Different Types Of Impairments Research Articles

Real-Time Diagnostics on a QKD Link via QBER Time-Series Analysis

The integration of QKD systems in metro optical networks raises challenges that cannot be fully resolved with current technological means. In this work, we devised a methodology for identifying different types of impairments for a QKD link embedded in a communication network. Identification occurs in real time using a supervised machine learning model designed for this purpose. The model takes only QBER and SKR time-series data as the input, making its applicability not restricted to any specific QKD protocol or system. The output of the model specifies the working conditions for the QKD link, which is information that can be valuable for users and key management systems.

Usage of Artificial Intelligence Tools to Improve Digital Web Accessibility

Accessibility of websites considers challenges related to creation of web pages adapted to user with different types of impairments. The goal of web accessibility is to remove barriers that may prevent people with disabilities from accessing or interacting with web content effectively. The paper presents some web accessibility standards and challenges related to their complying. A special attention is paid to some popular artificial intelligence tools and how they could be used to solve accessibility issues on web sites development.

Hippocampal Pyk2 regulates specific social skills: Implications for schizophrenia

Pyk2 has been shown previously to be involved in several psychological and cognitive alterations related to stress, Huntington's disease, and Alzheimer's disease. All these disorders are accompanied by different types of impairments in sociability, which has recently been linked to improper mitochondrial function. We hypothesize that Pyk2, which regulates mitochondria, could be associated with the regulation of mitochondrial dynamics and social skills. In the present manuscript, we report that a reduction of Pyk2 levels in mouse pyramidal neurons of the hippocampus decreased social dominance and aggressivity. Furthermore, social interactions induced robust Pyk2-dependent hippocampal changes in several oxidative phosphorylation complexes. We also observed that Pyk2 levels were increased in the CA1 pyramidal neurons of schizophrenic subjects, occurring alongside changes in different direct and indirect regulators of mitochondrial function including DISC1 and Grp75. Accordingly, overexpressing Pyk2 in hippocampal CA1 pyramidal cells mimicked some specific schizophrenia-like social behaviors in mice. In summary, our results indicate that Pyk2 might play a role in regulating specific social skills likely via mitochondrial dynamics and that there might be a link between Pyk2 levels in hippocampal neurons and social disturbances in schizophrenia.

Laser-light cueing shoes with integrated foot pressure and inertial sensing for investigating the impact of visual cueing on gait characteristics in Parkinson's disease individuals.

Gait disorders are a fundamental challenge in Parkinson's disease (PD). The use of laser-light visual cues emitted from shoes has demonstrated effective in improving freezing of gait within less restrictive environments. However, the effectiveness of shoes-based laser-light cueing may vary among individuals with PD who have different types of impairments. We introduced an innovative laser-light visual shoes system capable of producing alternating visual cues for the left and right feet through one-side cueing at a time, while simultaneously recording foot inertial data and foot pressures. The effects of this visual cueing system on gait patterns were assessed in individuals with PD, both those with well-gait and those with worse-gait. Our device successfully quantified gait characteristics, including the asymmetry in the center of pressure trajectory, in individuals with PD. Furthermore, visual cueing prolonged stride times and increased the percentage of stance phase, while concurrently reducing stride length in PD individuals with well-gait. Conversely, in PD individuals with worse-gait, visual cueing resulted in a decreased freeze index and a reduction in the proportion of intervals prone to freezing episodes. The effects of visual cueing varied between PD individuals with well-gait and those with worse-gait. Visual cueing slowed down gait in the well-gait group while it appeared to mitigate freezing episodes in worse-gait group. Future researches, including enhancements to extend the projection distance of visual cues and clinical assessments conducted in real-world settings, will help establish the clinical utility of our proposed visual cueing system.

Making it Work: Closing the Inclusion Gap for Persons with Disabilities in Humanitarian Crises

Abstract Disability inclusion has been firmly established as a human rights issue in humanitarian action. Numerous stakeholders have entered into commitments and designed policies to make their services inclusive and accessible for persons with disabilities. In practice, however, persons with disabilities are still excluded from participating in humanitarian action and cannot access the services they need. Drawing on evidence from the Rohingya refugee response in Cox’s Bazar, Bangladesh and the civil war in South Sudan, this policy and practice note shows that humanitarians often lack the knowledge and confidence to make their services inclusive for persons with different types of impairments. To anchor disability inclusion in all programmes and operations, it should be treated as a strategic issue. It requires sustainable and reliable funding, capacity development at the individual, organizational and strategic level of the humanitarian response, better coordination, robust and reliable data collection based on quantitative and qualitative assessments, and meaningful participation with organizations of persons with disabilities that represent the diversity of persons with disabilities.

Disability digital divide: survey of accessibility of eHealth services as perceived by people with and without impairment

BackgroundSustainable and effective eHealth requires accessibility for everyone. Little is known about how accessibility of eHealth is perceived among people with various impairments. The aim of this study was to compare use and perceived difficulty in the use of eHealth among people with and without impairment, and how different types of impairment were associated with perceived difficulty in the use of eHealth.MethodsThis study used data collected in a nationwide survey in Sweden. Snowball sampling was used to recruit participants with self-reported impairment, from June to October 2019. In February 2020, the survey was posted to people in the general population who were matched to the participants with impairment by age, gender and county of residence. Multiple logistic regression was used to analyse the use of four eHealth services, and perceived difficulty in the use of six eHealth services.ResultsIn total, 1631 participants with, and 1084 participants without impairment responded to the survey. Participants with impairment reported less use and more difficulty in the use of all eHealth services as compared to participants without impairment. When comparing types of impairment, booking healthcare appointments online was least used and most avoided by participants with communication, language and calculation impairments (adjusted odds ratio (aOR) use 0.64, 95% confidence interval (95%CI) 0.49–0.83; aOR avoid 1.64, 95%CI 1.19–2.27), and intellectual impairments (aOR use 0.28, 95%CI 0.20–0.39; aOR avoid 2.88, 95%CI 1.86–4.45). The Swedish national web-portal for health information and services, 1177.se, was reported difficult to use the most among participants with communication, language and calculation impairments (aOR 2.24, 95%CI 1.50–3.36), deaf-blindness (aOR 11.24, 95%CI 3.49–36.23) and hearing impairment (aOR 2.50, 95%CI 1.17–5.35).ConclusionsThe results confirm the existence of an eHealth disability digital divide. People with impairment were not one homogeneous group, but differed in perceived difficulties in regard to eHealth. Based on a purposeful subgrouping of impairments, we showed that people with communication, language and calculation impairments, and intellectual impairments, reported least use and most difficulty in using eHealth. The findings can guide further research in creating eHealth that is accessible for all, including those with the most significant difficulties.

An Assistance System for Deaf, Dumb, Blind, and Learning Disability Individuals

There is always some kind of barrier to impaired individuals in performing daily chores. It is difficult for them to perform and carry out even the simplest of tasks with ease. Whether it may be reading, writing, communicating, or studying, it becomes an impossible job for them to execute. Systems are separately designed for people with different types of impairments, but there lacks a system that can solve all problems as a whole. The purpose of our research work is to create one single system which is able solve all issues for deaf, dumb, blind, and learning disability individuals, which is not only simple to use but also provides accurate results. By using the developed system, people with different disabilities can perform simple daily activities with much ease than before. The developed system, which is a website, helps impaired individuals to read, write, communicate, etc. through various application programming interfaces (APIs). Key Words: Assistance system, application programming interface, deaf, dumb, blind, learning disability

The experiences, needs and barriers of people with impairments related to usability and accessibility of digital health solutions, levels of involvement in the design process and strategies for participatory and universal design: a scoping review

ObjectiveGlobally, the number of digital health solutions is increasing, but they are not always designed with access and utilisation for people with impairments in mind. Development efforts have often not included the voice and requirements of people with impairments, who make up 15% of the world’s population, despite the fact that this can help ensure broad access and utilisation. Little attention to and limited inclusion of people with impairments in the development of digital health solutions results in continued and reinforced inequalities in health services provision for people with impairments. This review investigates the needs and barriers of people with impairments related to use of digital health solutions and strategies to foster user participation, access and utilisation of digital health solutions.MethodsThis scoping review, based on the Joanna Briggs Institute Manual, had five phases: 1) identification of aim and research questions, 2) literature search in five databases (April/May 2020), 3) literature screening based on predetermined inclusion and exclusion criteria, 4) data extraction, and (5) reporting results.ResultsThe literature search resulted in 5968 sources, of which 25 met our inclusion criteria. People with impairments appreciate digital health solutions that are designed to meet their specific impairment-related challenges. The reported needs and barriers related to technological design varied depending on the individuals’ challenges. The literature reported different types of participatory co-design strategies to foster access and utilisation of digital health solutions.ConclusionThis scoping review support needs for increased awareness among developers to design solutions that meet people’s needs, contexts and states of health. By applying universal design as a strategy and including people with different types of impairments, starting in the idea creation phase of digital health solutions and throughout the development, developers can design solutions with better accessibility. Digital health solutions that are accessible and usable have a tremendous opportunity to foster health equity and achieve health promotion, prevention and self-care. This in turn can contribute to closing the gap between different population groups, reduce disparities and get the most from available healthcare services.

The role of workplace accommodations in explaining the disability employment gap in the UK

There has been limited theoretical and empirical research into the role of workplace accommodations in enabling workers with and without impairments to remain in work. This study used the International Classification of Functioning, Disability and Health (ICF) model to examine (a) whether workplace accommodations enable workers, particularly those with different impairments, to remain economically active; and (b) the predictors of the onset of work accommodations. Data from two waves of a large-scale longitudinal survey of disability in Great Britain, the Life Opportunities Survey (2009–2012) were analysed. 2307 workers with an impairment and 4308 workers without an impairment were followed up for a year. Work accommodations appear to enable workers with impairments to remain economically active, especially those with mental impairments. There was no difference in the employment rates of workers with and without mental impairments who had two or more work accommodations, in contrast to the 10% employment gap between workers with and without mental impairments who did not have any work accommodations. While there was no gender difference in the disability employment gap, barriers to employment related to caregiving were much greater for women compared to men. Moreover, only workers with incident pain impairments were associated with an increase in their work accommodations, not workers with incident mental impairments. Despite the evidence that workers with mental impairments could benefit considerably from workplace accommodations, they are less likely to have their workplace adjusted. The ICF model is particularly useful in analysing the role of work accommodations because it considers a much wider range of factors that are relevant not just to workers with different types of impairments, but are also relevant to the wider group of workers who use workplace accommodations.

Free space optic channel monitoring using machine learning

Free space optic (FSO) is a type of optical communication where the signal is transmitted in free space instead of fiber cables. Because of this, the signal is subject to different types of impairments that affect its quality. Predicting these impairments help in automatic system diagnosis and building adaptive optical networks. Using machine learning for predicting the signal impairments in optical networks has been extensively covered during the past few years. However, for FSO links, the work is still in its infancy. In this paper, we consider predicting three channel parameters in FSO links that are related to amplified spontaneous emission (ASE) noise, turbulence, and pointing errors. To the best of authors knowledge, this work is the first to consider predicting FSO channel parameters under the effect of more than one impairment. First, we report the performance of predicting the FSO parameters using asynchronous amplitude histogram (AAH) and asynchronous delay-tap sampling (ADTS) histogram features. The results show that ADTS histogram features provide better prediction accuracy. Second, we compare the performance of support vector machine (SVM) regressor and convolutional neural network (CNN) regressor using ADTS histogram features. The results show that CNN regressor outperforms SVM regressor for some cases, while for other cases they have similar performance. Finally, we investigate the capability of CNN regressor for predicting the channel parameters for three different transmission speeds. The results show that the CNN regressor has good performance for predicting the OSNR parameter regardless of the value of transmission speed. However, for the turbulence and pointing errors, the prediction under low speed transmission is more accurate than under high speed transmission.

Energy expenditure in a Syme’s amputee triathlete

Energy expenditure prediction equations developed for able-bodied populations may be inaccurate for para-athletes, a population characterized by different types of impairments. Sufficient data do not exist currently to generate or validate energy expenditure predictive equations for para-athletes to establish dietary recommendations to cover the demands of sport. The purpose of this observational study was to assess energy expenditure and substrate usage from a trained para-athlete at rest and while performing the athlete’s specific mode of exercise. One para-athlete recruited from the Challenged Athletes Foundation (female; age 32) participated in the study. The participant was a left leg Syme’s amputee triathlete. Resting metabolic rate was measured for the triathlete. Energy expenditure was also measured at moderate (64-76% of age-predicted HRmax) and vigorous intensity exercise (77-95% of age-predicted HRmax) on a stationary cycle ergometer on a separate day. The triathlete’s energy expenditure during exercise was higher than that predicted by the metabolic equivalent of task (MET) matched by exercise type at a moderate (measured: 7.0 kcal/min, predicted: 5.0 kcal/min) and vigorous intensity (measured: 9.3 kcal/min, predicted: 7.0 kcal/min). The Revised Harris-Benedict and the Mifflin-St Jeor equations underestimated resting metabolic rate in the triathlete (measured: 2,194 kcal/day, predicted: 1,348 ± 39 kcal/day). This study indicates that equations developed for able-bodied populations underestimate energy expenditure in a Syme’s amputee when compared to the measured energy expenditure values assessed by indirect calorimetry at rest and during a workout on both a stationary cycle ergometer and while running on the track.

Ability of Head-Mounted Display Technology to Improve Mobility in People With Low Vision: A Systematic Review.

PurposeThe purpose of this study was to undertake a systematic literature review on how vision enhancements, implemented using head-mounted displays (HMDs), can improve mobility, orientation, and associated aspects of visual function in people with low vision.MethodsThe databases Medline, Chinl, Scopus, and Web of Science were searched for potentially relevant studies. Publications from all years until November 2018 were identified based on predefined inclusion and exclusion criteria. The data were tabulated and synthesized to produce a systematic review.ResultsThe search identified 28 relevant papers describing the performance of vision enhancement techniques on mobility and associated visual tasks. Simplifying visual scenes improved obstacle detection and object recognition but decreased walking speed. Minification techniques increased the size of the visual field by 3 to 5 times and improved visual search performance. However, the impact of minification on mobility has not been studied extensively. Clinical trials with commercially available devices recorded poor results relative to conventional aids.ConclusionsThe effects of current vision enhancements using HMDs are mixed. They appear to reduce mobility efficiency but improved obstacle detection and object recognition. The review highlights the lack of controlled studies with robust study designs. To support the evidence base, well-designed trials with larger sample sizes that represent different types of impairments and real-life scenarios are required. Future work should focus on identifying the needs of people with different types of vision impairment and providing targeted enhancements.Translational RelevanceThis literature review examines the evidence regarding the ability of HMD technology to improve mobility in people with sight loss.

The intersectional jeopardy of disability, gender and sexual and reproductive health: experiences and recommendations of women and men with disabilities in Northern Uganda

The 2030 Sustainable Development Goals committed to “Leave No One Behind” regardless of social identity. While access to sexual and reproductive health (SRH) services has improved globally, people with disabilities continue to face enormous barriers to SRH, infringing on their SRH rights (SRHR). Uganda adopted pro-disability legislation to promote the rights of people with disabilities. Despite these legal instruments, SRHR of people with disabilities continue to be violated and denied. To address this, we sought to understand and document how people with disabilities perceive the relationships between their use of SRH services, legislation, and health policy in three districts of the post-conflict Northern region of Uganda. Through an intersectionality-informed analysis, we interviewed 32 women and men with different types of impairments (physical, sensory and mental) and conducted two focus groups with 12 hearing and non-hearing disabled people as well as non-participant observations at seven health facilities. We found that disabled people’s access to SHR services is shaped by the intersections of gender, disability, and violence, and that individuals with disabilities experienced discrimination across both private-not-for-profit and public health facilities. They also encountered numerous physical, attitudinal, and communication accessibility barriers. Despite policy implementation challenges, people with disabilities expected to exercise their rights and made concrete multi-level recommendations to redress situations of inequity and disadvantages in SRH service utilisation. Intersectionality revealed blind spots in policy implementation and service utilisation gaps. Universal health coverage can be operationalised in actionable measures where its universality meets with social justice.

Should I Stay or Should I Go

To improve the user engagement, especially under moderate to high traffic demand, it is important to understand the impact of the network and application QoS on user experience. This article comparatively evaluates the impact of impairments, with emphasis on rebufferings, startup delay, and bitrate changes, and their intensity and temporal dynamics, on user engagement in the context of video streaming. The analysis employed two large YouTube datasets. To characterize the user engagement and the impact of impairments, several new metrics were defined. We assessed whether or not there is astatistically significant relationshipbetween different types of impairments and user engagement metrics, taking into account not only the characteristics of the impairments but also the covariates of the session (e.g., video duration, mean data rate). After observing the relationships across the entire dataset, we tested whether these relationships also persist under specific conditions with respect to the covariates. The introduction of several new metrics and of various covariates in the analysis are two innovative aspects of this work. We found that the presence of negative bitrate changes (BR-) is a stronger predictor of abandonment than rebufferrings (RB). Positive bitrate changes (BR+) in low resolution sessions are not well received. High rebufferring ratio has a prominent impact on the video watching percentage. These results can be used to guide the video streaming adaptation as well as suggest which parameters should be varied in controlled field studies.

St. Thomas Aquinas on Impairment, Natural Goods, and Human Flourishing

This essay examines St. Thomas Aquinas’s views on different types of impairment. Aquinas situates physical and moral impairments in a teleological account of the human species, and these impairments are made relative in light of our ultimate flourishing in God. For Aquinas, moral and spiritual impairments are of primary significance. Drawing on Philippa Foot’s account of natural goods, we describe what constitutes an impairment for Aquinas. In the Thomistic sense, an impairment is a lack or privation in relation to that which is appropriate to the human being, known by our nature and ultimate perfection. For Aquinas, perfection lies in the transformation necessary for union with God.

A roadmap towards mobile applications with accessibility for visually impaired users: guideline and its evaluation

When applications intend to support accessibility, several aspects of interface design and usability must be reviewed to adapt or extend common functional requirements that are implemented to ensure easy use of applications. However, initiatives to develop guidelines for accessible mobile applications are recent and several approaches present only suggestions rather than a concrete list of requirements. It is becoming increasingly apparent not only the need for social and digital inclusion of people with disabilities but also the urgency to make devices and applications truly accessible to anyone. This work focuses on accessibility requirements for visually impaired users and it is part of a broader effort that involves different types of impairments. Our research method was based on three main steps. First, from an initial set of 1014 scientific and technical articles, 46 were analyzed to identify requirements that are related to visual impairments. Second, we carried out an observation-based analysis to confirm the importance of these requirements, considering a set of accessibility tests with impaired volunteers. Third, the Design Thinking process was used to implement an application prototype, considering the most important requirements that were identified along with the two first steps. This application was submitted to a user-centered evaluation with volunteers, which also supported the evolution of our requirements. We sought to include prior knowledge aligned with all pre-identified requirements, culminating in something that would add to the procedure greater validation. As the main result, this paper presents the complete roadmap of this process, which resulted in a guideline and evaluation method to support the integration of accessibility aspects into mobile applications.

Development of a Biomimetic Extensor Mechanism for Restoring Normal Kinematics of Finger Movements Post-Stroke.

Cable-driven devices for hands allow compact and lightweight design that could provide various functional movements. However, for many patients post-stroke, cable-driven devices produce nonphysiologic movements, such as metacarpophalangeal joint hyperextension, due to their abnormal passive joint impedance. In this study, we developed a novel bio-inspired device mimicking the anatomy of the extensor mechanism of the human finger, which can be tuned for individuals to provide 'subject-specific' assistance to achieve physiological movement patterns. We first evaluated the proposed design via mathematical modeling and computer simulation. Its performance was then tested experimentally with twenty-four subjects, including six healthy and eighteen chronic stroke survivors. We determined the loading condition of the device from the experimental identification of passive joint impedance of each subject before device use. Our results showed that the proposed design could achieve improved spatiotemporal coordination of finger movements compared to conventional cable-driven design by providing 'subject-specific' assistance based on identified passive stiffness values of each subject. We also identified a significant (negative) correlation between the metacarpophalangeal joint stiffness and the intrinsic exotendon loading level across subjects. The proposed system can restore normal movement patterns for patients with different types of impairments, which were previously found important in improving rehabilitative outcomes.

Disability-Disaggregated Data Collection: Hospital-Based Application of the Washington Group Questions in an Eye Hospital in Paraguay.

Disability-disaggregated data are increasingly considered important to monitor progress in Universal Eye Health Care. Hospital-based data are still elusive because of the cultural ambiguities of the term disability, especially in under-resourced Health Information Systems in low-and middle-income countries. The aim of this study was to estimate the hospital-based rate of disability in patients presenting at an eye department of a rural hospital in Paraguay and to discuss implications for the management of access barriers. Therefore, we introduced two standardized sets of the Washington Group (WG) Questions as a pilot project. In total, 999 patients answered the self-report WG short set (WG-SS) questionnaire with six functional domains, and 501 of these patients answered an extended set, which included additional domains for “anxiety” and “depression” (WG-ES3). Overall, 27.7% (95% Confidence Interval (CI) 24.9–30.3) were categorized as having a disability. A total of 9.6% (95% CI 7.9–11.6) were categorized as having a disability because of communication difficulties, which was second only to visual difficulties. The odds ratio for disability for patients aged 70 years and older was 8.5 (95% CI 5.0–14.4) and for male patients, it was 0.83 (95% CI 0.62–1.1). Of those patients who answered the WG-ES3, 3.4% were categorized as having a disability because of being worried, nervous or anxious and 1.4% because of feeling depressed. An analysis of the questions of the “depression” domain was impeded by a high rate of measurement errors. The results of the different domains can now be used to inform the identification and mitigation of potential access barriers to eye health services for different types of impairments.

The challenge of inclusion for older people with impairments: Insights from a stigma-based analysis

The intersection of disability and aging often presents obstacles and discomfort for older people with disabilities keen to access mainstream opportunities for social participation. Besides individual situations and preferences – disability-based or not – environmental and social factors may limit full access to participation for older people with disabilities. Although ageist and ableist trends of contemporary ideas of aging have been documented, few studies have examined how those discourses are enacted in the field. In the context of participatory action research carried out since 2014 in a seniors' leisure club, we conducted 14 individual interviews with volunteers and seven focus groups with 45 members in order to explore their personal experiences with impairments and disability within the club, whether members who develop impairments can continue to participate and whether prospective new members with different types of impairments would be welcomed. We used an interactionist framework inspired by Goffman's work and based on the concept of stigma to analyze participants' narratives. Results indicate that participation by members with disabilities is seen as unusual, disconcerting and disjunctive. Evidence exposes the stigmatizing practices, encompassing labeling, stereotyping, setting apart and discrimination against members with impairments. Their participation may be acceptable if it does not affect the normal course of activities; otherwise, stigmatizing discourses relegate them to the margins. Because stigma can have an overwhelming impact on the lives and social participation of older people with impairments, stakeholders' awareness should be raised so they can understand it and intervene more effectively.

The most effective type of feedback for rehabilitation in different types of impairment of upper limb function in patients with chronic stroke

The most effective type of feedback for rehabilitation in different types of impairment of upper limb function in patients with chronic stroke