Access to urban transportation system for individuals with disabilities

Aging not only affect biomarker-related processes, but it also affects the physiological processes of the human body. Of all the physiological processes, hearing and vision are of utmost importance to a human. Therefore, this study examines the prevalence and factors associated with hearing and vision difficulty and their sequential treatment among older adults in India. Utilizing data from Building a Knowledge Base on Population Aging in India, study used two sets of outcome variables; firstly, self-reported hearing and vision difficulty and secondly, treatment-seeking for hearing and vision difficulty. A total of 9541 older adults aged 60+ years from seven major regionally representative states were selected. Descriptive statistics were used to perform preliminary analysis. Additionally, the study employed the Heckprobit selection model. It is a two-equation model. This model is used in order to accommodate the heterogeneity (i.e., shared unobserved factors) among older adults and then address the endogeneity (between hearing and vision loss problems and their treatment-seeking behaviour) for older adults in India, the model offers a two-step analysis and deals with the zero-sample issue. Around 59% and 21% of older adults reported vision and hearing difficulty, respectively. Only 5% of older adults suffering from hearing difficulty reported utilizing hearing aids. Lifestyle factors (smoking tobacco and chewing tobacco) significantly affect hearing and vision difficulty; various chronic diseases were also found to be associated with high levels of hearing and vision difficulty among older adults. Results from Heckprobit model shows that older adults with 11+ years of education had higher probability to use visual [β = 0.54, 95% confidence interval (CI): 0.37, 0.70] and hearing aids [β = 0.6, 95% CI: 0.18, 1.02]. The use of hearing and vision aids was lower among poor older adults, older adults from Scheduled Caste, and older adults in rural areas. The study indicates that more than half of older adults face vision difficulty and almost one-fourth face hearing difficulty in rural India, education and lifestyle appear to be the main driver of health-seeking behaviour. Additional attention shall be given to understand the strategies that may advocate a higher use for hearing aids among older adults.

Preconception health risks by presence and type of disability among U.S. women

Scenario simulation of CO2 emissions from light-duty passenger vehicles under land use-transport planning: A case of Shenzhen International Low Carbon City

Introduction Transportation access, a social determinant of health, influences health outcomes and community participation. However, transportation is an underexplored factor in burn outcomes. Therefore, this study aims to examine the associations between transportation access, service utilization, and community reintegration after burn injury. Methods A multicenter burn longitudinal dataset was analyzed from 2018 to 2024. Self-reported mode of transportation was examined for adults at discharge and 6, 12, 24, and 60 months after injury. The population was categorized into two groups: driving their own vehicle versus other modes of transportation (riding with someone else, public transit, and not applicable). Self-reported utilization of outpatient care services included physical/occupational therapy, peer support, psychological services, and burn-related surgeries. Demographic and clinical variables were compared between groups. Logistic and linear regression analyses, respectively, examined the association between transportation modality and service utilization and community integration (Community Integration Questionnaire – Social Interaction domain) at 6 months. Results Of the 563 participants with self-reported transportation data at 6 months, 373 (66.3%) reported driving their own vehicle, 151 (26.8%) riding with someone else, and 31 (5.5%) using public transit. The proportion of those who reported driving their own vehicle increased at each post-injury time point (74.7-83.8%). The driving own-vehicle group was more likely to be White (p=0.002), non-Hispanic/Latino (p=0.001), higher educated, earning a higher income, employed, and married or living with a partner; they also exhibited shorter acute and rehabilitation hospital stays and were less likely to have a range of motion deficit and receive disability income (p< 0.001 for all other comparisons). Regression analyses revealed no significant associations between driving one’s own vehicle and utilization of the four health care services examined at 6 months. In contrast, regression analysis indicated that driving one’s own vehicle was associated with higher community integration scores (β = 1.23, p< 0.001). Conclusions This study found that driving one’s own vehicle was positively associated with community integration but not with utilization of services 6 months after injury. Results suggest that transportation access may play an important role early in community reintegration. Applicability of Research to Practice Addressing transportation barriers may contribute to improved community integration outcomes after burn injury. Funding for the Study NIDILRR #90DPBU0008 and #90DPGE0004

BackgroundThe United Nations through universal health coverage, including sexual and reproductive health (SRH), pledges to include all people, leaving no one behind. However, people with disabilities continue to experience multiple barriers in accessing SRH services. Studies analysing the impacts of disability in conjunction with other social identities and health determinants reveal a complex pattern in SRH service use. Framed within a larger mixed methods study conducted in Uganda, we examined how disability, among other key social determinants of health (SDH), was associated with the use of SRH services.MethodsWe analysed data from repeated cross-sectional national surveys, the Uganda Demographic and Health Surveys (DHS) of 2006, 2011, and 2016. The three outcomes of interest were antenatal care visits, HIV testing, and modern contraception use. Our main exposure of interest was the type of disability, classified according to six functional dimensions: seeing, hearing, walking/climbing steps, remembering/concentrating, communicating, and self-care. We performed descriptive and multivariable logistic regression analyses, which controlled for covariates such as survey year, sex, age, place of residence, education, and wealth index. Interaction terms between disability and other factors such as sex, education, and wealth index were explored. Regression analyses were informed by an intersectionality framework to highlight social and health disparities within groups.ResultsFrom 2006 to 2016, 15.5-18.5% of study participants lived with some form of disability. Over the same period, the overall prevalence of at least four antenatal care visits increased from 48.3 to 61.0%, while overall HIV testing prevalence rose from 30.8 to 92.4% and the overall prevalence of modern contraception use increased from 18.6 to 34.2%. The DHS year, highest education level attained, and wealth index were the most consistent determinants of SRH service utilisation. People with different types of disabilities did not have the same SRH use patterns. Interactions between disability type and wealth index were associated with neither HIV testing nor the use of modern contraception. Women who were wealthy with hearing difficulty (Odds Ratio (OR) = 0.15, 95%CI 0.03 – 0.87) or with communication difficulty (OR = 0.17, 95%CI 0.03 – 0.82) had lower odds of having had optimal antenatal care visits compared to women without disabilities who were poorer.ConclusionThis study provided evidence that SRH service use prevalence increased over time in Uganda and highlights the importance of studying SRH and the different disability types when examining SDH. The SDH are pivotal to the attainment of universal health coverage, including SRH services, for all people irrespective of their social identities.

REVIEW QUESTION/OBJECTIVE The objective of this systematic review is to identify policies related to age-friendly cities, and to establish the impact of age-friendly policies on psychosocial wellbeing and quality of life for older adults living in inner city environs. INCLUSION CRITERIA Types of participants The participants of interest will be older adults as defined by the WHO criteria ageing, and who live in an inner city context. Phenomena of interest The phenomena of interest are the experiences that impact quality of life and psychosocial wellbeing attributable to policies that initiate, promote or enhance an 'age-friendly' city living for older adults. Phenomena associated with impact on the lives of older adults, or impact on the perspectives of the wider local community will also be included where available. Context The context is focused on establishing what policy imperatives are associated with an age-friendly city plan. This includes both western and eastern perspectives, and all geographic/cultural regions provided there are accessible policy documents that relate to inner city living. The context may be expressed through changes in policy, in design or development, changes in cultural policy or perspectives on being aged and living in an inner city environment, and empowerment of older adults living in an inner city environment.

A disproportionate number of persons with disabilities live in developing countries, often marginalized and in extreme poverty. They face discrimination and barriers that restrict them from participating in society. About 10 to 12% of the total populations in Egypt are suffering from different types of disabilities. They face restrictions that prevent them from normal life, and then they lose their motivation for challenging their disabilities. Besides that, there are problems about accessing entertainment spaces to keep their positive energy. Architects have their role to help people with disabilities to enjoy accessible recreational spaces although their disabilities. The aim of this research is to determine strategies for design entertainment spaces which is accessible, provide an integration in community with different abilities in a safe pleasing environment for all. This research will analyse examples of inclusion in recreational spaces in deferent countries, study universal design strategies that are common in these examples, then with making comparison between international strategies and the requirements which are included in the Egyptian Code, Conclusion can be achieved as a step toward accessible recreational spaces for people with disabilities.

This is a comparative study aiming to investigate quality of life (QoL) and depression in individuals diagnosed either with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), or genital warts (GW) and genital herpes (GH), in two healthcare settings, in the United Kingdom (UK) or in Greece (Gr). Using a matched-pairs design, two equalized patient samples with sexually transmitted infections (STI) were recruited: from UK (n=43) and from Greece (n=43). QoL was assessed with WHOQOL-HIV BREF for HIV patients and WHOQOL-STI BREF -a newly adapted instrument- for genital warts and genital herpes patients. Depressive symptomatology was measured by the Centre for Epidemiological Studies- Depression Scale (CES-D) along with sociodemographic data. Results indicate that in both country- healthcare settings, a high percentage of individuals diagnosed with any type of STI, reported considerable depressive symptomatology: 35.7% for UK and 41.5% for Greek participants respectively. Regarding QoL, participants in the Greek healthcare settings reported significantly lower scores in the environment domain, and even lower scores were reported by the GW/GH group, in comparison to HIV. Specifically, these groups indicated significantly lower values in the following WHOQOL-BREF environment facets: (i) physical safety and security, (ii) participation in and opportunities for recreation/leisure activities, (iii) home environment, (iv) accessibility and quality in health and social care, and (v) transport facilities. Regarding correlation of QoL and depression, regression analysis provided significant evidence for depression having a differential effect on WHOQOL-BREF QoL domains. Evidence of increased depressive symptomatology in both STI patient- cohorts may shed light into unmet healthcare needs that should be addressed by healthcare providers in UK and Greece respectively. Furthermore, all types of Greek STI participants reported lower QoL, particularly the GW/GH group, indicating important unmet QoL needs in the environment domain, such as health and social care accessibility and quality, or environmental and social resources, all lowering everyday QoL. The present findings may provide guidelines for tailored mental health interventions alleviating depressive symptomatology in STI patients. Provision of targeted-interventions at healthcare and social-environmental levels will contribute to QoL/ health improvement in STI patients.

BackgroundThe use of personal computers (PCs) and the Internet to provide health care information and interventions has increased substantially over the past decade. Yet the effectiveness of such an approach is highly dependent upon whether the target population has both access and the skill set required to use this technology. This is particularly relevant in the delivery of hearing health care because most people with hearing loss are over 50 years (average age for initial hearing aid fitting is 74 years). Although PC skill and Internet use by demographic factors have been examined previously, data do not currently exist that examine the effects of hearing difficulties on PC skill or Internet use in older adults.ObjectiveTo explore the effect that hearing difficulty has on PC skill and Internet use in an opportunistic sample of adults aged 50-74 years.MethodsPostal questionnaires about hearing difficulty, PC skill, and Internet use (n=3629) were distributed to adults aged 50-74 years through three family physician practices in Nottingham, United Kingdom. A subsample of 84 respondents completed a second detailed questionnaire on confidence in using a keyboard, mouse, and track pad. Summed scores were termed the “PC confidence index.” The PC confidence index was used to verify the PC skill categories in the postal questionnaire (ie, never used a computer, beginner, and competent).ResultsThe postal questionnaire response rate was 36.78% (1298/3529) and 95.15% (1235/1298) of these contained complete information. There was a significant between-category difference for PC skill by PC confidence index (P<.001), thus verifying the three-category PC skill scale. PC and Internet use was greater in the younger respondents (50-62 years) than in the older respondents (63-74 years). The younger group’s PC and Internet use was 81.0% and 60.9%, respectively; the older group’s PC and Internet use was 54.0% and 29.8%, respectively. Those with slight hearing difficulties in the older group had significantly greater odds of PC use compared to those with no hearing difficulties (odds ratio [OR]=1.57, 95% confidence interval [CI] 1.06-2.30, P=.02). Those with moderate+ hearing difficulties had lower odds of PC use compared with those with no hearing difficulties, both overall (OR=0.58, 95% CI 0.39-0.87, P=.008) and in the younger group (OR=0.49, 95% CI 0.26-0.86, P=.008). Similar results were demonstrated for Internet use by age group (older: OR=1.57, 95% CI 0.99-2.47, P=.05; younger: OR=0.32, 95% CI 0.16-0.62, P=.001).ConclusionsHearing health care is of particular relevance to older adults because of the prevalence of age-related hearing loss. Our data show that older adults experiencing slight hearing difficulty have increased odds of greater PC skill and Internet use than those reporting no difficulty. These findings suggest that PC and Internet delivery of hearing screening, information, and intervention is feasible for people between 50-74 years who have hearing loss, but who would not typically present to an audiologist.

Travel patterns in suburban areas are different from those of other areas as the characteristics of activities are specific to a particular area. The distribution of such activities in an area may be found in terms of the economic activities of the households and their social attributes such as age, sex, educational level etc, denoting the intensity of engagement in these activities. On the other hand, the level of activity in an area is also determined by the supply of facilities for such activities, such as availability of transport, employment opportunities, commercial and service facilities and recreational facilities, found in the given area, it has been observed that most of these supply functions do not vary significantly in the short term, a concept which has been used since the very early stages of travel forecast modelling. Therefore, it has been found, that travel behaviour in a given area can be forecasted using primarily, the activity characteristics, of its population, as the demand variable. This research paper is an attempt to forecast the travel behaviour of a suburban community, based on their social and economic activity status. It is based on an empirical analysis of travel demand data and the corresponding socio-economic activity profile of 30 Gramaseva Niladhari Divisions (GNDs) in a suburban area of Colombo. The results based on a category analysis between these variables, indicate the possibility of estimating the aggregate trip rates of a GND, based on its population classified by groups engaged in different socio-economic activities. The paper concludes by determining trip generation rates for different socio-economic households, based on their aggregate activity profile. Furthermore, that this method could be used for estimating trip generation in any suburban area wherein such data are available.

PurposeAs the population of the western world is aging, the importance of seniors for the tourism economy is growing. Seniors are expected to be an important future market. Thus overall leisure behaviour in general, and travel and tourism behaviour in particular, are analysed for the example of the Austrian market.Design methodology/approach A focus group was conducted with participants aged 55+, where their leisure and travel habits as well as preferences were investigated.FindingsThe results showed that leisure and travelling played a major role in the participants’ lives. Additionally, the participants did not change their travel behaviour considerably when entering retirement status. While they changed their preferences to longer stays and to travelling off‐season, their preferences considering holiday destinations, mode of transport or distance of travel did not change significantly. The assumption that travel behaviour and travel preferences are acquired over a longer time span during the life of tourists and will therefore not change considerably when retiring can be confirmed for the participants of the focus group.Research limitations/implicationsIt can be concluded that future senior tourists will differ from today’s travelling seniors in their travel behaviour and their preferences. A larger sample and more detailed research concerning the actual motivation and preferences of Austrian holiday travellers, as well as the factors influencing them, are necessary in order to be able to react adequately to future demands of senior tourists.Originality/value The paper contributes to a better understanding of the importance of and attitude towards leisure and tourism in the growing senior market. Based on the results of a focus group, it serves as a basis for further research in the field.

WHAT IS KNOWN ON THE SUBJECT?: Mental health treatments have become patient-centred. Evaluating recovery in people with mental health difficulties living in the community can help to develop better client-centred services. Community integration is critical to recovery in patients with mental health difficulties. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This is the first study to use a single integrated measure of mental health recovery to evaluate the effect of community integration. Physical community integration was the easiest goal for most to reach. Developing independence/self-actualization was harder. In mental health recovery, most people were able to overcome stuckness. Developing abilities for basic functioning was harder. Participating in mental health centre day programmes promoted mental health recovery in people with mental health difficulties living in the community. Independence/self-actualization, psychological integration and social support improved mental health recovery in people with mental health difficulties living in the community. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is a need to develop and actively promote programmes that attract people with mental health difficulties living in the community so that they will actively use mental health centre services. Offering systematic social skills training and occupational rehabilitation therapy to people with mental health difficulties living in the community may help them function independently. Mental health service programmes should provide volunteer opportunities for people with mental health difficulties living in the community to facilitate a sense of belonging. Mental health nurses should serve as a social support resource for people with mental health difficulties living in the community by providing education to family and friends on how to support patients' recovery, and invigorating integration projects such as "making healthy friends." Abstract Introduction Although community integration of people with mental health difficulties and a consumer-centred recovery paradigm are of global importance, little research has been conducted on community integration factors that directly affect mental health recovery. Aim This study investigated the relationship between community integration and mental health recovery in people with mental health difficulties living in the community in South Korea. Method Data were collected from 155 people with mental health difficulties living in the community, using the Self-Reporting Scale of Community Integration and the Mental Health Recovery Measure (Korean version), and analysed using hierarchical regression analysis. Results Among the community integration subscales, independence/self-actualization, psychological integration and social support were significant factors in mental health recovery, explaining 47.3% of the variance. Discussion An effective intervention strategy for mental health recovery of people with mental health difficulties living in the community may reinforce community integration by carefully considering independence/self-actualization, psychological integration and social support. Implications for practice Mental health nurses should provide intervention to people with mental health difficulties living in the community to help them develop strategies for functioning independently, experiencing a sense of achievement and developing a sense belonging in the community.

The whole world experienced in the last decades a continuous change in the age pyramid related to the population aging, where there is an increase in the elderly population (over 65 years) when compared with other age groups [1]. Such demographic change is not essentially an issue, since it demonstrates that the life expectancy is increasing, directly related to many advances in medicine, public health and biotechnology as well as social and economic developments that allow access for the general population to health treatments [1]. The population aging in conjunction with chronic diseases, where some of them are also age-related, leads to some clinical conditions that can affect human health such as osteoarthritis, rheumatoid arthritis, Alzheimer's disease, Parkinson's disease and weakness of the skeletal muscles [2]. These clinical conditions can lead to different types of disabilities, and the most common type is locomotion impairment, which occurs with nearly 14% of the world population [3] and represents around 1 billion people. As locomotor impairment harms work performance, activities of daily living and independence in the community, there is a necessity for continuous treatment of the different conditions that result in locomotor impairments.

BackgroundIt has been estimated that 9.4% of women giving birth in the United Kingdom have one or more limiting longstanding illness which may cause disability, affecting pregnancy, birth and early parenting. No large scale studies on a nationally representative population have been carried out on the maternity experiences of disabled women to our knowledge.MethodSecondary analysis of data from a survey of women in 2010 by English National Health Service Trusts on behalf of the Care Quality Commission was undertaken. 144 trusts in England took part in the postal survey.Women self-identified with disability and were excluded if less than 16 years of age or if their baby had died. The 12 page structured questionnaire with sections on antenatal, labour and birth and postnatal care covered access, information, communication and choice. Descriptive and adjusted analyses compared disabled and non-disabled groups. Comparisons were made separately for five disability subgroups: physical disability, sensory impairment, mental health conditions, learning disability and women with more than one type of disability.ResultsDisabled women comprised 6.14% (1,482) of the total sample (24,155) and appeared to use maternity services more than non-disabled women. Most were positive about their care and reported sufficient access and involvement, but were less likely to breastfeed. The experience of women with different types of disability varied: physically disabled women used antenatal and postnatal services more, but had less choice about labour and birth; the experience of those with a sensory impairment differed little from the non-disabled women, but they were more likely to have met staff before labour; women with mental health disabilities also used services more, but were more critical of communication and support; women with a learning disability and those with multiple disabilities were least likely to report a positive experience of maternity care.ConclusionThis national study describes disabled women’s experiences of pregnancy, child birth and postnatal care in comparison with non-disabled women. While in many areas there were no differences, there was evidence of specific groups appropriately receiving more care. Areas for improvement included infant feeding and better communication in the context of individualised care.

Can we afford to grow older? Population aging and social security