; entre autres pour ce qui est des aspects relationnels. L’intention d’utilisation des connaissances et le sentiment d’efficacité personnelle ont progressé entre les ateliers et les apprentissages ont été réutilisés pour pallier certaines difficultés de communication. Ainsi, ce type d’atelier devrait être pérennisé à long terme afin de favoriser la participation sociale des personnes vivant une perte auditive les empêchant de participer pleinement à la vie citoyenne., People with hearing impairment hearing encounter communication barriers in their daily lives. Using a community-based approach aimed at self-determination, this study describes the contribution of experiential knowledge-sharing workshops on the use of ICT among people with hearing impairment. Participants appreciated these workshops. Self-efficacy and intention to use knowledge increased from one workshop to another. Learning was reused to overcome some communication difficulties. Thus, this type of workshop should be continued in the long term, in order to promote social participation of people with hearing impairment, so they can fully engage in their civic life.

Quality interprofessional and interorganizational practices are key to supporting people with disabilities and their families (Gilbert et al., 2010). It is critical to increase efforts to give health and social care professionals a better understanding of the roles and contributions of their colleagues and to encourage sharing between different disciplines. Professionals must also be supported in developing essential clinical knowledge, attitudes, and skills to build the foundations of a person-centred approach focusing on the needs of people with disabilities and their families (Lezzoni & Long-Belil, 2012).

The aim of this study is to evaluate the longitudinal transverse growth of the maxillo-mandibular complex in untreated children using the Cone Beam Computed Tomography (CBCT). Two sets of scans on 12 males (mean 8.75 years at T1 and 11.52 years at T2) and 18 females (mean 9.09 years at T1 and 10.80 years at T2) were analyzed using Dolphin 3D imaging. The transverse widths of various maxillary and mandibular skeletal landmarks and the dentoalveolar and dental landmarks at the level of first molars were measured. Overall, there were greater increases in the transverse dimension in the posterior than anterior portions of the maxilla and mandible. The increase in intergonial width of the mandible seems to be primarily due to the lengthening of the mandibular body. The dentoalveolar process at the first molar level increases at an equal rate corono-apically and is independent to the changes in molar inclination. When comparing maxillary dentoalveolar changes with that of the mandible, greater increases were noticed in the maxilla, which might be explained by the presence of sutural growth in the maxilla. Moreover, the first molars maintain their coordination with each other despite the differential increase in the maxillary and mandibular dentoalveolar processes.

The development of dedicated leisure and recreational programs raises questions about their low level of utilization by persons with disabilities. The article aims to identify factors influencing l...

Introduction En 2018 et 2019, la Societe de transport de Montreal (STM) a cree une formation visant a faciliter l’utilisation des transports en commun par des personnes ayant des limitations fonctionnelles motrices et a fait appel a une equipe interdisciplinaire de chercheurs afin d’en faire la bonification et l’evaluation. Au printemps 2019, la formation a ete offerte a douze personnes ayant des limitations fonctionnelles motrices. Materiel et methode Afin de mieux preparer la formation, elle a premierement ete offerte a deux groupes tests puis presentee a un groupe focalise d’experts provenant des milieux communautaires, du milieu de la readaptation ainsi que gouvernemental (OPHQ). Par la suite, la formation a ete bonifiee et offerte a deux groupes de participants. Avant la formation, les participants ont premierement ete evalues sur leurs connaissances du reseau de transport ainsi que sur leurs objectifs et capacites de deplacements. Suite a la formation de sept heures comprenant des activites theoriques et pratiques puis d’un bref entrainement individuel, les personnes devaient documenter douze trajets faits de maniere autonome a l’aide d’un carnet de voyage afin de connaitre les effets de la formation/entrainement dans leur utilisation du transport regulier. Finalement, apres avoir effectue leurs deplacements, leurs points de vue ont ete recueillis a l’aide d’entrevues individuelles. Resultats Les resultats de la recherche indiquent que la mise en place d’un programme de formation et d’entrainement a l’utilisation des reseaux de bus et de metro accessibles vient augmenter l’utilisation du transport regulier et facilite la participation sociale. La presentation permettra d’aborder ces elements afin de faire connaitre les portees et limites de la formation.

Understanding disability remains a challenge. Although the international community has largely embraced the idea that disability is the product of social and environmental practices, society still lacks good conceptual frameworks. In an era when the rights of persons with disabilities have been enshrined in international and national laws, such frameworks have become a necessity. Within the province of Quebec, Canada, the Disability Creation Process (DCP) model has served such a role. Furthermore, recent efforts to enrich the model enhance the applicability of this powerful tool to a broader range of contexts. As a result, the DCP model could be used more widely than it is today. In this paper we provide the foundations of the approach encapsulated by the model and explain how its usage guides policy development and service delivery within the province of Quebec. We also highlight its forward-looking capacities.

Background The COVID-19 pandemic caused drastic changes in the lives of the general population. People with physical disabilities, who commonly encounter daily challenges such as barriers to community mobility, reduced access to healthcare services and higher risk of suffering from depression, may face additional challenges in the context of the pandemic. Objective This study aims to review the impact of the COVID-19 pandemic, and associated isolation and protective measures, among people with physical disabilities. Methods A rapid review of the published literature was conducted on August 10, 2020 through a search in six online databases to synthesize results from original studies regarding the impact of the COVID-19 pandemic on people with physical disabilities. The International Classification of Functioning, Disability and Health was used to describe the population and the personal and environmental factors with a unified and standard health language. Results Eleven records were extracted from 1621 individual papers retrieved from the search strategy. Various impacts on daily functioning such as a decrease in access to healthcare have been noted during the pandemic. Changes in social and lifestyle habits, mood changes and decreased levels of physical activity were also noted. Conclusions Our results highlighted the lack of early research about the impacts of COVID-19 experienced by people with physical disabilities. Future studies should focus on specific consequences and needs of this vulnerable population to ensure their inclusion in public health recommendations and consideration by policy makers.

Due to the ageing population and higher prevalence of individuals living with physical disabilities, there is a critical need for inclusive practices when designing accessible pedestrian infrastructures for ensuring social participation and equal opportunities.Summarize the physical characteristics of current pedestrian infrastructure design for individuals with physical disabilities (IPD - motor, visual and hearing) found in the scientific literature and assess its quality.A mapping review of the existing literature on pedestrian infrastructures specifically built for individuals with physical disabilities identifying measurable physical characteristics for their design was done using online databases (Urban Studies Abstracts, Geobase, PubMed, and Cairn and secondary research). Information about accessibility (physical characteristics) of existing pedestrian infrastructures was extracted. The quality of the evidence was assessed using the Guidelines for critical review form - Quantitative studies and Qualitative studies version 2.0 (SAGE Publications, Inc., Thousand Oaks, CA).Of the 1131 articles identified, forty-one articles examined access to bus stops, curb ramps, lighting, pedestrian crossings, ramps, shared spaces, sidewalks and steps. Six articles reported on more than one physical disability. Quality scores were generally low (quantitative: 2-11/15 and qualitative: 1-22/23). Recommended design features differed for the same infrastructure.While there were a fair number of articles (n = 41) documenting accessible design features of pedestrian infrastructures, the quality of the evidence was low. The review identified knowledge gaps. Although specific design solutions exist, they have not yet been tested among individuals with various or multiple types of physical disabilities to ensure access to pedestrian infrastructures by all. Implications for Rehabilitation Pedestrian infrastructures still pose problems to mobility, limiting social participation and quality of life outcomes for individuals with physical disabilities (motor, visual and hearing). The results of this mapping review show that few articles are concerned with the accessibility of pedestrian infrastructures for more than one type physical disability, which might lead to recommendations that are inadequate for individuals with differing disabilities, few recommendations have been compared, most studies have been performed in environments not representative of northern countries and their quality score was generally low. Health professionals and State Parties have a complementary expertise that should be put to use in the determination and implementation of best design solutions to ensure the respect of the needs of individuals with physical disabilities. This review can thus help them have an idea of what has already been done to identify what needs to be achieved to fill the gap of knowledge required to insure access for individuals with motor, visual as well as hearing disabilities. Rehabilitation profesionals should take part in the assessment of the proposed solutions as well as the development of new designs to fill knowledge gaps.

RésuméLes personnes ayant des incapacités sont en général négligées, voire oubliées dans les processus de développement local, et leurs avis de citoyens ne sont pas, ou très peu, pris en compte. Cette situation constitue une discrimination, contraire aux droits humains tels que rappelés dans la Convention relative aux droits des personnes handicapées. Pour réduire l’isolement des personnes ayant des incapacités et améliorer la qualité de leur participation sociale par l’exercice de leurs droits, Handicap International met en œuvre des projets de développement local inclusif. De son côté, le centre interdisciplinaire de recherche en réadaptation et intégration sociale appuie le même type d’approche dans un contexte de développement urbain inclusif. Le centre international d’études pour le développement local s’est associé à ces deux organismes afin de mettre en place un programme de recherche visant à développer des méthodes, outils et indicateurs permettant de mesurer les effets des stratégies de gouvernance et de développement locaux sur l’amélioration de la participation citoyenne tant individuelle que collective des personnes ayant des incapacités. Le présent article reflète l’état d’avancement de la réflexion, et l’inscrit dans le cadre des objectifs et enjeux méthodologiques du projet.AbstractPeople with disabilities are more often than not overlooked or simply ignored in local development initiatives and their opinions as citizens more or less taken into account. Such discrimination is contrary to human rights and to the Convention on the rights of persons with disabilities. For some years, Handicap International has been implementing inclusive local development projects to reduce the social isolation of people with disabilities and improve the quality of their social participation by empowering them to exercise their human rights. For its part, the center for interdisciplinary research in rehabilitation and social integration promotes such an approach by implementing inclusive urban development research projects. Recently, the centre international d’études pour le développement local began a collaboration with these two organizations to design and implement a research program aiming at developing methods, assessment tools, and indicators for measuring the impact of inclusive local development strategies on the quality of individual and collective citizenship of persons with disabilities participation in local governance mechanisms. This article will present the state of reflection on inclusive local development, as well as the research project objectives and methodologies being used.

The purpose of this study was to use cone-beam computed tomography imaging to examine the skeletal and dental changes in the sagittal and vertical dimensions after rapid palatal expansion.Twenty-eight healthy children (mean age, 9.9 years; range, 7.8-12.8 years; 17 boys, 11 girls) who required rapid palatal expansion treatment were included. For each patient, a bonded Haas-type expander with full occlusal and palatal acrylic coverage was cemented in place. Cone-beam computed tomography images were obtained as part of the pretreatment orthodontic records and at the completion of rapid palatal expansion for all patients. The mean interval between pretreatment and completion of rapid palatal expansion was 52 days (range, 19-96 days). The average skeletal age of the patients, determined from hand-wrist films also obtained before treatment, was 10.1 years. The mean expansion of the expander was 8.0 mm (range, 5.9-9.6 mm). Each cone-beam computed tomography image was compressed from the outer portion of the right side of the patient's head to the center of the left central incisor into a 2-dimensional synthesized cephalogram, which was then traced and measured.The results showed that from pretreatment to completion of rapid palatal expansion, SNA, FH-NA, and A-Nperp increased by means of 1.04°, 0.92°, and 0.87 mm, respectively (P0.05). In addition, 1/-NA, 1/-SN, 1/-NA, 1/-Nperp, and 1/-PP showed mean decreases of 3.74°, 2.53°, 1.17 mm, 0.49 mm, and 2.69°, respectively (P0.05). Both ANS and PNS moved significantly downward (ANS, 2.05 mm; PNS, 1.16 mm).There was forward movement of the maxilla as a result of rapid palatal expansion treatment. Bonded rapid palatal expansion treatment resulted in downward displacement of the maxilla with a greater displacement of ANS than PNS and posterior movement of the maxillary central incisors.

Objectives: Despite the growing number of individuals with motor disabilities who decide to become parents, their parenting role has received little attention in society, research or rehabilitation. The aim of this study was to document the various dimensions of the experience of parents in wheelchairs with children aged 6 to 12. More specifically, the objectives were to: 1) identify the environmental and personal obstacles encountered, 2) document the personal strategies developed, and 3) document the types of formal and informal support used. A conceptual model was then developed. Method: Interviews were conducted with six fathers and six mothers in wheelchairs, followed by a thematic analysis of the content using procedures that met rigorous qualitative research criteria. Results: In performing their parenting role in the three dimensions, the parents encountered two types of obstacles, developed seven types of personal strategies and used four types of informal and formal support. Discussion and conclusion: The diversity of personal strategies is evidence of the parents' desire to develop alternative ways to overcome obstacles. The main reason for seeking support was accessibility limitations. Social prejudices against parents in wheelchairs still exist. Clinical, political and social recommendations are suggested. The initial conceptual model was improved and discussed.

Support services to families of children with disabilities have previously been documented. While the effectiveness and consequences of some support strategies have been defined, their comparison remains problematic primarily because of the diversified existing definitions. The present study aimed to elaborate and validate a typology to describe different types of support that can be offered to families of children with disabilities. A review of literature highlighted a variety of support services and allowed a categorical grouping. Content analysis ensured that each category was defined distinctively. Afterwards, a panel of experts and representatives of organizations from seven developed countries (Australia, Belgium, Canada, Denmark, France, Sweden and Switzerland) validated the typology. A database of services offered in these countries was created. The resulting typology was divided into four categories related to the family needs: support, respite, child minding and emergency support. Each type of support can be illustrated within organizations in the database. As such, social workers can use the defined typology to identify the needs of families of children with disabilities and suggest alternatives when services are not available. Overall, the described typology should facilitate discussion between stakeholders and families by providing a common communication system.

Returning to the community after intensive functional rehabilitation can be a challenge for people who have sustained a traumatic spinal cord injury (SCI) and for their family members.1-4 They may need different services in order to facilitate their social participation and improve their quality of life.3,5,6 Research was conducted to better understand the role of the environment in community reintegration in the first years post rehabilitation. This article focuses on the needs from the perspective of persons with SCI and their family members. A more complete understanding of unmet needs will help better address them in future intervention and policies.

To explore what factors besides walking ability, e.g., additional health problems or complications, general health, and sociodemographic status, may be related to physical activity in adults with cerebral palsy.We administered a questionnaire regarding sociodemographic and health-related factors of potential relevance to physical activity to 66 men (20-41 yrs) and 66 women (18-39 yrs) with various types of cerebral palsy. Data were analyzed using logistic regression.Use of walking as the primary means of self-transport (walking ability) was associated with a higher odds of being physically active (odds ratio = 3.75; P = 0.002). Among those who could walk, being younger and having a positive perception of health were also associated with a higher odds of being active (odds ratios of 2.6 and 3.0, respectively). This was not true among nonwalkers. For individuals who walked, inactivity was associated with an increase in the severity (during the past 3 yrs) of several additional health problems or complications. For the nonwalkers, inactivity was most clearly associated with perceived range-of-motion limitations.Among adults with cerebral palsy, the ability to walk, as expected, is associated with being physically active. The factors additionally related to physical activity differ between walkers and nonwalkers.

This study examined the influence of selected personal and environmental factors on leisure participation in adults with cerebral palsy (CP).A group of 145 adults with CP (18-41 years old, 51% male) responded to questionnaires regarding 1) socio-demographic and health factors, 2) life habits (Life-H: short version 3.1) and 3) the environment (Measure of the Quality of the Environment: version 2.0). A chi2 statistic (p0.05) estimated the association between 1) socio-demographic and health factors and the environment and 2) the level of leisure activity participation.Most participants (mean age=28 years) lived with their parents. Leisure activities were their principal occupation. Mobility and participation were positively associated. The environment (e.g. accompanying services, adapted transport, cultural services and computers) facilitated leisure for those with a high or moderate participation level. Individuals with low participation perceived the environment as having no influence.Adults with CP who are more mobile participate more in leisure activities. A positive perception of the environment (facilitating leisure participation) likely reflects the individual's ability to benefit from the environment, whereas a neutral view of the environment may reflect the fact that other factors, such as mobility limitations, are of greater relevance to leisure participation.

L’article présente les résultats d’une recherche qualitative qui avait pour objectif d’identifier et de décrire les conséquences sociales sur la santé de l’inaccessibilité aux services et aux compensations financières pour les personnes ayant des incapacités et leurs proches. Cinquante-deux personnes ont été rencontrées lors d’une entrevue individuelle. L’analyse de contenu des entrevues révèle que l’inaccessibilité entraîne des conséquences négatives sur la santé physique, la santé mentale et la participation sociale. L’analyse fait également ressortir comment les personnes composent face aux carences de la protection sociale. Ces résultats sont discutés à la lumière des transformations récentes dans les pratiques de compensation au Québec., This article presents the results of a qualitative study aiming to identify and describe the social and health consequences of the inaccessibility of services and financial compensations for people with disabilities and their close relations. Fifty-two people were individually interviewed. Content analysis of the interviews reveals that inaccessibility leads to negative consequences on physical health, mental health and social participation. The analysis also revealed how people deal with inadequacies in social protection. These results are discussed in light of recent transformations in Quebec’s compensation practices.

This chapter examines three aspects of the community access issue: access to services, the value of both existing and emerging technologies, and social and economic policy-making. In addition to an efficient rehabilitation process focusing on physical and mental capabilities, enhancing community access and social participation will require the optimization of access to services. Key concepts in this regard include the notion of support both for individuals and their families. Technologies that enhance mobility, communication, and home adaptation also play an increasingly important role. While they are essential to compensate for various forms of disabilities, the current rapid evolution of technologies does not allow adequate efficacy testing, limiting the establishment of best practices or recommendations regarding these products and often overestimating their benefits. Finally, better community access and participation should not be based on a culture of disability but a culture of ‘ability’ that impacts all citizens.

Purpose Since the mid-1990s, the social model of disability has come under scrutiny. Several researchers have examined the role of ontology (philosophical ideas about the nature of what it means to be human) in relation to disability. In this paper, we situate this burgeoning understanding of disability within the set of post-cartesian ontologies, which disrupt the separation of the mind from the body and its attendant dichotomies. Furthermore, we seek to show how such a change can carry through to the research paradigm and therefore affect tangible outcomes of disability research. Design/methodology/approach A commitment to an embodied ontology requires first and foremost that researchers rethink what is being studied by focusing on the diverse characteristics of being and its actualization within the world. This will involve an emphasis on the lived experience of the body, including issues of affect, identity and movement, as well as broader issues of embodied being. Findings Using a research program currently underway at the Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) as a detailed example, we draw on the ontological framework to help articulate the way research can be re-organized. We show how projects at different scales can be brought to work together, and highlight how a focus on embodiment issues facilitates such multi-disciplinary, inter-project collaboration. We note that adopting such an ontology-based framework will accomplish three major outcomes: (1) increase the relevance and effectiveness of new projects with regard to the overall vision; (2) enhance cross-project synergies and ensure stronger ties between research and practice; and (3) contribute to shifting the underlying ontology from a more cartesian approach to a post-cartesian embodied perspective. Originality/value The new ontologies embrace, integrate and extend the earlier social and biomedical perspectives, and offer a critical perspective on technology. The embodied approach recognizes not only the embodiment of research subjects, but also the embodied experience of the researchers themselves. In addition, the approach leads to a more holistic organization of research within a global, interconnected structure of projects rather than simply a collection of separate projects organized into thematic areas, as was done in previous decades. This reorganization of research enhances the ability to engage academic researchers with practitioners not just in the hospital and clinical settings, but also within the wider community.