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Dsouza SA, Ramachandran M, Bangera K, Acharya V. Assistive products to support daily time management of older persons with dementia in India: experiences and views of informal caregivers and occupational therapists. Disabil Rehabil Assist Technol 2024; 19:982-993. [PMID: 36346332 DOI: 10.1080/17483107.2022.2138995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 09/02/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE The present study aimed to understand how informal caregivers and occupational therapists support daily time management (DTM) of older persons with dementia (PwD) and their views regarding assistive products for DTM, i.e., time management products (TMPs). METHODS The study involved a qualitative descriptive approach rooted in principles of naturalistic inquiry. Twelve caregivers of PwD and eight occupational therapists were interviewed. Conventional content analysis was performed. RESULTS Findings are described in three categories. The first category "current strategies to support DTM" described the low-tech strategies used for specific cognitive functions. The second category "factors influencing DTM and TMP" entailed factors related to the PwD (especially premorbid time management), the caregiver (multiple caregivers, attitude towards technology), the occupational therapist (impairment-oriented practice, limited resources and training in DTM) and the context (attitude towards time, poor awareness and knowledge of dementia, an expectation of recovery, negative societal attitudes towards devices, affordability/access). The third category "expectations from TMP" described the participants' expectations regarding device-related features (low-cost, easy to use, portable, low maintenance, customisable and useable across the disease continuum) and support for device use (maintenance, caregiver education). CONCLUSIONS The study provides contextually relevant recommendations and strategies to inform the provision, acceptance and adherence to DTM interventions and guide the development and prescription of indigenous TMP for PwD in India. Implications for rehabilitationAdoption of time management products (TMPs) for people with dementia in India requires an understanding of contextual factors, especially culturally influenced attitudes of persons with dementia and their family members towards time, assistive products and elders.Contextually relevant approaches and strategies are suggested to guide the provision of daily time management (DTM) interventions including TMPs for people with dementia and their families in India.It is imperative to assess the relevance, acceptance and feasibility of available TMPs for people with dementia and their families living in India and develop contextually relevant indigenous products.Occupational therapists working with people with dementia and their families would benefit from more opportunities for training and access to resources (including contextually relevant standardized assessments) to implement DTM interventions.
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Affiliation(s)
- Sebestina Anita Dsouza
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Centre for Studies on Healthy Aging, Manipal Academy of Higher Education, Manipal, India
| | - Meena Ramachandran
- Bridgepoint Collaboratory for Research and Innovation, Sinai Health, Toronto, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Kshama Bangera
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Vinita Acharya
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
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Brien M, Krishna D, Borish M, Coutinho F, Bernardo A, Shah SR, Venkatachalaphy N. Enabling local provision of assistive products in rural South India: an organisational survey of needs, barriers, and facilitators. Disabil Rehabil Assist Technol 2024:1-11. [PMID: 38419594 DOI: 10.1080/17483107.2024.2321601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
Objective: Access to assistive products (APs) is essential to maximising function, participation, and inclusion of persons with disabilities. Challenges to AP access in low- and middle-income countries include stigma, costs, supply, and rehabilitation capacity gaps. This study aimed to examine AT access in the context of a low-resource setting in rural South India. Objectives were to examine rehabilitation professionals' perceptions of AP needs, barriers and facilitators of AP provision, and AT knowledge.Methods: A descriptive study design with a 2-part online survey methodology was utilized. This study was conducted in April-September 2020 at a non-governmental organization (NGO) serving children and adults with disabilities in 3 districts of rural South India. Purposive sampling of NGO's multidisciplinary rehabilitation professionals (N=62) was used. The survey was developed based on WHO's Assistive Products List (APL). Barriers and facilitators were classified according to the principles of AT access. Analyses revealed acceptability, affordability, and availability as the top three barrier themes across disciplines, including poor acceptance by clients/families due to stigma, high AP costs, and a long waitlist for government-provided devices. Acceptability, affordability, and accessibility were the top three facilitator themes, including community awareness, availability of AP funding, client/family education, and AT service provision training.Impact: Our study identified key enabling strategies for AT access, aimed at reducing reported barriers. Enabling AP provision was determined to be multi-factorial, aimed at users/ families, service providers, organizations, communities, and policymakers. Local stakeholder groups are crucial to understanding challenges and opportunities to AP provision within a low-resource context.
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Affiliation(s)
- Marie Brien
- Amar Seva Sangam, Ayikudy, Tamil Nadu, India
| | - Dinesh Krishna
- Amar Seva Sangam, Ayikudy, Tamil Nadu, India
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Margo Borish
- Faculty of Social Sciences, Applied Disability Studies, Brock University, St Catharines, Canada
| | - Franzina Coutinho
- Amar Seva Sangam, Ayikudy, Tamil Nadu, India
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Abigail Bernardo
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Syeda Rafia Shah
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Kim AJ, An KO, Yang J, Rho ER, Shim J, Eun SD. Predicting adoption of the assistive technology open platform: extended unified theory of acceptance and use of technology. Disabil Rehabil Assist Technol 2024:1-13. [PMID: 38357965 DOI: 10.1080/17483107.2023.2300050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 12/21/2023] [Indexed: 02/16/2024]
Abstract
PURPOSE The Assistive Technology (AT) Open Platform supports people with disabilities, older people, and developers in co-creating new assistive products outside the business realm. To address dissatisfaction with and non-adoption of commercial assistive products, the National Rehabilitation Centre in South Korea created an AT Open Platform as an open-source AT sharing platform to research and develop appropriate assistive technology suitable for users' needs. The emerging concept of AT Open Platform is new for both assistive product users and developers in South Korea. The Extended Unified Theory of Acceptance and Use of Technology (UTAUT2) was utilised to understand the factors influencing the adoption of the AT Open Platform and to gain further insights on its design and future use. MATERIALS AND METHODS Interviews were conducted with six potential AT Open Platform users to develop a questionnaire for predicting behavioural intention. Subsequently, we surveyed 175 potential users to validate the UTAUT2. RESULTS The results revealed that behavioural intention was significantly predicted by social influence, performance expectancy, facilitating conditions, and hedonic motivation. CONCLUSIONS The AT Open Platform should focus on both online and offline platforms to educate and facilitate the co-creation of ATs for assistive product users and makers. This study, which targeted assistive product users and developers, has significant implications for policymakers and future research in using and adopting the AT Open Platform as it reflects the actual voices of the platform's stakeholders.
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Affiliation(s)
- Agnes Jihae Kim
- Graduate School of Science and Technology Policy, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Kwang-Ok An
- Assistive Technology Research Team for Independent Living, National Rehabilitation Center, Seoul, Republic of Korea
| | - Jisun Yang
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Eun-Rea Rho
- Assistive Technology Research Team for Independent Living, National Rehabilitation Center, Seoul, Republic of Korea
| | - Jaewoo Shim
- Assistive Technology Research Team for Independent Living, National Rehabilitation Center, Seoul, Republic of Korea
| | - Seon-Deok Eun
- Assistive Technology Research Team for Independent Living, National Rehabilitation Center, Seoul, Republic of Korea
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Karki J, Rushton S, Bhattarai S, Norman G, Rakhshanda S, De Witte PL. Processes of assistive technology service delivery in Bangladesh, India and Nepal: a critical reflection. Disabil Rehabil Assist Technol 2024; 19:292-301. [PMID: 35746866 DOI: 10.1080/17483107.2022.2087769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE This paper critically reviews and reflects on the processes for providing Assistive Technology (AT) services to Persons with Disabilities (PWD) in Bangladesh, India and Nepal. The aim is to investigate the AT service delivery systems in these countries and suggest improvements where weaknesses are identified. MATERIALS AND METHODS We carried out a descriptive qualitative exploratory study in Bangladesh, India and Nepal by conducting key informant interviews with policymakers (5), AT service providers (22) and mobility and hearing related AT service users (21). We used a directed content analysis approach guided by a seven-point AT service delivery process model to thematically analyse the existing processes for AT service delivery, from first contact through to follow-up and maintenance. RESULTS AT service delivery processes are sub-optimal in all three countries, and improvements are needed. No common AT service delivery process was found, although there are common features. In general, it is easier for PWDs in India and Nepal to access AT than for those in Bangladesh, but all three countries are failing to live up to their commitments to uphold the human rights of PWDs. CONCLUSIONS Although good elements of AT service delivery processes can be identified, the systems in all three countries are fragmented and generally weak. A more holistic approach of looking at the process of AT service delivery, from first contact right through to follow-up and device maintenance, with a single door service delivery system, free of cost at the point of service is recommended in these countries. IMPLICATIONS FOR REHABILITATIONAlthough we found significant weaknesses in AT delivery in all three countries, there are some good AT service delivery practices and opportunities for these countries to learn from one another.A systematic and stepwise approach to assessing current AT service delivery processes in the three countries - examining the delivery system as a whole, from initiation to repair and management - can help identify opportunities to improve the process for (prospective) AT users.A more coherent single door system of AT service delivery will increase the quality and efficiency of the fragmented AT service delivery practices in Bangladesh, India and Nepal.
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Affiliation(s)
- Jiban Karki
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Simon Rushton
- Department of Politics and International Relations, The University of Sheffield, Sheffield, UK
| | | | - Gift Norman
- Community Health, Bangalore Baptist's Hospital, Bangalore, India
| | | | - Prof Luc De Witte
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
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Jacobsen TB, Róin Á. Assistive technology services: user experiences from the Faroe Islands, a small-scale society. Disabil Rehabil Assist Technol 2023:1-9. [PMID: 38038955 DOI: 10.1080/17483107.2023.2289547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/24/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE In the Faroe Islands, an Assistive Technology (AT) Centre allocates and finances AT for all AT users. This study aimed to provide a preliminary evaluation of the Faroese AT services from a user perspective by using recommendations from the Horizontal European Activity on Rehabilitation Technology (HEART) study. METHOD The study enrolled 101 persons aged 8-95 (mean 69 years) using a study-specific questionnaire. The AT service delivery process (AT-SDP) questions included questions about the application and the implementation. User satisfaction was assessed with KWAZO and the service subscale of QUEST with seven and four questions, respectively. The sample and the steps in the AT-SDP were described with frequency distribution. The KWAZO and QUEST results were analysed item-by-item and grouped in "Satisfied" and "Not fully satisfied". A threshold of 33% was used to identify items rated "Not fully satisfied". Associations between items rated "Not fully satisfied" and the AT-SDP were assessed with statistical analysis. RESULTS The participants were mostly satisfied, but Instruction, Professional services and Follow-up were rated "not fully satisfied". The AT centre helped with application and implementation in 9.6% and 12% of the cases, respectively, and other institutions in 62.3% and 43.7% of the cases. No contact had been with professionals in 28.7% and 37.6% of the cases. CONCLUSIONS There was a low degree of satisfaction in different quality parameters. The role of the AT-center seemed reduced to delivering AT and the whole service delivery process appeared to be fragmented and not in line with HEART recommendations.
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Affiliation(s)
| | - Ása Róin
- Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
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Simeoni R, Pirrera A, Meli P, Giansanti D. Promoting Universal Equitable Accessibility: An Overview on the Impact of Assistive Technology in the UN, UNICEF, and WHO Web Portals. Healthcare (Basel) 2023; 11:2904. [PMID: 37958048 PMCID: PMC10650659 DOI: 10.3390/healthcare11212904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
The number of people with disabilities and frailties who need support and assistance is increasing. Assistive technologies (ATs) are increasingly playing a central role in supporting people with disabilities and frailties. The study investigated the impact of the ATs on the websites of the UN, UNICEF, and WHO in terms of proposed activities and actions. The methodology proposed was based on two points of view: (1) A formal process to directly select elements in the institutional webs of the UN, UNICEF, and WHO. (2) A formal process for a complementary literature narrative review based on an umbrella review of Pubmed and Scopus. A standard checklist and a qualification process were applied. The outcome reported 35 documents from the direct search on the web and 19 systematic reviews for the complimentary literature overview. The direct search returned documents related to initiatives focused on the following: The tailoring of the ATs to a person based on international guidelines and specific monitoring initiatives of the AT introduction/access based on surveys both at the population and system/government level with the publication of the data/metadata in an observatory. Dissemination initiatives of both the culture of ATs (e.g., catalog, guidelines, reports, congresses) and of recommendations. The literature overview contributed more specifically to the use and effectiveness of categories of ATs. Both direct research and the literature overview have shown a consistent growth in interest in ATs. The initiatives of the UN, UNICEF, and WHO have been consistent with the institutional role and aimed at improving the diffusion of ATs through capillary monitoring, which is not free from obstacles, and a diffusion of the culture and rational use of ATs. The narrative review shows also the important role of research in monitoring the development, use, and effectiveness of devices, strategies, and support of international institutional initiatives. Important initiatives have been launched internationally on AT in terms of monitoring, dissemination, and improvement in access. However, it is necessary to consider and face the obstacles that limit these initiatives.
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Affiliation(s)
- Rossella Simeoni
- Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168 Roma, Italy
| | - Antonia Pirrera
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| | - Paola Meli
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| | - Daniele Giansanti
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
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Marasinghe KM, Chaurasia A, Adil M, Liu QY, Nur TI, Oremus M. The impact of assistive devices on community-dwelling older adults and their informal caregivers: a systematic review. BMC Geriatr 2022; 22:897. [PMID: 36424533 PMCID: PMC9686024 DOI: 10.1186/s12877-022-03557-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/25/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The purpose of this systematic review is to assess the impact of assistive devices on the life satisfaction of (Research Question 1), and informal caregiving hours received by (Research Question 2), community-dwelling older adults (≥ 65 years). METHODS We searched CINAHL, MEDLINE, and Scopus from database inception to March 2022. For each question, two reviewers independently screened citations, extracted and narratively synthesized the data, and assessed article quality and strength of evidence. RESULTS Of the 1391 citations screened, we found two articles pertaining to each question, for a total of four articles. In general, assistive device use was not associated with life satisfaction, while it was positively associated with informal caregiving hours. However, the risk of bias was serious across the two studies for Research Question 1, and the overall quality of evidence was "very low". The risk of bias was not serious across the two studies included in Research Question 2 and the overall quality of evidence was "low". CONCLUSION Due to the scarcity of studies, the limitations of existing studies (i.e., risk of bias), and the evidence being low or very low quality, we could not draw firm conclusions about the associations of interest. Additional research will produce a better understanding of the two relationships and provide further evidence to inform policy decisions regarding the provision and funding of assistive devices for community-dwelling older adults. TRIAL REGISTRATION This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database of systematic reviews (identification number: CRD42021248929 ).
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Affiliation(s)
- Keshini Madara Marasinghe
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada.,Oxford Institute of Population Ageing, University of Oxford, Oxford, UK
| | - Ashok Chaurasia
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada
| | - Maisha Adil
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada
| | - Qian Yue Liu
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada.,UBC Hospital, 2211 Wesbrook Mall, Vancouver, BC, Canada
| | - Teeyaa Ibrahim Nur
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada
| | - Mark Oremus
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada.
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Albala SA, Kasteng F, Eide AH, Kattel R. Scoping review of economic evaluations of assistive technology globally. Assist Technol 2021; 33:50-67. [PMID: 34951826 DOI: 10.1080/10400435.2021.1960449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The paper presents a scoping review of existing economic evaluations of assistive technology (AT). The study methodology utilized a PRISMA flow approach with final included studies that met an adapted PICOS framework. Types of economic evaluations employed, study type and rigor and domains of AT impact were considered and analyzed. The economic evaluations in this study included 13 CBA, 9 CMA, 18 CEAs and 10 CUA. The majority of studies (32 studies in total) mentioned or recorded that AT investment, access and/or usage had impacts on the domain of both informal and formal health care. Specifically, care costs, time, and resources were affected. Our study has found that current AT economic evaluations are limited. This study advocates for a wider use of robust alternative evaluation and appraisal methodologies that can highlight AT value and which would subsequently provide further evidence that may make governments more willing to invest in and shape AT markets.
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Affiliation(s)
- Sarah Averi Albala
- Institute for Innovation and Public Purpose, University College London, London, UK
| | | | | | - Rainer Kattel
- Institute for Innovation and Public Purpose, University College London, London, UK
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Mental health, substance use, and suicidal ideation among unpaid caregivers of adults in the United States during the COVID-19 pandemic: Relationships to age, race/ethnicity, employment, and caregiver intensity. J Affect Disord 2021; 295:1259-1268. [PMID: 34706440 PMCID: PMC8413485 DOI: 10.1016/j.jad.2021.08.130] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/30/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unpaid caregivers of adults play critical roles in health care systems by providing care to older adults and those with chronic conditions. The COVID-19 pandemic has heightened caregiving needs, forcing some into caregiving roles and disrupting others. We sought to estimate the prevalence of and identify factors associated with adverse mental health symptoms, substance use, and suicidal ideation amongst unpaid caregivers of adults versus non-caregivers. METHODS During June 24-30, 2020, surveys were administered to U.S. adults. Quota sampling and survey weighting were implemented to improve sample representativeness of age, gender, and race/ethnicity. RESULTS Of 9,896 eligible invited adults, 5,412 (54.7%) completed surveys and 5,011 (92.6%) met screening criteria and were analyzed, including 1,362 (27.2%) caregivers. Caregivers had higher adverse mental health symptom prevalences than non-caregivers, including suicidal ideation (33.4% vs 3.7%, p < 0.0001). Symptoms were more common among caregivers who were young vs older adults (e.g., aged 18-24 vs ≥65 years, aPR 2.75, 95% CI 1.95-3.88, p < 0.0001) and with moderate and high vs low Caregiver Intensity Index scores (2.31, 1.65-3.23; 2.81, 2.00-3.94; both p < 0.0001). LIMITATIONS Self-report data may be subject to recall, response, and social desirability biases; unpaid caregivers were self-identified; child caregiving roles were not assessed; and internet-based survey samples might not fully represent the U.S. CONCLUSIONS Caregivers experienced disproportionately high levels of adverse mental health symptoms. Younger caregivers and those with higher caregiving intensity were disproportionately affected. Increased visibility of and access to mental health care resources are urgently needed to address mental health challenges of caregiving.
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Welch V, Mathew CM, Babelmorad P, Li Y, Ghogomu ET, Borg J, Conde M, Kristjansson E, Lyddiatt A, Marcus S, Nickerson JW, Pottie K, Rogers M, Sadana R, Saran A, Shea B, Sheehy L, Sveistrup H, Tanuseputro P, Thompson‐Coon J, Walker P, Zhang W, Howe TE. Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1175. [PMID: 37051456 PMCID: PMC8988637 DOI: 10.1002/cl2.1175] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Background By 2030, the global population of people older than 60 years is expected to be higher than the number of children under 10 years, resulting in major health and social care system implications worldwide. Without a supportive environment, whether social or built, diminished functional ability may arise in older people. Functional ability comprises an individual's intrinsic capacity and people's interaction with their environment enabling them to be and do what they value. Objectives This evidence and gap map aims to identify primary studies and systematic reviews of health and social support services as well as assistive devices designed to support functional ability among older adults living at home or in other places of residence. Search Methods We systematically searched from inception to August 2018 in: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, PsycINFO, AgeLine, Campbell Library, ASSIA, Social Science Citation Index and Social Policy & Practice. We conducted a focused search for grey literature and protocols of studies (e.g., ProQuest Theses and Dissertation Global, conference abstract databases, Help Age, PROSPERO, Cochrane and Campbell libraries and ClinicalTrials.gov). Selection Criteria Screening and data extraction were performed independently in duplicate according to our intervention and outcome framework. We included completed and on-going systematic reviews and randomized controlled trials of effectiveness on health and social support services provided at home, assistive products and technology for personal indoor and outdoor mobility and transportation as well as design, construction and building products and technology of buildings for private use such as wheelchairs, and ramps. Data Collection and Analysis We coded interventions and outcomes, and the number of studies that assessed health inequities across equity factors. We mapped outcomes based on the International Classification of Function, Disability and Health (ICF) adapted categories: intrinsic capacities (body function and structures) and functional abilities (activities). We assessed methodological quality of systematic reviews using the AMSTAR II checklist. Main Results After de-duplication, 10,783 records were screened. The map includes 548 studies (120 systematic reviews and 428 randomized controlled trials). Interventions and outcomes were classified using domains from the International Classification of Function, Disability and Health (ICF) framework. Most systematic reviews (n = 71, 59%) were rated low or critically low for methodological quality.The most common interventions were home-based rehabilitation for older adults (n = 276) and home-based health services for disease prevention (n = 233), mostly delivered by visiting healthcare professionals (n = 474). There was a relative paucity of studies on personal mobility, building adaptations, family support, personal support and befriending or friendly visits. The most measured intrinsic capacity domains were mental function (n = 269) and neuromusculoskeletal function (n = 164). The most measured outcomes for functional ability were basic needs (n = 277) and mobility (n = 160). There were few studies which evaluated outcome domains of social participation, financial security, ability to maintain relationships and communication.There was a lack of studies in low- and middle-income countries (LMICs) and a gap in the assessment of health equity issues. Authors' Conclusions There is substantial evidence for interventions to promote functional ability in older adults at home including mostly home-based rehabilitation for older adults and home-based health services for disease prevention. Remotely delivered home-based services are of greater importance to policy-makers and practitioners in the context of the COVID-19 pandemic. This map of studies published prior to the pandemic provides an initial resource to identify relevant home-based services which may be of interest for policy-makers and practitioners, such as home-based rehabilitation and social support, although these interventions would likely require further adaptation for online delivery during the COVID-19 pandemic. There is a need to strengthen assessment of social support and mobility interventions and outcomes related to making decisions, building relationships, financial security, and communication in future studies. More studies are needed to assess LMIC contexts and health equity issues.
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Affiliation(s)
- Vivian Welch
- Methods CentreBruyère Research InstituteOttawaCanada
| | | | | | - Yanfei Li
- Evidence‐Based Social Science Research Center, School of Public HealthLanzhou UniversityLanzhouChina
| | | | | | - Monserrat Conde
- Cochrane Campbell Global Ageing Partnership FieldFaroPortugal
| | | | | | - Sue Marcus
- Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | | | | | - Morwenna Rogers
- NIHR ARC, South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
| | | | | | - Beverly Shea
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Lisa Sheehy
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Heidi Sveistrup
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
- Faculty of Health SciencesUniversity of OttawaOttawaCanada
| | | | - Joanna Thompson‐Coon
- NIHR ARC South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
| | - Peter Walker
- Faculty of MedicineUniversity of OttawaOttawaCanada
| | - Wei Zhang
- Access to Medicines, Vaccines and Health ProductsWorld Health OrganizationGenevaSwitzerland
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Munyoro J, Machimbidza T, Mutula S. Examining key strategies for building assistive technology (AT) competence of academic library personnel at university libraries in Midlands and Harare provinces in Zimbabwe. JOURNAL OF ACADEMIC LIBRARIANSHIP 2021. [DOI: 10.1016/j.acalib.2021.102364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Pérès K, Zamudio-Rodriguez A, Dartigues JF, Amieva H, Lafitte S. Prospective pragmatic quasi-experimental study to assess the impact and effectiveness of an innovative large-scale public health intervention to foster healthy ageing in place: the SoBeezy program protocol. BMJ Open 2021; 11:e043082. [PMID: 33926977 PMCID: PMC8094369 DOI: 10.1136/bmjopen-2020-043082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION With the accelerating pace of ageing, healthy ageing has become a major challenge for all societies worldwide. Based on that Healthy Ageing concept proposed by the WHO, the SoBeezy intervention has been designed through an older person-centred and integrated approach. The programme creates the environments that maximise functional ability to enable people to be and do what they value and to stay at home in best possible conditions. METHODS AND ANALYSIS Five levers are targeted: tackling loneliness, restoring feeling of usefulness, finding solutions to face material daily life difficulties, promoting social participation and combating digital divide. Concretely, the SoBeezy programme relies on: (1) a digital intelligent platform available on smartphone, tablet and computer, but also on a voice assistant specifically developed for people with digital divide; (2) a large solidarity network which potentially relies on everyone's engagement through a participatory intergenerational approach, where the older persons themselves are not only service receivers but also potential contributors; (3) an engagement of local partners and stakeholders (citizens, associations, artisans and professionals). Organised as a hub, the system connects all the resources of a territory and provides to the older person the best solution to meet his demand. Through a mixed, qualitative and quantitative (before/after analyses and compared to controls) approach, the research programme will assess the impact and effectiveness on healthy ageing, the technical usage, the mechanisms of the intervention and conditions of transferability and scalability. ETHICS AND DISSEMINATION Inserm Ethics Committee and the Comité Éthique et Scientifique pour les Recherches, les Études et les Évaluations dans le domaine de la Santé approved this research and collected data will be deposited with a suitable data archive.
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Affiliation(s)
- Karine Pérès
- Univ. Bordeaux, INSERM, Bordeaux Population Health, U1219, Bordeaux, France
| | | | | | - Hélène Amieva
- Univ. Bordeaux, INSERM, Bordeaux Population Health, U1219, Bordeaux, France
| | - Stephane Lafitte
- University Hospital Centre Bordeaux Cardiology Hospital Anaesthesiology and Reanimation, Pessac, Nouvelle-Aquitaine, France
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13
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Thiamwong L, Stout JR, Park JH, Yan X. Technology-Based Fall Risk Assessments for Older Adults in Low-Income Settings: Protocol for a Cross-sectional Study. JMIR Res Protoc 2021; 10:e27381. [PMID: 33825688 PMCID: PMC8060859 DOI: 10.2196/27381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/19/2021] [Indexed: 01/20/2023] Open
Abstract
Background One-third of older adults have maladaptive fall risk appraisal (FRA), a condition in which there is a discrepancy between the level of fear of falling (FOF) and physiological fall risk (balance performance). Older adults who overestimate their physiological fall risk and report a high FOF are less likely to participate in physical activity. Limited data suggest that the association among FOF, body composition, and physical activity intensity differs by fear severity.
Objective This study aims to examine the associations among FRA, body composition, and physical activity using assistive health technology, including the BTrackS balance system, bioelectrical impedance analysis, and activity monitoring devices. This study also aims to examine the feasibility of recruitment and acceptability of technologies and procedures for use among older adults in low-income settings.
Methods This cross-sectional study will be conducted in older adults’ homes or apartments in low-income settings in Central Florida, United States. Following consent, participants will be contacted, and our team will visit them twice. The first visit includes questionnaire completion (eg, sociodemographic or FOF) and balance performance test using the BTrackS balance system. The participants will be stratified by the FRA matrix. In addition, they will perform hand grip strength and dynamic balance performance tests. Participants will then be asked to wear the ActiGraph GT9X Link wireless activity monitor on the nondominant wrist for 7 consecutive days. The second visit includes body composition testing and a structured interview about the acceptability of the technologies and procedures.
Results Ethical approval was obtained from the institutional review board of the University of Central Florida (protocol number 2189; September 10, 2020). As of December 2020, participation enrollment is ongoing and the results are expected to be published in Summer 2022.
Conclusions Accurate FRA is essential for implementing physical activity programs, especially in older adults with low income. This study will provide data for developing technology-based fall risk assessments to improve participation in physical activity, thus enhancing healthy longevity among older adults in low-income settings.
International Registered Report Identifier (IRRID) PRR1-10.2196/27381
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Affiliation(s)
- Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL, United States.,Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States
| | - Jeffrey R Stout
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States.,School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, United States
| | - Joon-Hyuk Park
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States.,Mechanical and Aerospace Engineering Department, University of Central Florida, Orlando, FL, United States
| | - Xin Yan
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL, United States
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14
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Romli MH, Mackenzie L, Lovarini M, Clemson L, Tan MP. Home Hazards With Fear of Falling: Findings From the Baseline Study of the Malaysian Elders Longitudinal Research (MELoR). Front Public Health 2021; 8:612599. [PMID: 33511098 PMCID: PMC7835712 DOI: 10.3389/fpubh.2020.612599] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/09/2020] [Indexed: 01/18/2023] Open
Abstract
Background: Fear of falling (FoF) is a common issue among older people, impacting on psychological health, functional performance and mortality. Many factors associated with fear of falling have been investigated but little is known about the role of home hazards. Home hazards can be due to unsafe environmental and functional features. This study is aims to evaluate the association between home hazards with fear of falling among community-dwelling individuals aged 55 years and over. Methods: Baseline data with 1,489 older individuals from the Malaysian Elders Longitudinal Research (MELoR) study were analyzed. Home visits for interview and observations in the home were conducted with the participants. FoF was established with a single-item question and home hazards with the Home Falls and Accidents Screening Tool (HOME FAST). Results: The majority (76.4%) of older participants experienced FoF. The history of falls was not associated with FoF (p = 0.868), but FoF was associated with participants limiting their daily activities (p < 0.001). Home hazards were less likely (p = 0.023) and functional issues were more likely (p < 0.001) to be associated with a high degree of FoF. However, both home hazards domains were not associated with activity restriction due to FoF. Conclusions: Education about home hazards from the perspective of person-environment interaction may encourage home hazards management and reduce FoF which should be evaluated in future studies.
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Affiliation(s)
- Muhammad Hibatullah Romli
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.,Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Serdang, Malaysia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Meryl Lovarini
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Lindy Clemson
- Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Maw Pin Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, Faculty of Healthcare and Medical Sciences, Sunway University, Petaling Jaya, Malaysia
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15
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Toro-Hernández ML, Augustine N, Kankipati P, Karg P, Rispin K, Schein RM, Kandavel K, D’Innocenzo ME, Goldberg M, Pearlman J. Preliminary steps of the development of a Minimum Uniform Dataset applicable to the international wheelchair sector. PLoS One 2020; 15:e0238851. [PMID: 32915874 PMCID: PMC7485892 DOI: 10.1371/journal.pone.0238851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 08/25/2020] [Indexed: 11/21/2022] Open
Abstract
Assistive products outcomes are needed globally to inform policy, practice, and drive investment. The International Society of Wheelchair Professionals developed a Minimum Uniform Dataset (MUD) for wheelchair services worldwide with the intent to gather data that is comparable globally. The MUD was developed with the participation of members from around the globe and its feasibility piloted at 3 sites. Three versions of the MUD are now available—a short form with 29 data points (available in English, Spanish, and French) and a standard version with 38 data points in English. Future work is to validate and complete the translation cycles followed by promoting the use of the MUD globally so that the data can be leveraged to inform policy, practice and direct investments.
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Affiliation(s)
| | - Nancy Augustine
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Padmaja Kankipati
- Specialized Mobility Operations and Innovation Pvt. Ltd, Bangalore, India
- Member of the International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
| | - Patricia Karg
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Karen Rispin
- Member of the International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Arts and Science, Letourneau University, Longview, Texas, United States of America
| | - Richard M. Schein
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Member of the International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
| | - Krithika Kandavel
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Megan E. D’Innocenzo
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Mary Goldberg
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jonathan Pearlman
- International Society of Wheelchair Professionals, Pittsburgh, Pennsylvania, United States of America
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
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16
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Toro-Hernández ML, Alvarez L, Vargas-Chaparro MC, Goldberg M. Final Year Students' Knowledge on Basic Manual Wheelchair Provision: The State of Occupational Therapy Programs in Colombia. Occup Ther Int 2020; 2020:3025456. [PMID: 32410924 PMCID: PMC7206879 DOI: 10.1155/2020/3025456] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 04/15/2020] [Indexed: 12/18/2022] Open
Abstract
Access to personal mobility is a human right and as such, it implies the provision of wheelchair services for those with mobility impairments that need one. Lack of appropriately trained personnel is a major contributor to the gap in access to wheelchairs. Assistive technology provision is one of the core competencies of occupational therapists. The goal of this study was to assess the current wheelchair provision knowledge of final year occupational therapy students in Colombia as measured by the International Society of Wheelchair Professionals Basic Wheelchair Service Knowledge Test. A total of 83 students from 7 universities took the test. None of the students met the 70% passing threshold. The highest scores were in the assessment domain while the lowest in the fitting and user training domains. These results suggest that the current wheelchair provision education received in these programs do not meet the World Health Organization guidelines on appropriate wheelchair provision. The implementation of strategies to improve current wheelchair provision education in Colombian occupational therapy programs is granted.
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Affiliation(s)
| | - Liliana Alvarez
- School of Occupational Therapy, Western University, London, Canada
| | | | - Mary Goldberg
- International Society of Wheelchair Professionals, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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17
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Parra MA, Butler S, McGeown WJ, Brown Nicholls LA, Robertson DJ. Globalising strategies to meet global challenges: the case of ageing and dementia. J Glob Health 2020; 9:020310. [PMID: 31777656 PMCID: PMC6858988 DOI: 10.7189/jogh.09.020310] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.,Alzheimer's Scotland Dementia Research Centre, Edinburgh University, UK.,Autonomous University of the Caribbean, Barranquilla, Colombia
| | - Stephen Butler
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.,Equal contribution, sorted alphabetically by surname
| | - William J McGeown
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.,Equal contribution, sorted alphabetically by surname
| | - Louise A Brown Nicholls
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.,Equal contribution, sorted alphabetically by surname
| | - David J Robertson
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.,Equal contribution, sorted alphabetically by surname
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18
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Welch V, Howe TE, Marcus S, Mathew CM, Sadana R, Rogers M, Sheehy L, Borg J, Pottie K, Thompson‐Coon J, Lyddiatt A, Kristjansson E, Nickerson JW, Walker P, Tanuseputro P, Shea B, Sveistrup H, Babelmorad P, Zhang W. PROTOCOL: Health, social care and technological interventions to improve functional ability of older adults: Evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2019; 15:e1054. [PMID: 37131851 PMCID: PMC8356486 DOI: 10.1002/cl2.1054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This is a protocol for a Campbell Evidence and Gap Map. The objectives are to identify and assess the available evidence on health, social care and technological interventions to improve functional ability among older adults.
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Affiliation(s)
- Vivian Welch
- Methods CentreBruyère Research InstituteOttawaCanada
| | - Tracey E. Howe
- School of Health & Life SciencesGlasgow Caledonian UniversityGlasgowUK
| | - Sue Marcus
- Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | | | - Ritu Sadana
- Ageing and Life‐courseWorld Health OrganizationGenevaSwitzerland
| | - Morwenna Rogers
- NIHR PenCLAHRC, Institute of Health ResearchUniversity of Exeter Medical SchoolExeterUK
| | | | - Johan Borg
- Division of Social Medicine and Global HealthLund UniversityMalmoSweden
| | - Kevin Pottie
- Bruyère Research InstituteOttawaONCanada
- Department of Family MedicineUniversity of OttawaOttawaONCanada
| | - Joanna Thompson‐Coon
- NIHR CLAHRC South West Peninsula (PenCLAHRC)University of Exeter Medical SchoolExeterUK
| | | | | | | | - Peter Walker
- Department of MedicineThe Ottawa HospitalOttawaONCanada
| | - Peter Tanuseputro
- Bruyère Research InstituteOttawaONCanada
- Ottawa Hospital Research InstituteOttawaONCanada
| | | | - Heidi Sveistrup
- Bruyère Research InstituteOttawaONCanada
- School of Rehabilitation Sciences, Faculty of Health SciencesUniversity of OttawaOttawaONCanada
| | | | - Wei Zhang
- Vaccines and Health ProductsWorld Health OrganizationGenevaSwitzerland
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19
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Toro-Hernández ML, Kankipati P, Goldberg M, Contepomi S, Tsukimoto DR, Bray N. Appropriate Assistive Technology for Developing Countries. Phys Med Rehabil Clin N Am 2019; 30:847-865. [PMID: 31563175 DOI: 10.1016/j.pmr.2019.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Access to appropriate and affordable assistive technology is a human right, and a public health and development priority. This article elaborates on these aspects and illustrates the various opportunities and barriers to achieving equitable access to assistive technology through 4 specific country snapshots. In Brazil, mobility aids are provided through universal health coverage in rehabilitation reference centers in urban areas. A community-based rehabilitation pilot project in Argentina demonstrates how to reach an excluded indigenous community. A rapidly developing national legal framework in Colombia with imminent implementation challenges is showcased, as is a technology transfer model in India.
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Affiliation(s)
| | - Padmaja Kankipati
- Specialized Mobility Operations & Innovation, 804, Brigade Rubix, No. 20, HMT Main Road, Yeshwanthpura, Bangalore 560022, India
| | - Mary Goldberg
- International Society of Wheelchair Professionals, Department of Rehabilitation Science and Technology, Human Engineering Research Laboratories, University of Pittsburgh, 6425 Penn Avenue Suite 400, Pittsburgh, PA 15206, USA
| | - Silvana Contepomi
- Asociación Argentina de Tecnología Asistiva (AATA), Francia 3166, San Isidro 1642, Argentina
| | - Denise Rodrigues Tsukimoto
- Physical Medicine and Rehabilitation Institute (IMREA), Hospital das Clinicas, University of Sao Paulo, IMREA Rua Diderot, 43, Sao Paulo, Sao Paulo CEP: 04116030, Brazil
| | - Nathan Bray
- School of Health Sciences, Bangor University, Bangor, Gwynedd LL57 2EF, UK
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20
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Bennett B. Technology, ageing and human rights: Challenges for an ageing world. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 66:101449. [PMID: 31706404 DOI: 10.1016/j.ijlp.2019.101449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 05/14/2019] [Indexed: 06/10/2023]
Abstract
Technology can be used to support healthy ageing and to support those who are living with disabilities. With the ageing of populations globally there is increasing interest in the role that technology can potentially play in supporting older persons. This paper analyses the role of technology in supporting everyday living, social engagement, and mobility by older persons, including those living with dementia. It argues for a human rights-based approach to assessing the role that technology can potentially play, arguing for a consideration of: decision-making in relation to use of technology; whether the technology protects privacy, dignity and liberty; whether it fosters mobility and social engagement; and whether it is accessible to all who need it on an equitable basis.
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Affiliation(s)
- Belinda Bennett
- Faculty of Law, Queensland University of Technology (QUT), 2 George Street, Brisbane, Australia.
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21
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Mhatre AA, Lachell S, Pearlman JL. Development, reliability, and piloting of a wheelchair caster failure inspection tool (C-FIT). Disabil Rehabil Assist Technol 2019; 15:195-204. [PMID: 30729825 DOI: 10.1080/17483107.2018.1554714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Wheelchair casters fail frequently in the field causing multiple user consequences and wheelchair breakdowns. To inform caster design improvement, there exists no validated tools that can collect caster failures. This need motivated the development of a user-reported, caster failure inspection tool (C-FIT).Methods: To develop C-FIT, a multistep design and testing approach was used which included face validity testing, test-retest reliability testing and expert review. Reliability testing was conducted with two independent cohorts of wheelchair professionals who inspected caster failures physically and online through pictures. The tool was revised based on testing outcomes and expert feedback. For preliminary data collection and evaluating usability, C-FIT was piloted at wheelchair service centers in Scotland, Indonesia and Mexico.Results: Caster failure items reported in the literature were screened to develop the initial list of C-FIT items. Face validity testing conducted through surveys with wheelchair experts (n = 6) provided 14 items for C-FIT inclusion. The test-retest reliability was found to be high for 10 items with physical failure inspections (n = 12). For each of these items, 75% or more participants had substantial to almost perfect agreement scores (κ = 0.6-1.0). Lower reliability scores were found with online failure inspections (n = 11). C-FIT received positive usability feedback from study participants and data collectors in the field. Pilot field data (n = 31) included comprehensive details about failures useful for manufacturers, designers and researchers to improve caster designs.Conclusions: The C-FIT tool developed in this study has substantial reliability and can be used for documenting caster failures at wheelchair service centers.Implications for rehabilitationCollecting data on caster failures is an important first step to inform design improvements and caster quality testing methods.The caster failure inspection tool is a reliable tool that can be used during wheelchair repair and servicing to collect caster failures in a standardized way.The failure data can be used by wheelchair manufacturers, designers, technicians and researchers to develop reliable caster designs. Wheelchair providers can select caster designs based on context of use.
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Affiliation(s)
- Anand A Mhatre
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephanie Lachell
- Department of Mechanical Engineering and Materials Science, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jonathan L Pearlman
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
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22
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Matter RA, Eide AH. Access to assistive technology in two Southern African countries. BMC Health Serv Res 2018; 18:792. [PMID: 30340484 PMCID: PMC6194741 DOI: 10.1186/s12913-018-3605-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 10/04/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Millions of people in Southern Africa are deprived of basic human rights such as the right to education and work because of the large and growing unmet demand for assistive technologies (AT). Evidence is needed to better characterize the lack of AT access. METHODS This study serves to identify the sociodemographic factors that are associated with access to AT in two countries in Southern Africa, Botswana and Swaziland. To achieve this aim, logistics regression was applied to a subset of variables from two Living Conditions Studies, nationally representative surveys that were conducted in Southern Africa (2014 and 2010). RESULTS In Botswana, 44% of people who needed AT did not receive it, while in Swaziland the unmet need was 67%. Among the sociodemographic variables tested, the type of disability was the most important factor in determining AT access in both countries. The likelihood of AT access was highest in both countries for those who had mobility limitations (i.e., difficulty walking/climbing stairs) [Botswana: 6.4 odds ratio (OR) = 6.4., 95% confidence internal (CI) (3.6-11.3); Swaziland: OR = 3.2, CI (1.4-7.3)], in comparison to those with non-mobility types of disabilities. CONCLUSIONS These findings provide support for governments and other stakeholders in the AT sector to prioritize AT to address the large unmet demand, and expand the range of AT products provided so that people with hearing, seeing, self-care, communication and cognition difficulties have equal access to AT as those with mobility impairments. A step toward achieving these aims is to inventory AT product types that are commonly covered through the public sector in each country, and identify common gaps (e.g., daily living aids). Advancing the AT sector as a whole within Southern Africa will require large scale qualitative studies that achieve a comprehensive understanding of the bottlenecks in regional AT supply, procurement, and delivery systems.
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Affiliation(s)
- Rebecca A. Matter
- Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Falmouth Rd., Observatory, Cape Town, 7925 South Africa
| | - Arne H. Eide
- SINTEF Technology and Society, Oslo, Norway
- Centre for Rehabilitation Studies, Stellenbosch University, Stellenbosch, South Africa
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23
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Smith EM, Gowran RJ, Mannan H, Donnelly B, Alvarez L, Bell D, Contepomi S, Ennion Wegner L, Hoogerwerf EJ, Howe T, Jan YK, Kagwiza J, Layton N, Ledgerd R, MacLachlan M, Oggero G, Pettersson C, Pousada T, Scheffler E, Wu S. Enabling appropriate personnel skill-mix for progressive realization of equitable access to assistive technology. Disabil Rehabil Assist Technol 2018; 13:445-453. [PMID: 29772939 DOI: 10.1080/17483107.2018.1470683] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND METHODS This paper reviews the current capacity of personnel in enabling access to assistive technology (AT) as well as the systems and processes within which they work, and was reviewed, discussed, and refined during and following the Global Research, Innovation, and Education in Assistive Technology (GREAT) Summit. FINDINGS Key concepts addressed include a person-centred team approach; sustainability indicators to monitor, measure, and respond to needs for service design and delivery; education, research, and training for competent practice, using the six rehab-workforce challenges framework; and credentialing frameworks. We propose development of a competence framework and associated education and training programs, and development and implementation of a certification framework for AT personnel. CONCLUSIONS There is a resolve to address the challenges faced by People globally to access assistive technology. Context specific needs assessment is required to understand the AT Personnel landscape, to shape and strengthen credentialing frameworks through competencies and certification, acknowledging both general and specific skill mix requirements. Implications for Rehabilitation Personnel in assistive technology (AT) provision should be trained using a person-centred team approach, which emphasizes appropriate skill-mix to address multiple needs within the community. Sustainability indicators should be used which allow personnel to monitor, measure and respond to needs for service design and delivery. A competence framework with associated education and training program, coupled with the development and implementation of a certification framework for AT personnel needs, will promote quality in AT personnel training globally.
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Affiliation(s)
- Emma M Smith
- a Rehabilitation Sciences, GF Strong Rehabilitation Research Program, University of British Columbia , Vancouver , Canada
| | - Rosemary Joan Gowran
- b School of Allied Health, University of Limerick , Limerick , Ireland.,c University of Sunshine Coast , Sunshine Coast , Australia
| | - Hasheem Mannan
- d School of Nursing, Midwifery & Health Systems Health Sciences Centre, University College Dublin , Dublin , Ireland
| | | | - Liliana Alvarez
- f School of Occupational Therapy, Western University , London , Canada
| | - Diane Bell
- g World Health Organization , Geneva , Switzerland
| | - Silvana Contepomi
- h Argentine Assistive Technology Association , Buenos Aires , Argentina
| | - Liezel Ennion Wegner
- i Department of Physiotherapy, University of Western Cape , Cape Town , South Africa
| | | | | | - Yih-Kuen Jan
- l The Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign , Champaign , IL , USA
| | - Jeanne Kagwiza
- m College of Medicine and Health Sciences, University of Rwanda , Kigali , Rwanda
| | - Natasha Layton
- n Department of Health Professions, Swinburne University , Hawthorn , Australia
| | | | - Malcolm MacLachlan
- p Assisting Living & Learning (ALL) Institute, Maynooth University , Maynooth , Ireland
| | | | - Cecilia Pettersson
- q Department of Architecture and Civil Engineering, Chalmers University of Technology , Goteborg , Sweden
| | - Thais Pousada
- r Faculty of Health Sciences, of A Coruña , A Coruña , Spain
| | - Elsje Scheffler
- s Centre for Rehabilitation Studies, Stellenbosch University , Stellenbosch , South Africa
| | - Sam Wu
- t Geisinger Health System , Danville , CA , USA
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Information Management for the Assistive Technology Provision in Community: Perspectives of Local Policymakers and Health Service Providers. Occup Ther Int 2018; 2018:8019283. [PMID: 29681786 PMCID: PMC5851335 DOI: 10.1155/2018/8019283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 02/13/2018] [Indexed: 11/17/2022] Open
Abstract
Background Assistive technology (AT) is a way to enhance the performance of daily activities in people with disabilities and help them live more independently. However, an important problem in providing AT lies in the effectiveness of information management. Local policymakers and health service providers have become aware of this problem and their perspectives are the key to solving it. Methods This study explored the types of AT provided for people with disabilities in the community and the perspectives on information management of local policymakers and health service providers. A survey checklist and semistructured in-depth interview were the instruments of this study. The key informants in this study included administrators, nurses, and physical therapists from four community areas in Chiang Mai, Thailand. Results The medical records showed that the types of AT provided were mostly second-hand (57.24%) and borrowed devices (57.73%). All of them were low-tech devices (crutch, cane, walker, wheelchair, and adaptive tricycle). In addition, the results indicated three perspective aspects related to information management: (1) problems in the database recording system, (2) different policies and processes of information management, and (3) improvement of the AT provision system. Conclusion The perspectives of local policymakers and health service providers indicated related problems, impacts of policies, and ways to improve the AT provision system by applying information technology.
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Shanmugapriya S, Saravanan T, Rajee SS, Venkatrajan R, Thomas PM. Drug prescription pattern of outpatients in a tertiary care teaching hospital in Tamil Nadu. Perspect Clin Res 2018; 9:133-138. [PMID: 30090712 PMCID: PMC6058512 DOI: 10.4103/picr.picr_86_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose: Drug use prescribing indicators advocated by the World Health Organization (WHO) are important tools for assessing the degree of polypharmacy, use of generic medicines, and to evaluate if there is inappropriate use of antibiotics or parenteral medications besides estimating the adherence to the essential drugs list. This study aimed to assess the WHO prescribing indicators in prescriptions given at the medical outpatient department (OPD) in a private medical college hospital in South India. Materials and Methods: The study was done prospectively from patients when they presented for consultation at the medical OPD at our tertiary care center. Prescriptions were randomly chosen to be analyzed for the WHO prescribing indicators from September 2016 to April 2017. Results: A total of 700 prescriptions were analyzed and the average number of drugs per prescription was 2.955 ± 1.32. 32.57% of prescriptions had fixed drug combinations and a similar value of 36% was obtained for prescriptions containing more than one drug for the same indication. Amongst the prescribing indicators, generic prescribing was appallingly low (6.42%). In contrast, antibiotic prescribing and prescription of injections showed an appreciably rational trend with 15.42% and 8.14%, respectively. Furthermore, the prescription of the drugs enlisted in the essential drugs list was determined to be 90.67%. Discussion: The need for increase in generic prescribing and augmenting the adherence of prescriptions to the essential drugs list has been identified. This can be accomplished by multimodal approach that includes regulatory changes, conducting educational programs directed at attitudinal change among current doctors and imparting modifications in medical curriculum so as to inculcate the culture of abiding by the best prescription practices among budding doctors. Conclusion: This study has delineated the requisite for pertinent changes in current prescribing trends in a tertiary care teaching private colleges.
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Affiliation(s)
- S Shanmugapriya
- Department of Pharmacology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - T Saravanan
- Department of Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - S Saranya Rajee
- Department of Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - R Venkatrajan
- Department of Pharmacy Practice, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Pinky Mariam Thomas
- Department of Pharmacy Practice, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
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McSweeney E, Gowran RJ. Wheelchair service provision education and training in low and lower middle income countries: a scoping review. Disabil Rehabil Assist Technol 2017; 14:33-45. [PMID: 29092684 DOI: 10.1080/17483107.2017.1392621] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Improving access to education and training for those providing wheelchair and seating assistive technology to meet personal posture and mobility requirements, as a basic human right, is a priority. This review considers education and training available to personnel within low and lower middle income countries (LLMIC), to ascertain where gaps in knowledge exist and identify human resource education priorities. METHOD A scoping review, mapping out existing scientific and grey literature within the field between 1993 and 2017 was conducted. The search strategy included use of online databases, manual analogue searches and key stakeholder informant advice. A content analysis process was applied to organize the literature retrieved and extract key themes. RESULTS Education and training in LLMIC appears ad hoc and limited, however, there is growing recognition as to its importance, notably by the World Health Organization and nongovernmental organizations, delivering education initiatives to a number of countries, along with the development of a credentialing test. Inconsistency exists regarding personnel responsible for wheelchair provision, with no specific professional clearly recognized to oversee the system within many LLMIC. CONCLUSIONS Education and training is required for all stakeholders involved in wheelchair provision. Advocating for programme development to enhance personnel skills, build capacity and ensure best practice is a priority. Pilot sites, delivering and credentialing appropriate wheelchair provision education and training within context should be considered. Measuring outcomes and transferable skills should be part of education programme delivery structures. Considering a new discipline responsible for oversight of wheelchair provision should be investigated. Implications for rehabilitation Education and training is an essential step in the wheelchair provision process in the bid to obtain an appropriate wheelchair via appropriate provision services. However, it is more than education and training; its a human rights issue. Mandatory education and training needs to be a requirement for all stakeholders involved in wheelchair provision. Key wheelchair personnel need to establish their central role in this arena. The study raises awareness as to the importance of working with governments to commit to building sustainable wheelchair provision infrastructures.
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Affiliation(s)
- Elizabeth McSweeney
- a Department of Clinical Therapies , Faculty of Education and Health Sciences, University of Limerick , Ireland
| | - Rosemary Joan Gowran
- a Department of Clinical Therapies , Faculty of Education and Health Sciences, University of Limerick , Ireland.,b School of Health & Sport Sciences , Faculty of Science, Health, Education & Engineering, University of the Sunshine Coast , Australia
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Sefcik JS, Johnson MJ, Yim M, Lau T, Vivio N, Mucchiani C, Cacchione PZ. Stakeholders' Perceptions Sought to Inform the Development of a Low-Cost Mobile Robot for Older Adults: A Qualitative Descriptive Study. Clin Nurs Res 2017; 27:61-80. [PMID: 28918654 DOI: 10.1177/1054773817730517] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Creative solutions are needed to support community-dwelling older adults residing in a variety of settings including their house, apartment, or Supportive Apartment Living (SAL) to promote independence and reduce the risk of nursing home replacement. The objective of this study was to gain an understanding of older adults' needs for physical, mental, and social activities to support the design and functionality of a low-cost mobile assistive robot. A qualitative descriptive study was designed which included three stakeholder focus groups (caregivers, clinicians, and older adults). We held three focus groups with a total of 19 participants: one with paid caregivers ( n = 6), one with interdisciplinary clinicians ( n = 8), and one with older adults residing in SAL ( n = 5). Conventional content analysis was the analytical technique. Four themes emerged: (a) Accomplishing Everyday Tasks: activities of daily living (ADLs) and instrumental activities of daily living (IADLs) were important from the perspectives of all three groups for the older adults to accomplish daily, as well as the "use it or lose it" attitude of the older adults; (b) Personal Connections and Meaningful Activities: for the older adults, it was important for them to engage in socialization and leisure activities, and for the caregivers and clinicians, they work to build personal relationships with the older adults; (c) Cognitive Interventions: the clinicians provided cognitive tools (including reminders, routine and designing interventions) to older adults so they can remain as safe and independent as possible in the SAL; and (d) Safety Measures: encompassed clinicians addressing safety and injury prevention and the caregivers checking in on the older adults in their SAL apartments. This work contributed to the design and functionality specifications for an autonomous low-cost mobile robot for deployment to increase the independence of older adults.
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Affiliation(s)
| | | | - Mark Yim
- 1 University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | - Pamela Z Cacchione
- 1 University of Pennsylvania, Philadelphia, PA, USA.,4 Penn Presbyterian Medical Center, Philadelphia, PA, USA
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Mhatre A, Martin D, McCambridge M, Reese N, Sullivan M, Schoendorfer D, Wunderlich E, Rushman C, Mahilo D, Pearlman J. Developing product quality standards for wheelchairs used in less-resourced environments. Afr J Disabil 2017; 6:288. [PMID: 28936410 PMCID: PMC5594264 DOI: 10.4102/ajod.v6i0.288] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 06/27/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Premature failures of wheelchairs in less-resourced environments (LREs) may be because of shortcomings in product regulation and quality standards. The standards published by the International Organization for Standardization (ISO) specify wheelchair tests for durability, safety and performance, but their applicability to products used in the rugged conditions of LREs is unclear. Because of this, wheelchair-related guidelines published by the World Health Organization recommended developing more rigorous durability tests for wheelchairs. OBJECTIVES This study was performed to identify the additional tests needed for LREs. METHODS First, a literature review of the development of ISO test standards, wheelchair standards testing studies and wheelchair evaluations in LREs was performed. Second, expert advice from members of the Standards Working Group of the International Society of Wheelchair Professionals (ISWP) was compiled and reviewed. RESULTS A total of 35 articles were included in the literature review. Participation from LREs was not observed in the ISO standards development. As per wheelchair testing study evidence, wheelchair models delivered in LREs did not meet the minimum standards requirement. Multiple part failures and repairs were observed with reviewed field evaluation studies. ISWP experts noted that several testing factors responsible for premature failures with wheelchair parts are not included in the standards and accordingly provided advice for additional test development. CONCLUSION The study findings indicate the need to develop a wide range of tests, with specific tests for measuring corrosion resistance of the entire wheelchair, rolling resistance of castors and rear wheels, and durability of whole wheelchair and castor assemblies.
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Affiliation(s)
- Anand Mhatre
- Human Engineering Research Laboratories, Department of Veterans Affairs, United States
- Department of Rehabilitation Science and Technology, University of Pittsburgh, United States
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
| | - Daniel Martin
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
| | - Matt McCambridge
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
| | - Norman Reese
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
| | - Mark Sullivan
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
| | - Don Schoendorfer
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
| | - Eric Wunderlich
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
| | - Chris Rushman
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
| | - Dave Mahilo
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
| | - Jon Pearlman
- Human Engineering Research Laboratories, Department of Veterans Affairs, United States
- Department of Rehabilitation Science and Technology, University of Pittsburgh, United States
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
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Bennett B, McDonald F, Beattie E, Carney T, Freckelton I, White B, Willmott L. Assistive technologies for people with dementia: ethical considerations. Bull World Health Organ 2017; 95:749-755. [PMID: 29147055 PMCID: PMC5677608 DOI: 10.2471/blt.16.187484] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/09/2017] [Accepted: 03/29/2017] [Indexed: 12/03/2022] Open
Abstract
The sustainable development goals (SDGs) adopted by the United Nations in 2015 include a new target for global health: SDG 3 aims to “ensure healthy lives and promote well-being for all at all ages.” Dementia care of good quality is particularly important given the projected increase in the number of people living with the condition. A range of assistive technologies have been proposed to support dementia care. However, the World Health Organization estimated in 2017 that only one in 10 of the 1 billion or more people globally who could benefit from these technologies in some way actually has access to them. For people living with dementia, there has been little analysis of whether assistive technologies will support their human rights in ways that are consistent with the United Nations Convention on the Rights of Persons with Disabilities. The aim of this paper is to examine the relevant provisions of the convention and consider their implications for the use of assistive technologies in dementia care. Assistive technologies can clearly play an important role in supporting social engagement, decision-making and advance planning by people living with dementia. However, concerns exist that some of these technologies also have the potential to restrict freedom of movement and intrude into privacy. In conclusion, an analysis of the implications of assistive technologies for human rights laws is needed to ensure that technologies are used in ways that support human rights and help meet the health-related SDG 3.
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Affiliation(s)
- Belinda Bennett
- Australian Centre for Health Law Research, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4000, Australia
| | - Fiona McDonald
- Australian Centre for Health Law Research, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4000, Australia
| | - Elizabeth Beattie
- Dementia Collaborative Research Centre, Queensland University of Technology, Brisbane, Australia
| | - Terry Carney
- Law School, University of Sydney, Sydney, Australia
| | - Ian Freckelton
- Law School, University of Melbourne, Melbourne, Australia
| | - Ben White
- Australian Centre for Health Law Research, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4000, Australia
| | - Lindy Willmott
- Australian Centre for Health Law Research, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4000, Australia
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Garçon L, Khasnabis C, Walker L, Nakatani Y, Lapitan J, Borg J, Ross A, Velazquez Berumen A. Medical and Assistive Health Technology: Meeting the Needs of Aging Populations. THE GERONTOLOGIST 2017; 56 Suppl 2:S293-302. [PMID: 26994268 DOI: 10.1093/geront/gnw005] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE OF THE STUDY To identify policy gaps in the delivery and availability of assistive health technology (AHT) and medical devices (MD) for aging populations, particularly in low- and middle-income countries (LMICs). DESIGN AND METHODS The findings presented in this paper are the results of several narrative overviews. They provide a contextual analysis of the conclusions and evidence from WHO commissioned research and expert consultations in 2013 and 2014, as well as a synthesis of literature reviews conducted on AHT and MD. RESULTS Practical, life-enhancing support for older people through AHT, MD, and related health and social services is a neglected issue. This is particularly so in LMICs where the biggest increases in aging populations are occurring, and yet where there is commonly little or no access to these vital components of healthy aging. IMPLICATIONS Health technologies, especially medical and assistive health technology, are essential to ensure older people's dignity and autonomy, but their current and potential benefits have received little recognition in LMICs. Viewing these technologies as relevant only to disabled people is an inadequate approach. They should be accessible to both older adults with disabilities and older adults with functional limitation. Many countries need much greater official awareness of older adults' needs and preferences. Such attitudinal changes should then be reflected in laws and regulations to address the specificities of care for older people.
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Affiliation(s)
- Loïc Garçon
- World Health Organization Centre for Health Development, Kobe, Japan.
| | | | | | | | - Jostacio Lapitan
- World Health Organization Centre for Health Development, Kobe, Japan
| | - Johan Borg
- Department of Health Sciences, Lund University, Malmö, Sweden
| | - Alex Ross
- World Health Organization Centre for Health Development, Kobe, Japan
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Psychosocial Impact of Assistive Technologies for Mobility and Their Implications for Active Ageing. TECHNOLOGIES 2016. [DOI: 10.3390/technologies4030028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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