Accessibility Guidelines Research Articles

Towards Web Equality: Efforts on Web Accessibility for Persons with Cognitive Disability

With the fast-paced development of digital innovations, web technologies are on the rise. With this in mind, making the web accessible for all became an interesting line of research and development. Web accessibility means that websites, tools, and technologies are designed and developed so that people with disabilities can use them with minimal to no supervision. More specifically, people can perceive, understand, navigate, and interact with the web. Over the past years, there have been attempts to achieve web accessibility for web users with physical, visual, and sensory disabilities. However, people with cognitive disabilities were not seen as a user group, thus, leaving them far behind the target general population for improving web accessibility. This paper presents an overview of the current state of web accessibility for people with cognitive disabilities. This paper attempts to come up with a unified definition of web accessibility and identify its components. The study identified the common reasons for the non-conformity of web accessibility. Moreover, the different cognitive disabilities and their linked issues are presented. Furthermore, this study reviews the various interventions made by governments and private organizations worldwide. The study uncovered that web accessibility for people with cognitive disabilities hadn’t been a priority for research which resulted in non-conformities with the accessibility guidelines such as poor interface design, confusing guides and instructions, robustness, and lack of features to cater to the needs of people with cognitive disabilities. Results show that in each kind of cognitive disability, namely Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Intellectual Disability, Memory Impairments, Perceptual Disability, and Seizure Disorder, people experience various difficulties in accessing the web, specifically on processing too much content or information, confusing instructions, typographies, and grammar. Laws have been imposed on different Asian and Western countries to address these difficulties. In contrast, other countries and organizations have adopted the Web Accessibility Guidelines of the World Wide Web Consortium (W3C). In conclusion, as organizations gear toward web equality, governments have the initiative to move towards the goal by implementing different laws and policies driving the WCAG 2.0 as a basis of these to orchestrate the design of websites effectively. Furthermore, this study calls for action for extensive research on web accessibility for cognitive disabilities as it is not only valuable to the vulnerable sector of society but also for the rest of the population.

Towards Web Equality: Efforts on Web Accessibility for Persons with Cognitive Disability

With the fast-paced development of digital innovations, web technologies are on the rise. With this in mind, making the web accessible for all became an interesting line of research and development. Web accessibility means that websites, tools, and technologies are designed and developed so that people with disabilities can use them with minimal to no supervision. More specifically, people can perceive, understand, navigate, and interact with the web. Over the past years, there have been attempts to achieve web accessibility for web users with physical, visual, and sensory disabilities. However, people with cognitive disabilities were not seen as a user group, thus, leaving them far behind the target general population for improving web accessibility. This paper presents an overview of the current state of web accessibility for people with cognitive disabilities. This paper attempts to come up with a unified definition of web accessibility and identify its components. The study identified the common reasons for the non-conformity of web accessibility. Moreover, the different cognitive disabilities and their linked issues are presented. Furthermore, this study reviews the various interventions made by governments and private organizations worldwide. The study uncovered that web accessibility for people with cognitive disabilities hadn’t been a priority for research which resulted in non-conformities with the accessibility guidelines such as poor interface design, confusing guides and instructions, robustness, and lack of features to cater to the needs of people with cognitive disabilities. Results show that in each kind of cognitive disability, namely Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Intellectual Disability, Memory Impairments, Perceptual Disability, and Seizure Disorder, people experience various difficulties in accessing the web, specifically on processing too much content or information, confusing instructions, typographies, and grammar. Laws have been imposed on different Asian and Western countries to address these difficulties. In contrast, other countries and organizations have adopted the Web Accessibility Guidelines of the World Wide Web Consortium (W3C). In conclusion, as organizations gear toward web equality, governments have the initiative to move towards the goal by implementing different laws and policies driving the WCAG 2.0 as a basis of these to orchestrate the design of websites effectively. Furthermore, this study calls for action for extensive research on web accessibility for cognitive disabilities as it is not only valuable to the vulnerable sector of society but also for the rest of the population.

INCLUSIVE PEDAGOGY AND HEALTH: A BRIEF INTERDISCIPLINARY APPROACH WITH AN EMPHASIS ON DISABILITY

The purpose of this paper is a co-education framework for teachers and educators, parents and health professionals, through accessible educational materials principles and guidelines as good inclusion practices, based on the clinical and learning characteristics of children with disabilities. The paper shows how concepts informed actions and combines theory and practice through key points.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0939/a.php" alt="Hit counter" /></p>

Development of a System and Interface for Speech Synthesis in Ukrainian for Websites

The paper describes the system of content synthesis and sounding on websites in Ukrainian, designed to simplify the consumption of content for the visually impaired, which features easy integration into the most popular content management system on sites, namely CMC Wordpress. Currently, people with visual impairments are severely limited in their use of Internet products because most web resources are not tailored to their needs. Modern information technology allows such people to receive information along with healthy ones thanks to solutions developed by scientists and engineers from different countries. Text information can be delivered to the visually impaired with a magnifying glass or by enlarging the font by software, blind - by sounding the text using computer programs or displaying texts on the Braille screen of the monitor. This is an effective solution, but the choice of methods for reproducing such information must be fully provided by people with disabilities themselves, which is a significant problem due to the significant time spent on information consumption. To facilitate the perception of visually impaired people when using websites, an international standard for webmasters has been developed - a guide to web content accessibility called the W3 Web Content Accessibility Guidelines (WCAG) Consortium 2.0. The standard describes in detail the requirements of visually impaired people that are recommended to be met in order for them to view the website without any problems. The basic provisions of WCAG 2.0 will describe the parameters and algorithms for scaling, clustering and separation of information by programs for the visually impaired and provide recommendations for writing website code. However, to implement such recommendations, webmasters need to learn new programming principles and algorithms and use additional development tools. This is often difficult, requiring additional training, which entails non-compliance by webmasters with such requirements.

About time! A scoping review of public-facing emergency department wait time displays in Canada.

Waiting is a common experience for patients during an emergency department (ED) visit. While high acuity patients are seen with little delay, low acuity patients may experience dissatisfaction from prolonged wait times. One strategy to improve patient experience involves changing the perception of the wait by providing realistic expectations of wait times using public-facing wait time displays. The primary objective of this study is to quantify the number of Canadian EDs with online wait time displays and describe the features and type of information provided. A systematic online search of all Canadian EDs was completed to identify EDs with public-facing wait time displays. A scoping review was then performed to assess their message characteristics, translations offered, availability of multi-site information, and accessibility features. Data were summarized using descriptive statistics. Sixty (9.3%) of the 647 Canadian EDs identified provide public-facing real-time wait time displays. Thirteen of these (21.7%) were associated with a single proprietary system. Distribution of wait time displays differs across Canada, with a range of zero to 100% of EDs within each province utilizing this communication tool. Common characteristics include "average" wait time (95%), graphical trend data (32%), number of patients waiting (33%), longest wait time (12%), and expected length of stay (10%). Sixty-two percent of wait time displays provide a combination of these methods to inform wait times. Important accessibility features include language translation, compliance with Canadian National Institute for the Blind (CNIB) accessibility guidelines and availability on a mobile application. Currently, there is emerging use of wait time displays in Canada with considerable variability in the information communicated through these tools. Effectiveness of these displays and their content needs to be determined.

Dyslexia and Accessibility Guidelines – How to Avoid Barriers to Access in Public Services

Abstract Interaction becomes increasingly digital, including interactions with public authorities, requiring websites to be accessible for all. The strong focus on written words in digital interactions allows for assistive technology to improve access for many users. However, it might impede usability for users with reading and writing difficulties. The present paper examines whether guidelines such as the Web Content Accessibility Guidelines (WCAG) sufficiently cover users with dyslexia and how usability can be improved for this user group. This paper expands a previously published version at the Mensch und Computer 2021 conference [1]. Using literature research and interviews with users with dyslexia and focusing on an application of the WCAG on the country level (a German law regulating accessibility for e-government websites), we confirmed and identified gaps in the WCAG for this group. We focus on within-site search, as this function is frequently used to find relevant information, esp. on infrequently visited sites such as e-government websites. Modifications to improve search were developed based on literature and the results of the interviews. They were empirically evaluated in an online study with 31 users with dyslexia and 71 without. Results indicate that an auto-complete function, a search that compensates for spelling errors, an indicator that the search was corrected, search term summary information, and avoidance of capital letters were useful for both groups, while wider line spacing should only be used in end-user customization.

A quality improvement project reducing adverse events and improving adherence to guidelines surrounding VRIII usage

Variable rate intravenous insulin infusions (VRIII) are frequently used in hospitals and incorrect use can lead to electrolyte imbalance, hypoglycaemia and adverse outcomes. The Joint British Diabetes Societies (JDBS) published...

Guidelines on how to manage cutaneous lupus erythematosus

British Journal of DermatologyVolume 186, Issue 4 p. e175-e175 Plain Language SummaryFree Access Guidelines on how to manage cutaneous lupus erythematosus First published: 04 April 2022 https://doi.org/10.1111/bjd.21069AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Linked article: O’Kane et al. Br J Dermatol 2021; 185:1112–1123 Cutaneous lupus erythematous (CLE) refers to a range of skin conditions with common clinical and laboratory findings. CLE is caused by a combination of genetic factors, autoantibodies and the environment, and can occur alone or as a feature of systemic lupus erythematosus (SLE). The British Association of Dermatologists put together a group that included consultant dermatologists, a consultant rheumatologist and patient representatives to review published evidence on treating adults, young people and children with CLE. The UK-based group produced 53 recommendations, based on a review of the evidence, for the management of CLE in general practitioner clinics and in hospitals. They used an approach called the GRADE system (Grading of Recommendations Assessment, Development and Evaluation) for developing guidelines. General measures central to the management of CLE include sun protection and smoking avoidance. The possibility of drug-induced CLE should be considered, and medications that might potentially be the culprit stopped. Where the psychological impact of CLE on a patient is significant, referral to psychological support services should be considered. Topical steroids are an appropriate first-line medication for localized CLE. However, in active or widespread CLE, oral medications should be introduced early, with antimalarial drugs (such as hydroxychloroquine) being the first choice in most cases. The recommended patient management pathway for CLE is presented as a flow diagram to guide clinicians through options for first-line, second-line and third-line treatments. Recommendations for future research and audit points (to help check the care of patients with CLE is meeting the right standards) are also included. Volume186, Issue4April 2022Pages e175-e175 RelatedInformation

Inclusive Design and Web Accessibility for Autism and Cognitive Disabilities

There are 23.2 million individuals in the United States with a Cognitive Disability. Morespecifically, an estimated 5.5 million individuals in the United States are diagnosed with AutismSpectrum Disorder. Current web accessibility standards enforced assist in creating equalopportunities for individuals with most disabilities. However, a large population of individuals with cognitive disabilities are not considered within these guidelines. Technologyisincreasinglyrelied on within the workplace and school environments creating a barrier for individuals withcognition deficits. Web accessibility cannot be accurately described as inclusive unless it isuniversally inclusive of all disabilities, including neurodevelopmental disabilities. Inclusive Design for Autism and Cognition (IDAC), aims to close this gap and create a web experiencethat is accessible to everyone allowing for equal opportunities regardless of cognitive level.This project’s objective was to create web accessibility standards to be adopted andenforced alongside current ADA Section 508 requirements. This was accomplished throughextensive research and identification of common symptoms of Autism Spectrum Disorder, Related Cognitive Disorders, and current web accessibility guidelines. The final deliverablesincluded the branding and creation of IDAC. The IDAC Standards for Accessible Designcovered over thirteen topics of User Interface Design which can act as visual stimulants toindividuals with ASD or Related Cognitive Disabilities. Further, a digital and print referenceguidewascreatedalongside promotionalcollateraltoraiseawareness of IDAC’s cause.

An Initial Investigation into Parental Perceptions Surrounding the Impact of Mobile Media Use on Child Behavior and Executive Functioning

Children demonstrate increasing early engagement with mobile media facilitated by its portability and interactivity. Parents are known to employ a range of mediation strategies for mobile media use but continue to have limited awareness about the impact of mobile media on their child’s executive functioning. Mobile media use has previously been shown to be negatively correlated with the executive functioning development of a child; however, little is known of how parents approach their child’s mobile media use. This study employed a survey design ( N = 281 ) to examine how parents access information related to mobile media and document their perspectives about the impact of mobile media on their child’s behavior and executive functioning. Correlational analyses and cooccurrence graphs showed that parents implement several mediation strategies but rarely access guidelines on mobile media use. A confirmatory factor analysis examined the model fit for four latent constructs of the Behavior Rating Inventory of Executive Function (BRIEF®), which included the Inhibit, Emotional Control, Initiate, and Working Memory scales. Structural equation modelling substantiated the association between parental perception of negative impacts of mobile media related to their child’s behavior, academics, and/or attention and a lower observed executive functioning. Overall, these findings suggest that parents recognize the negative impacts of mobile media on their child’s behavior, and this is associated with how they see the development of their child’s executive functioning. The results emphasize the importance of educating parents as to the role of mobile media in shaping their child’s behavior and associated executive functions.

Examination of web-accessibility in the restaurant industry

ABSTRACT The purpose of this research is to investigate web content accessibility on restaurant industry segments’ websites and explore the differences across different segments on accessibility guidelines. To achieve the goal, the number of accessibility errors in the 405 websites (180 Michelin star restaurants; 125 casual restaurant chain websites; 100 local independent restaurants) were collected and further analyzed to achieve the study goal. AChecker was used to evaluate HTML content for web-accessibility problems. The numbers of known errors were analyzed by utilizing Web Content Accessibility Guideline 2.0. The results showed there are specific guidelines that are not fully compliant and Michelin star restaurants have done a relatively better job on e-accessibility. More details are discussed in the main body of the paper.

Accessibility of the Affordable Care Act (ACA) marketplace websites

ABSTRACT Background The Affordable Care Act (ACA) mandated that creation of online health insurance websites to ease the complex process of shopping for and enrolling into coverage. Ensuring that these sites are not only available but also meet digital accessibility standards is important so that individuals with disabilities are able to access healthcare services and efficiently obtain insurance coverage. Method We evaluated each of the marketplace sites in 2020 to assess whether they are digitally accessible. We employed a custom audit tool based on a subset of the Web Content Accessibility Guidelines (WCAG) 1.0 and 2.0 AA and used content analysis to compare the site’s accessibility statements with best practices. Results Nearly all of the ACA marketplace websites have significant room to improve their digital accessibility. Notable technical problem areas include lack of text equivalents for images, difficult site navigation, and lack of optimization for mobile use, particularly on those pages that provide instructions on how to get in-person help. Conclusions Given that access to health insurance is a primary predictor of access to health care – sites must be easy to use and accessible to all individuals regardless of ability. Barriers to online enrollment, such as those identified in this work, may exacerbate disparities in quality of care, treatment continuity and affordability for individuals with mental and physical disabilities. Entities providing health-related online information & engagement should be aware of actionable opportunities to improve digital accessibility to optimize the enrollment process for both maintaining coverage and assisting those that remain uninsured.

Web Simplification Prototype for Cognitive Disabled Users

Information and communication technology (ICT) and World Wide Web (WWW) are increasingly being used in daily life and becoming important in community, business, personal performance, and improvement of livelihood. people with disabilities (PWDs) can easily perform many tasks using WWW which might be difficult or impossible for them. However, many websites applications such as e-learning, e-commerce, and e-government are not specifically designed keeping in view PWD users. Through the web accessibility guidelines, web developers can build a web program accessible to PWDs. In this paper, we have investigated the issues related to website design that make it unavailable for PWDs. Keeping in view these issues, we have built a framework to make the web easier for PWDs. In addition, these issues are assessed using the GTmetrix, Netcraft, and WAVE accessibility tools and the results are generated using Google Analytics. Based on these results, we have proposed a simplified web version to improve website access for people with disabilities. The proposed prototype is also implemented on a website called Easywebcare by incorporating our recommendations for resolving the investigated issues. Analytics shows that the proposed type surpasses all existing activities in improving website accessibility for people with disabilities.

Satisfaction of visually disabled users with California educational websites

BACKGROUND: College and university websites in the United States are legally required to meet accessibility standards to promote equal opportunity in education for blind and visually disabled students. Web Content Accessibility Guidelines are the recognized standard for website accessibility. OBJECTIVE: Determine how satisfied blind and visually disabled college and university students are with college and university websites in California, and whether compliance with Web Content Accessibility Guidelines is a good predictor of that satisfaction. METHODS: A random sample of websites from California colleges and universities was evaluated for accessibility compliance. A stratified sample of six websites was taken from the initial sample. Thirty blind or visually disabled students performed a prescribed series of tasks on each of the six websites, then answered a Likert-format survey regarding their satisfaction with each website. RESULTS: Sixty-three percent of websites did not meet the first priority accessibility criteria. Participant responses showed a majority were satisfied with websites, both compliant and non-compliant, and a strong correlation between satisfaction and accessibility compliance. CONCLUSIONS: Despite legal requirements, a majority or large minority of college and university websites in California do not meet accessibility guidelines, indicating a significant opportunity to improve the accessibility of those websites.

South African healthcare workers' knowledge of dolutegravir's drug-drug interactions in the first year of its rollout: a cross-sectional online survey.

IntroductionIn December 2019, dolutegravir‐based treatment was recommended as first‐line antiretroviral therapy (ART) in South Africa. Dolutegravir has clinically significant interactions with several commonly used drugs, such as rifampicin, metformin and cation‐containing medicines. National guidelines detail these interactions and how to manage them. While previous international studies have shown low healthcare worker knowledge of drug–drug interactions, there is a paucity of information on antiretroviral interaction knowledge in the South African setting, where much ART is nurse‐led. The study aimed to determine this knowledge and to describe which variables were associated with gaps in knowledge.MethodsAn anonymous online survey of healthcare workers in the field of HIV was conducted in August/September 2020. The survey was designed, tested and piloted, and included sections on demographics, guideline access and training, interaction knowledge, counselling and the effect of COVID‐19. Dissemination was via e‐mail and social media (convenience sampling). Descriptive and inferential analysis was done using proportions and the 95% confidence interval to determine relationships between independent and dependent variables. Research ethics approval was obtained from the University of Cape Town's Human Research Ethics Committee (HREC Ref: 357/2020).Results and discussionIn total, 1950 survey responses were included in the analysis – 47.1% nurses, 35.8% doctors and 8.9% pharmacists. When asked whether they were aware that dolutegravir has interactions, 70% said yes, 13.9% said no and 16.1% did not answer. Knowledge of specific interactions and the dosing changes needed was low with a wide range between different drugs: 79.7% knew to double the dolutegravir dose with rifampicin, but with calcium, 5.1% picked both correct dosing options and 33.7% picked one of the two correct options. Access to guidelines and training were positively associated with drug interaction knowledge.ConclusionsThere are gaps in the awareness and knowledge of dolutegravir interactions and how to adjust dosing among South African healthcare workers.

Investigation of COVID-19 Vaccine Information Websites across Europe and Asia Using Automated Accessibility Protocols.

Websites content accessibility guidelines (WCAG) ensure that websites should be perceivable, understandable, navigable, and interactive. During the SARS-CoV-2 pandemic, the importance of accessible websites and online content grew throughout the world. Therefore, in this study, we examined COVID-19-related official government websites. This research covered 21 government websites, with 13 websites from European countries and 8 websites from Asian countries, to evaluate their accessibility following WCAG 2.0 and WCAG 2.1 guidelines. The overall goal of this study was to identify the frequent accessibility problems that might help the website owners to identify the shortcomings of their websites. The target websites were evaluated in two steps: in step-1, evaluation was performed through four automatic web accessibility testing tools such as Mauve++, Nibbler, WAVE, and WEB accessibility tools; in step-2, evaluation went through human observation, such as system usability testing and expert testing. The automatic evaluation results showed that few of the websites were accessible; a significant number of websites were not accessible for people with disabilities. In addition, system usability testing found some complexity in website organization, short explanations, and outdated information. The expert testing suggested improving the color of the websites, organization of links, buttons, and font size. This study might be helpful for associated authorities to improve the quality of the websites in the future.

How fertility preservation guidelines have progressed worldwide: Potential implications and inspiration

Abstract To summarize fertility preservation (FP) guidelines and consensus provided by medical facilities worldwide. Five reference databases (PubMed/Embase, China BioMedical Literature Database, ClinicalKey, Wanfang Data, and China Knowledge Resource Integrated) and 7 guideline databases (Guideline International Network, National Collaborating Centre for Women's and Children's Health, National Guideline Clearinghouse, The National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, New Zealand Guideline Group, and Canadian Medical Association infobase) were searched. Official websites of societies were searched to find relevant guidelines and consensus, and guidelines and published systematic reviews and consensus were reviewed from inception through May 2021. A literature search was performed regarding guidance offered in professional facilities, and 304 records (including 4 in Chinese) of existing guidelines for full-text review were found. Moreover, 55 guidelines were identified after a manual search. The literature review demonstrated that FP guidance and options were unevenly distributed worldwide for women who wanted to post-pone pregnancy or had impaired fertility after gonadal toxicity. With promising cancer survival rates and diversified family decisions, more attention should be paid to the improvement and update of accessible guidelines and regulatory infrastructure to inform patients about the available options and empower them to make informed choices. Restrictions to such services can be gradually eased due to the efficacy and safety of certain FP techniques for the right candidates to initiate pregnancy conception.

Use and usability of GP online services: a mixed-methods sequential study, before and during the COVID-19 pandemic, based on qualitative interviews, analysis of routine eConsult usage and feedback data, and assessment of GP websites in Devon and Cornwall, England

ObjectivesWe explored use and usability of general practitioner (GP) online services.SettingDevon and Cornwall, England.DesignMixed-methods sequential study based on qualitative interviews, analysis of routine eConsult usage and feedback data, and assessment...

127 Accessibility and Ease of Use in Neuromodulation Devices

INTRODUCTION: Inclusive design is an engineering process that requires the product development team to balance the needs and limitations of many stakeholders, including those of the end user, regulatory organizations, and the designing institution. However, some patients confront challenges in using neuromodulation devices. These challenges include visual or hearing impairment and mobility and dexterity limitations that affect operation of the device components. METHODS: A primary set of points based on the seven principles of universal design, Twenty-First Century Communications and Video Accessibility Act (CVAA), Section 508, Web Content Accessibility Guidelines (WCAG), and the Americans with Disabilities Act (ADA) were created to obtain ratings of neuromodulation device characteristics for accessible operation. The author team developed a list of FDA-approved devices for brain, spinal, and peripheral pain neuromodulation available in the United States in 2021 and a standard survey was administered to evaluate each component. Data were gathered from representative patient-operated components of neuromodulation systems including device controllers and chargers to compare and rank the inclusivity of each. RESULTS: A representative number of neuromodulation devices in each category were assessed. Current data show multiple areas to improve the inclusivity of these devices. Multiple disabilities are not adequately considered during design. Inclusivity scores for the considered disabilities are summarized. CONCLUSION: Many currently FDA-approved neuromodulation devices are limited in their utility for disabled patients. Incorporating the recommendations of universal design into future devices will increase quality of care for our diverse and aging population.

Accessibility Analysis of Websites of Provincial Governments in Indonesia

Web accessibility means that people with disabilities can use, navigate, and interact with the website. The World Wide Web Consortium (W3C) has provided important guidelines on web accessibility known as the Web Content Accessible Guidelines (WCAG). The Indonesian government encourages the use of new media, namely website, via Presidential Instruction number 3 of 2003 concerning the National Policy and Strategy for e-government development, which mandates every government agency to build a website. In the previous study, the tools used had limitations and were unable to complete the websites evaluation. Therefore, in this study, WCAG 2.0 standard was applied to analyze the websites of provincial governments in Indonesia. Two accessibility evaluation tools were employed, namely TAW and aXe. In addition, for data analysis and interpretation, descriptive statistics and normality tests were applied. The results showed that the most common violation was found in perceivable principle. It was expected that the findings of this study could provide insight and recommendation for web developers working on provincial government website in Indonesia.