Accessibility, Disability, and Inclusive Instrument Design

There is an increasing body of work that explores the potential of inclusive and human-centred design to address challenges to our societies’ healthcare. However, there is limited evidence of the utilisation and understanding of these approaches specifically in oral healthcare. This paper reviews the state of inclusive and human-centred design in oral healthcare. A systematic mapping study is used to identify 50 projects relevant to inclusive and human-centred design in oral healthcare. The data extracted from each project helps to examine the nature of inclusive and human-centred design in oral healthcare, reflect on who is being designed for and with, and assess the balance of outcomes and contributions being produced. The review reveals limited recognition and awareness of the two fields, particularly inclusive design, highlighting issues of design communication and application, and uncovering key gaps and missed opportunities that might inform future design activity in this area.

Challenges and trends, such as person-centred care, demographic shifts and technological advancements, are transforming oral health systems. Inclusive design and human-centred design are disciplines highly relevant and potentially instrumental to these oral healthcare transformations. This paper provides an overview of the definitions and characteristics of inclusive and human-centred design which centre on understanding people's multifaceted needs, expectations, behaviours and relationships, and engaging with diverse and often excluded populations. Design's broad capabilities are outlined across outcome and contribution types and the potential role of inclusive and human-centred design to oral health is explored by outlining its relevance to key transformational, societal and technological shifts. Finally, barriers and drivers to the adoption of inclusive and human-centred design in oral health are discussed around three themes: awareness and understanding of the role and value of design; disciplinary differences; and the wider healthcare systems context.

Despite more autism research taking place than ever before, there is a disconnect between the current landscape of autism research and what autistic people and their allies want from research. While participatory research has been proposed as a potential solution, we know little about how researchers (particularly, early career researchers) employ this approach. We interviewed 25 researchers (14 early career and 11 established researchers) about their views and experiences of participatory autism research. Through reflexive thematic analysis of interview and focus group data, we identified three themes. First, our participants emphasised the flexible nature of participatory research, and the many forms it can take; yet noted that this flexibility could cause confusion. Second, our participants highlighted the importance of building relationships with research partners, while commenting on the challenges around effective communication and working with diverse groups of people who may have limited research experience. Finally, participants described the challenges of working within academic environments that are not conducive to participatory research (e.g. due to limited time, funding and support). We discuss these issues with regard to changes required at both an individual and systemic level, ensuring that efforts are made to meaningfully involve autistic people and their allies in all stages of the research process.Lay abstract‘Participatory autism research’ refers to ways of involving autistic people and their allies (e.g. family members) in making decisions about research. These decisions can include what research gets done, how it gets done and how research findings are used. While there is more and more interest in participatory autism research, we know little about how researchers at different stages of their careers use this approach. To find out more, we discussed these issues with 25 researchers. Fourteen of these were at an early stage of their careers, and 11 were more senior researchers. We spoke to people in individual interviews or in groups. We then used a technique called thematic analysis to analyse our data, which involved us looking for common topics or ‘themes’ discussed by our participants. What did we find? Our participants told us that participatory autism research was a flexible approach, meaning that autistic people can be involved in research in many different ways. While people viewed this flexibility in a positive way, it also caused some confusion about what does or does not ‘count’ as participatory research. Our participants also spoke about how important it was to build relationships with those involved in their research, but they also said it could be difficult to communicate well with diverse groups of people who may not have much experience of research. Finally, our participants said it was hard to do participatory research when there was not much time, funding or support available to researchers. In this article, we discuss these findings, focusing on what needs to change to ensure that autistic people and their allies are meaningfully involved in autism research.

A considerable literature has grown up around the theme of inclusive design, but few studies have pointed the challenges to educate it. Recently, the inclusive design concept and philosophy have been included in the engineering design curricula as part of human factors and ergonomics module in a Mexican University. The expected value was to create empathy and awareness about physical and cognitive differences of the potential users among young students. The aim of this paper is to describe the teaching experiences and challenges of executing a design project using by the first time an inclusive design approach. Nine design proposals were developed during a five-month workshop by 40 undergraduate students and two teachers following methods from both human-centered and inclusive design. In collaboration with a non-profit organisation, each team designed a product to help children with arthrogryposis, spinal cord injury, cerebral palsy or hemiparesis to carry out a daily life activity. Some issues were identified from the student’s viewpoint such as the complexity of reading scientific papers slow the design process, students felt overwhelmed with the responsibility to find a meaningful solution and they had problems to gain feedback from users. From the teacher’s perspective, the main challenges were the increase in the amount of time that students needed help and the lack of design research techniques to communicate with people with a speech disability. Another finding was that the use of a design logbook facilitated the process by allowing the student’s metacognition after each activity. Overall, the evidence showed positive effects in students, increasing their level of engagement and motivation during the project and achieving a design that tried to satisfy the different user’s needs. In addition, all the students recognised that the module had a great impact in their professional training and it should remain in the design engineering curricula. Despite its exploratory nature, this study offers some insight into how enhance the inclusive design training among young students.

Purpose Developing a human-centered design understanding in built environment-related professions and enabling them to encompass diversity are crucial for the improvement of more inclusive environments. Considering the value of guiding experiences of people with disabilities for more inclusive design practice and increasing the awareness of professionals with disabilities in design and building practice plays a key role in achieving this goal. There is a growing effort to implement inclusive and universal design issues to the educational programs of design and related disciplines for about two decades. Contrary to the developments in the pedagogy of “core” design disciplines, human-centered design perspective seems not to be widespread enough in the education of so-called “peripheral” occupations of design, like architectural drafting, especially in Turkey. Design Thinking (DT) approach, which is defined as a way of thinking, is in fact widely used in the design-related fields. In such a need of human-centered and creative problem solving, the approach seems to provide a potential to raise awareness about user-oriented design in such peripheral occupations like architectural drafting education. Considering the widening use of strategies of DT also in non-design fields, the research out of which this article comes from involves a special adaption of the approach. Departing from the ultimate aim “to raise awareness of hearing-impaired architectural drafting students about user oriented architectural design,” it applies the strategies of the DT to this special case and reports the process and its findings, hence not only providing a special instance of the model but also revealing its potential contribution to peripheral or non-design disciplines. Design/Methodology/Approach Since it particularly focuses on understanding of human behavior, provides flexible and holistic tools to investigate such phenomena and since it is based on a systematic and reflective process, the present research was carried out through qualitative research approach and its tools. Findings Study showed that in relation to hearing-impaired students’ underlined need for getting familiarized with the process of architectural design and focusing on human-centered design approach, present application of Design Thinking strategy worked effectively to provide basic information about architectural design, design process, and related tasks and user needs as well, as part of design process for hearing-impaired architectural drafting students with a certain level of hearing loss and language ability. Research Limitations/Implications Since the research was embedded within the existing educational system, data collection and observation processes had to be defined according to these boundaries. Also the students’ level of language abilities and their limited background about their field of study, because that they were first year students were the main limitations of the study. Apart from its aforementioned outcome, the research was a means of expanding the application of the initial DT model, and it could be seen as a contribution to the existing studies concerning the education of the hearing-impaired students. In general, the research illustrated that DT, as a carefully developed approach to be employed particularly for non-design occupations, could also be effectively used to teach design process for disabled design professionals. Consequently, it is thought that it could be applied to the formulation of courses such as; environmental design, design for all, inclusive design, as well as be utilized for students developing empathy with users, familiarizing with observation and interview techniques, and as a means of quick and systematic problem solving sessions. Practical Implications As it might be expected the study primarily contributes to the education of the hearing-impaired students. It helped students to develop an understanding of design process as well as develop their professional schemata (i.e. their conceptual vocabulary). As a research it provides a foundational knowledge concerning application of DT strategies in a specific field of study. Social Implications By nature, one of the basic problems confronting students with disabilities is to make them an integrated part of the society, from daily life to some specialized situations such as professional life and their education. Researcher strongly believes that this study has had implications as such although it was not primarily involved with such a goal. Originality/Value As it might be guessed the present study might be considered as a part of and a contribution to a larger research tradition evolving around the Design Thinking approach, i.e. its application and adaptation to different areas and field, and development of the strategy itself. On the other hand, since it adapts and applies DT to a specific case, and an original problem situation, actually a very rarely addressed one. As such, while it might be considered as a special contribution to that specific tradition, at the same time its primary contribution is to the education of the hearing-impaired students, and its pedagogy.

PurposeThe literature review explores how multidisciplinary approaches based on critical pedagogy and participatory research can provide frameworks for equitable partnerships and genuine participation in educational design and research practices. Additionally, the essay aims to expand understandings of equitable engagement within educational research and design based on principles from critical pedagogy.Design/methodology/approachThe essay draws from diverse literature in the learning sciences, health informatics, industrial design, disability studies, ethnic studies, rehabilitation science, and to a lesser extent HCI research to understand how critical pedagogy and participatory research methods can provide useful frameworks for disabled peoples' equitable engagement and genuine participation in educational research and design. The literature reviewed in the paper concern topics such as participatory approaches to community development with disabled adults, the implementation of university-initiated community partnerships, participatory research with students and disabled people, and the importance of culturally-responsive research practices. The design literature in this review explores various arenas such as the co-design of assistive technologies with disabled children and adults and the design of curricula for students with and without disabilities. This review focuses on research practices that engender disabled peoples' participation in educational research and design, with focus on developing multidisciplinary frameworks for such research.FindingsThe literature review concludes that participatory research methods and critical pedagogy provide useful frameworks for disabled peoples’ participation in educational design and research practices. Critical pedagogy and participatory design allow for the genuine participation of disabled people in the research process.Social implicationsEmphases on collaboration and collective knowledge-building in social transformation are present in scholarship concerning critical pedagogy, participatory research, and disability studies. However, these connections have been routinely underexplored in the literature. This paper aims to underscore these integral connections as a means to build solidarity between disabled and other marginalized people.Originality/valueThe connections between participatory research methods, critical pedagogy, and disability studies have been previously underexplored. The literature review proposes a combined approach, which has the potential to radically transform multiple realms of research beyond the learning and information sciences.

Research during residency training: good for all?

This systematic review aims to highlight the scope of pharmacogenomics research within global Indigenous populations. This review also explores the barriers and facilitators of pharmacogenomics research within this population. A systematic review of literature was conducted to identify and present an understanding of current empirical evidence demonstrating the conduct of genomics or pharmacogenomics research within global Indigenous populations (PROSPERO registration: CRD42021257226). Using key search terms, relevant databases were searched for articles published between January 2010 and July 2022. Screening, data extraction, and analysis was conducted using well-defined inclusion criteria. Quality assessment and risk of bias appraisal was conducted using the mixed methods appraisal tool. Indigenous community engagement and participation in genomics research was assessed using the social-ecological framework. From the 427 articles identified, 77 articles met inclusion criteria and underwent full-text screening. Of these, 30 articles were included in the final review, with 16 being quantitative and 14 either qualitative or mixed methods studies. Most studies were conducted with native Indigenous populations from the United States of America (36%). Content analysis revealed that studies either explored genetic variations associated with disease in Indigenous populations (23%) or markers for drug metabolism (30%) or were designed to understand perspectives of genomics research within this population (47%). Perspectives included the exploration of the role of participants in research, benefits or outcomes achieved from participation in genomics research, and levels of Indigenous engagement and participation in genomics research. This review highlights a growing gap in Indigenous genomics research globally. It presents several important considerations from Indigenous participants, identifying how researchers can co-create culturally safe and inclusive design, implementation, analysis, and subsequent outcomes of genomics research involving Indigenous people. Indigenous governance, self-determination and leadership is essential, with researchers required to be responsive to such fundamental partnerships for research to progress.

Design, when practised with ethical awareness, is a powerful tool at designers’ and society’s disposal. A method that allows solving problems and producing a positive impact on the lives of its users. Disability, rather than a personal attribute, is the result of a complex relationship of interaction between people and the environment. Inclusive design, a process in which the user's lack of capacity is always taken into consideration, allows everyone to participate in society equally and with confidence. Digital fabrication continues to revolutionise manufacturing processes, and the room for innovation in the field of accessibility is immense. In addition to saving time and costs, without compromising quality, the possibility of optimising the ideation process enables one of the most important phases of inclusive and human-centred design: co-creation. Product customisation is also an advantage of this technology, as many users have specific needs that need to be ensured in a tailored way. One in each one hundred and sixty people in the world has an autistic spectrum disorder. Autism is a developmental disorder in which there is a spectrum of symptoms and manifestations. The triad social interaction, communication and behaviour are expressive in this pathology. Early diagnosis, appropriate assessment and timely and intensive intervention can improve the prognosis since access to cures is not yet possible. In this study, we want to make the bridge between ASD, design and digital fabrication, creating playful-pedagogical objects co-designed alongside the project's stakeholders: XIS, a foldable mat that reduces the load of stimuli the child is exposed to, improving concentration-time; and ZIBBI a wearable that warns the child about their routine, allowing them to cope with the situation they are facing.

High-impact academic experiences, particularly research and internship experiences, have positive impacts for engineering students on engineering task self-efficacy (ETSE), a measure of students’ perception of their ability to perform technical engineering tasks. However, underrepresented racial/ethnic minority students (URM) and women in engineering are found to have relatively lower self-perceptions across several academic and professional self-efficacy measures. Previous studies examined the impact of research and internship experiences on ETSE for students categorized by gender and URM status separately. The current study explores the impact of these experiences on ETSE for the intersection between these two identity categories. This study found that both non-URM and URM women that participated in research and internship experiences had lower ETSE scores than non-URM and URM men, respectively. However, URM women that participated in both research and internship experiences had a statistically similar ETSE score to non-URM men that had not participated in either. This study uses multiple linear regression to measure the association between engineering internships and student’s reported ETSE (effects of participating in research were not found to be significant across identities). Preliminary findings indicate that differences in ETSE between internship participants and non-participants are highest for URM women when compared to their counterparts. Consistent with the literature, this research finds that there is a greater positive effect in ETSE scores, as a result of participation in both research and internship experiences, for URM women than their majority counterparts. These preliminary results provide a foundation for further studies to causally investigate the link between academic experiences and self-efficacy levels for students who are underrepresented in engineering programs. Future implications of this work include the creation of targeted intervention efforts to increase support for all URM students’ access and participation in research and internship experiences. Additionally, this work seeks to challenge the bias towards monolithic interpretations of women and URM engineering students as separate categories and encourage intersectional perspectives when analyzing data to produce more inclusive results

Subtle differences between universal design (UD) and inclusive design (ID) discourses impact inclusivity in practice. The level of service (LOS) is used as a proxy to evaluate inclusivity and agent-based modelling is used as a research instrument to probe how circulation and high levels of crowdedness impact inclusivity within a digital model of an underground transport building. Case 1 integrates ‘first-generation’ design methods and UD aims underpinned by social-model-of-disability discourses. Case 2 integrates ‘next, next generation’ design, vertical severance, service design and ID aims underpinned by socio-material-interactional discourses. While case 1 produced unsatisfactory results for inclusivity, case 2 increased the LOS and inclusivity throughout, and within the vertical circulation by five-fold, without increasing the overall cost or size of the building. Consequently, case 2 identifies how new ID guidelines, evaluation techniques and methods could enable inclusivity in practice.

This systematic review explores the application and evolution of Human-Centered Design (HCD) approaches in product innovation across the telecommunications and public sectors. As both domains face rapid technological change and evolving user expectations, incorporating user centric methodologies has become pivotal to ensuring relevance, usability, and adoption of services. This review synthesizes findings from 52 peer-reviewed articles, government reports, and industry whitepapers published between 2013 and 2021. It examines how HCD principles such as empathy driven research, iterative prototyping, participatory design, and cross functional collaboration are integrated into the design and development of digital and physical products. The review reveals that in the telecommunications sector, HCD practices are predominantly applied in service personalization, mobile application design, and user interface improvements to enhance customer experience and retention. Conversely, in the public sector, HCD is increasingly used to co create citizen facing digital platforms, improve accessibility in e-governance systems, and foster trust and transparency through inclusive design. Despite sectoral differences, shared challenges include institutional resistance, limited user research capacity, and difficulty aligning HCD with existing organizational structures and performance metrics. Notably, successful cases demonstrate that embedding HCD within agile or lean frameworks, engaging end-users early and consistently, and fostering organizational buy-in are critical enablers of effective innovation. This review also identifies a growing trend of integrating HCD with emerging technologies, including artificial intelligence and IoT, to better anticipate user needs and deliver responsive solutions. However, gaps persist in evaluating long term impact, scalability, and ethical considerations in user data handling. This study contributes to the discourse on sustainable innovation by offering a conceptual model that aligns HCD with strategic innovation objectives in both sectors. It underscores the need for policy frameworks and institutional reforms that promote human centered innovation cultures. Future research should focus on longitudinal studies and comparative cross-sectoral evaluations to validate and refine HCD’s role in systemic transformation.

This paper presents some of the findings from a global research study on inclusive infrastructure and city design and will focus on inclusive public spaces. Persons with disabilities can experience multi-dimensional exclusion from urban life, including but not limited to physical, attitudinal and social barriers. Public spaces, including recreational and social spaces, are often not prioritised. Inclusive public spaces are fundamental to participation and inclusive in society. Including persons with disabilities in the design and planning of the built environment supports equal rights and helps identify people’s aspirations for inclusive environments. Four city case studies will be discussed in this paper: Ulaanbaatar, Mongolia; Varanasi, India; Surakarta, Indonesia; and Nairobi, Kenya. Research participants and objectives are organised by three stakeholder groups:
 
 People - first-hand experiences of persons with disabilities living in the city and their aspirations for a more inclusive city
 Policy - the awareness and understanding of inclusive design among policy-makers
 Practice - the awareness and understanding of inclusive design among practitioners including barriers to implementation, opportunities and the relationship with assistive technology
 
 Methods include document reviews, interviews, photo diaries and co-design workshops with participatory and inclusive engagement of persons with disabilities throughout. Findings on public spaces are discussed in three ways:
 
 The types of public spaces valued by participants in each of the four cities.
 The barriers and challenges experienced by persons with disabilities in the public realm.
 Aspirations for more inclusive public spaces and opportunities for inclusive design
 
 The paper concludes by discussing how the targeted stakeholder groups of people, policy and practice also help represent three essential dimensions of inclusive city design and forming a framework for successful implementation and delivery and supporting targets set out through the UNCRPD and Sustainable Development Goals (SDGs).
 
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Building the Pipeline: Surveying Medical Student Interest in Hematology and Rare Disease Research

IntroductionAutism spectrum disorder (ASD) is a complex neuro-developmental condition. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), restricted interests and repetitive behaviors and difficulties with social communication and interaction characterize ASD. Different ways of learning, moving, or paying attention are related to the degree of impairments. By reducing environmental and social obstacles in school, work, and other areas of life, architecture could play a pivotal role in helping people on the spectrum become more independent and acquire more abilities.ObjectivesThe aim of this study was to outline the recommendations and guidelines of the inclusive architecture design for ASD.MethodsWe conducted a comprehensive review of the scientific literature using the following keywords: inclusive design, architecture, autism or ADS.ResultsOur research found that the Autism ASPECTSS design index reported in 2013 by Magda Mostafa from Canada, which was based on the sensory design theory, is the world’s first set of evidence-based design guidelines for managing built environments to serve ADS individuals interaction, particularly in schools and workspaces. ASPECTSS conceptual framework delineate seven design concepts: acoustics, spatial sequencing, escape space, compartmentalization, transition spaces, sensory zoning, and safety. In 2023, the same author published an autism friendly design guide for the world’s first autism-friendly university. This guide is characterized by a better understanding of human-centered design and advocates beyond the mere inclusion, aspiring to a state where the boundaries between ‘normal’ and ‘special’ are blurred in order to treat all users as human beings with equal rights, thus calling for equal opportunities beyond the ADS spectrum.ConclusionsWith such well-established conceptual framework, it is nowadays imperative to expand our buildings in cities, schools, workplaces, hospitals, and public areas using the guidelines of autism-friendly environments. These buildings will enhance our individual and social well-being.Disclosure of InterestNone Declared