Availability Of Assistive Technology Research Articles

Success of prehospital tracheal intubation during cardiac arrest varies based on race/ethnicity and sex

IntroductionTracheal intubation is a high-risk procedure often performed in the prehospital setting by emergency medical services (EMS) on patients experiencing cardiac arrest. Because of the high potential for adverse consequences resulting from unsuccessful intubation, intubation success rates are a topic of significant concern. There has been little research examining whether cardiac arrest intubation success rates vary based on patient race/ethnicity and patient sex. MethodsWe examined a national registry of EMS calls in the United States. Inclusion criteria were tracheal intubations (2017–2021) performed on adult cardiac arrest patients where EMS providers documented the patient's race/ethnicity and patient sex and whether the intubation was successful. A total of 210,992 cardiac arrests met inclusion criteria. When considering patient sex, intubation was more common in male patients than female patients, but intubation success rates were significantly higher in female patients (p < .01). When considering patient race/ethnicity, intubation success rates were highest in White patients and significantly lower in patients of all other races/ethnicities (p < .01). ConclusionsIntubation success rates were higher in female patients and White patients. Further studies need to examine disparities and identify strategies to improve intubation success for all patients with cardiac arrest. Possible explanations for the obtained results are differences in patient health, in provider familiarity with intubation, and in the availability of assistive technologies that facilitate intubation (e.g. video laryngoscopy).

Negotiating for new technologies: guidelines for the procurement of assistive technologies in spinal surgery: a narrative review.

This is a narrative review with the objective to discuss available assistive technologies for spinal surgery. Characteristics, costs, and compatibility of the different systems are summarized and recommendations made regarding acquiring these technologies. The availability of assistive technologies in spine surgery continues to evolve rapidly. The literature is lacking a collective summary of the available technologies and guidelines for acquisition. This is a narrative review which (I) presents an up-to-date summary of the currently available assistive technologies in spinal surgery; (II) makes comment on the utility of imaging, navigation, and robotics; (III) makes recommendations for the utility of the platform based on hospital size and (IV) discuss factors involved in negotiating for the purchase of these new technologies. We assemble the most up-to-date collection of description, characteristics and pricing of assistive technologies in spinal surgery. We compare and contrast these technologies and make recommendations regarding acquisition. These technologies require a learning-curve for the surgeon and the operating room staff to understand how to use them efficiently. Surgeons need to be involved in the process of purchase decisions. Surgeons occupy a unique position in the health care infrastructure as their approach to care has significant ramifications on both the quality and cost of care. Surgeons should maintain conviction that their training and practice has allowed the use of these technologies to provide safer and more effective care for patients. Assistive technologies and prostheses for spinal fusion are evolving rapidly. This article serves as an encompassing reference to the current technologies. These technologies will play a significant role in the delivery of spinal health care in the future. All stakeholders stand to benefit from the increased value these technologies bring to patient care.

Environmental Factors that Impact the Workplace Participation of Transition-Aged Young Adults with Brain-Based Disabilities: A Scoping Review.

Workplace participation of individuals with disabilities continues to be a challenge. The International Classification of Functioning, Disability and Health (ICF) places importance on the environment in explaining participation in different life domains, including work. A scoping review was conducted to investigate environmental facilitators and barriers relevant to workplace participation for transition-aged young adults aged 18–35 with brain-based disabilities. Studies published between 1995 and 2018 were screened by two reviewers. Findings were categorized into the ICF’s environmental domains: Products and technology/Natural environment and human-made changes to environment, Support and relationships, Attitudes, and Services, systems and policies. Out of 11,515 articles screened, 31 were retained. All environmental domains of the ICF influenced workplace participation. The majority of the studies (77%) highlighted factors in the Services, systems and policies domain such as inclusive and flexible systems, and well-defined policies exercised at the organizational level. Social support mainly from family, friends, employers and colleagues was reported as a facilitator (68%), followed by physical accessibility and finally, the availability of assistive technology (55%). Attitudes of colleagues and employers were mostly seen as a barrier to workplace participation (48%). Findings can inform the development of guidelines and processes for implementing and reinforcing policies, regulations and support at the organization level.

Dementia care in the Danube Region. A multi-national expert survey.

BackgroundDementia is a particularly severe societal challenge in several countries of the Danube Region due to higher-than-average increment in population longevity, disproportionate increase of the old-age dependency ratio, and selective outward migration of health care professionals. A survey was conducted among dementia experts to obtain a deeper understanding of the dementia care structures and services in this geographical area, and to identify the educational needs of health care professionals, and the availability of assistive technology.Subjects and methodsA standardized questionnaire was sent out to 15 leading dementia experts/clinicians in 10 Danube Region countries inquiring about professional groups involved in dementia care, availability and reimbursement of services, inclusion of dementia in professional education and training, acceptability of Internet-based education, and availability of assistive technology. The authors are the survey respondents.ResultsThe majority of individuals with dementia receive care in the community rather than in institutions. The roles of medical specialties are disparate. General practitioners usually identify dementia symptoms while specialists contribute most to clinical diagnosis and treatment. Health care professionals, particularly those who work closely with patients and carers, have limited access to dementia-specific education and training. The greatest need for dementia-specific education is seen for general practitioners and nurses. An Internet-based education and skill-building program is considered to be equivalent to traditional face-to-face but offer advantages in terms of convenience of access. Assistive technology is available in countries of the Danube Region but is significantly underused.ConclusionDementia care in the Danube Region can be improved by an educational and skill-building program for health care professionals who work in the frontline of dementia care. Such a program should also attempt to enhance interdisciplinary and intersectorial collaboration, to intensify the interaction between primary care and specialists, and to promote the implementation of assistive technology.

The Potential in Preparing Community Health Workers to Address Hearing Loss

In underserved areas, it is crucial to investigate ways of increasing access to hearing health care. The community health worker (CHW) is a model that has been applied to increase access in various health arenas. This article proposes further investigation into the application of this model to audiology. To assess the feasibility of training CHWs about hearing loss as a possible approach to increase accessibility of hearing health support services in an underserved area. A specialized three-phase training process for CHWs was developed, implemented, and evaluated by audiologists and public health researchers. The training process included (1) focus groups with CHWs and residents from the community to raise awareness of hearing loss among CHWs and the community; (2) a 3-hr workshop training to introduce basic topics to prepare CHWs to identify signs of hearing loss among community members and use effective communication strategies; and (3) a 24-hr multisession, interactive training >6 weeks for CHWs who would become facilitators of educational and peer-support groups for individuals with hearing loss and family members. Twelve Spanish-speaking local CHWs employed by a federally qualified health center participated in a focus group, twelve received the general training, and four individuals with prior experience as health educators received further in-person training as facilitators of peer-education groups on hearing loss and communication. Data was collected from each step of the three-phase training process. Thematic analysis was completed for the focus group data. Pre- and posttraining assessments and case study discussions were used to analyze results for the general workshop and the in-depth training sessions. CHWs increased their knowledge base and confidence in effective communication strategies and developed skills in facilitating hearing education and peer-support groups. Through case study practice, CHWs demonstrated competencies and applied their learning to specific situations related to effective communication with hearing loss, family support, availability of assistive technology, use of hearing protection, and making referrals for hearing health care. Needs were identified for ongoing training in the area of use of assistive technology and addressing situations of more severe hearing loss and its effects. Initial results suggest it is feasible to train CHWs to engage community members regarding hearing loss and facilitate culturally relevant peer-health education and peer-support groups for individuals with hearing loss and their family members. In efforts to increase access to audiological services in rural or underserved communities, application of the CHW model with a partnership of audiologists deserves further consideration as a viable approach.

Medical Schools' Willingness to Accommodate Medical Students with Sensory and Physical Disabilities: Ethical Foundations of a Functional Challenge to “Organic” Technical Standards

Students with sensory and physical disabilities are underrepresented in medical schools despite the availability of assistive technologies and accommodations. Unfortunately, many medical schools have adopted restrictive "organic" technical standards based on deficits rather than on the ability to do the work. Compelling ethical considerations of justice and beneficence should prompt change in this arena. Medical schools should instead embrace "functional" technical standards that permit accommodations for disabilities and update their admissions policies to promote applications from qualified students with disabilities. Medical schools thus should focus on what students with disabilities can do, rather than what they cannot do, because these students further diversify the health care profession and improve our ability to care for an expanding population of patients with disabilities.

Factors influencing work participation of adults with developmental dyslexia: a systematic review

BackgroundEvidence has been synthesized to determine hindering and facilitating factors associated with the work participation of adults with developmental dyslexia (DD), classified according to the International Classification of Functioning, Disability and Health (ICF).MethodsA systematic literature review has been performed. Two search strings were used to determine the population and the context of work. The ICF was expanded with two subdivisions: one that made the environmental factors more work-related and a subdivision of personal factors. For data extraction the method known as qualitative metasummary was used and the manifest frequency effect size (MFES) for each category in the ICF was calculated.ResultsFrom 33 included studies 318 factors have been extracted and classified in the ICF. In the classification the frequency of occurrences and the consistency in direction (i.e., hindering or facilitating) have been made visible. The ICF categories with the highest MFES were mental functions with factors like feelings and emotions about dyslexia; activities like reading or writing/spelling; participation with factors like acquiring and keeping a job; social relationships at work where the attitudes and support of the employer and co-workers are important; working conditions with factors like the availability of assistive technology and accommodations on the job; and personal factors like self-disclosure and coping strategies.ConclusionsIn the context of work DD affects nearly all domains of functioning, mostly in a negative way. Within each domain the impact of DD increases over the course of life. To overcome that negative influence, many forms of adaptation, compensation, or coping are mentioned. Also notable is the lack of positive attitudes toward DD of the participants with DD—with the exception of the attitudes of teachers with DD—as well as on the part of colleagues, supervisors, and employers.

Assistive Technology for Behavioral Interventions for Persons with Severe/Profound Multiple Disabilities: A Selective Overview

Persons with severe/profound multiple disabilities are often unable to interact with their immediate environment and control relevant stimuli. Some of these persons may also present behavioral problems (e.g., stereotypies) and inadequate postures (e.g., head forward tilting). The possibility of implementing successful behavioral programs with these persons may largely depend on the availability of assistive technology. The forms of assistive technology that may be particularly relevant for these persons include microswitches, voice output communication aids (VOCAs), and microswitch clusters. Microswitches are technical devices that a person can use to control relevant/pleasant environmental events on his or her own. VOCAs are devices set to translate simple non-verbal behaviors into synthesized or digitized verbal messages (e.g., attention requests). Microswitch clusters are combinations of microswitches that are used to increase the person’s adaptive responding and reduce problem behavior in an integrated approach. This paper presents a number of illustrative cases for the abovementioned forms of assistive technology in order to provide the reader a general picture of the evidence available and to discuss the implications of this evidence for education and rehabilitation programs.

Untapped Career Opportunities for Persons With Visual Impairments

In atmospheric science, information is often communicated in visual form. Maps, radar images, and satellite imagery are widely used to display daily weather forecasts and current conditions. Textbooks, professional journals, and conference presentations are rich in figures that illustrate concepts and research findings. Given this preponderance of visual material, students with visual impairments may be tempted to assume that atmospheric science is not a suitable field for them. In fact, however, thanks to the widespread use of the computer and the availability of assistive technology, many atmospheric science careers are well suited to students with visual impairments who have acquired the necessary skills. Both personal experience and literature suggest that for people with visual impairments, success in science hinges upon the use of effective modes of communication between them and their sighted instructors and colleagues. With these considerations in mind, the author discusses relevant assistive tech...

Factors that Influence Assistive Technology Decision Making

With technological advances and growth in availability of assistive technology, infants and toddlers with disabilities have many more options than they had previously. Professionals that serve this population are required by law to consider assistive technology for each child with a disability that they serve. This study examines the factors that impact the decisions made about assistive technology by the professionals that serve them through the Kentucky First Steps Program. Fifteen of 16 professionals approved to provide assistive technology services in Kentucky were interviewed. An analysis of the differences in experience, philosophy, and beliefs of the participants by discipline provide insight into the process of decision making and the implications they have on the implementation of assistive technology. The analysis revealed several contradictions. While appearing to be philosophically aligned, the participants delivered assistive technology services in many different ways. Teaming was espoused as an important component of service delivery but was frequently not implemented. Family members were not seen as important members of these teams but client goals were rated as extremely important factors in making decisions about assistive technology. Parents and professionals need to be aware of the differences between disciplines and delivery strategies to assure a complete and balanced look at the whole child.

Barriers for People with Multiple Sclerosis Who Want to Work: A Qualitative Study

Despite advances in treatment, the availability of assistive technology, and passage of the Americans with Disabilities Act (ADA), unemployment is a significant problem for people with multiple scl...

Assistive technology legislation applied for rural populations

A large percentage of individuals with disabilities reside in rural areas. It is imperative that outreach be effective, so that rural populations are aware of the benefits and availability of assistive technology which enable one to live independently and enjoy full inclusion in society. Traditional outreach methods do not lend themselves to rural areas; therefore, unconventional outreach approaches designed specifically for rural areas must be utilized. Partnerships between assistive technology agencies and rural community service providers have proven to be an effective means of transferring information to persons with disabilities living in rural areas. This article discusses the impact of the Technology-Related Assistance For Individuals With Disabilities Act of 1988 (Public Law 100-407) and cites examples of successful rural outreach practices using a partnership approach.