Impaired Research Articles

No Level Playing Field: Barriers to Disability Representation in Politics

AbstractWhile one in five people in the UK are disabled, their number among elected representatives remains disproportionately low. In ongoing efforts to make politics more inclusive and diverse, disabled people often remain sidelined. As a politically relevant identity, disability is associated with a shared set of experiences and policy interests which are often overlooked. This is at least in part owing to the under‐representation of disabled politicians, which is likely also contributing to a sense of political alienation. Thus, tackling the barriers that disabled people experience in the political recruitment process is not only a matter of democratic justice and equality, but also essential for ensuring that disabled people's needs and concerns are recognised and met. This article outlines the obstacles that disabled people experience in pursuing elected office—including inaccessibility, inadequate financial resources and ableist institutions and cultures—and offers recommendations to political parties, parliaments and governments on how to mitigate them.

Developing a rapid predictive model for falls in older hospitalized patients.

This study was aimed to identify the independent risk factors for falls n hospitalized older patients and develop a corresponding predictive model. A retrospective observational study design was adopted, comprising 440 older patients with falls history and 510 older patients without falls history during hospitalization. Data collected included demographic information, vital signs, comorbidities, psychiatric disorder, function absent, current medication, other clinical indicators. Mobility disability, high-risk medications use, frequency of hospitalizations, psychiatric disorder, visual impairment are independent risk factors for falls in older patients. The A-M2-HPV scoring system was developed. The AUC value of the nomogram was 0.884, indicating the model has excellent discriminative ability. The AUC value of the A-M2-HPV score was 0.788, demonstrating better discrimination and stratification capabilities. The A-M2-HPV scoring system provides a valuable tool to assess the risk of falls in hospitalized older patients and to aid in the implementation of preventive measures.

Learning from innovative staff practices that led to virtual disability services using the lens of Complex Adaptive Systems

This paper draws on a Complex Adaptive Systems lens to develop an understanding of the staff practices that supported the development of Virtual Disability Services in Ireland amid the COVID-19 pandemic. The study involved twelve interviews with service providers, which were analysed using Reflexive Thematic Analysis, leading to two overarching themes. The first theme focuses on the logistics of constructing the response. This includes dynamic adaptiveness, technological readiness, a positive attitude towards technology, resource availability, digital skills, and the level of take-up. The second theme centres on the enacted response, which encompasses sensemaking, developing technological expertise, managing upward, fostering creative innovation, cultivating a systems sensibility, and creating conditions for psychological safety and authentic engagement. We conclude that staff practices are key for creating conditions conducive to safe spaces, sustaining well-being, and reshaping power dynamics and emphasise the importance of embracing technology as a tool for innovation within complex operating environments. POINTS OF INTEREST Virtual Services offered a good alternative to face-to-face services for some disabled people during COVID-19: they supported people to stay connected while self-isolating. Even though some staff and disabled people did not have many technology skills before COVID-19, they learned in real-time, using the resources available to them. Online relationships were seen as more equal as everyone was learning as they went. People with disabilities developed new skills and sometimes co-facilitated sessions. This gave them greater choice and control over how they interacted with services and changed power relationships within services. Having choices about how to access services is in line with enhancing rights and choice under the Convention of the Rights of People with Disabilities. Promoting digital inclusion may protect people against future societal disruptions.

Examining spinal mobility, aerobic capacity and functional movement in patients with non-specific chronic low back pain: a case-control study

Background/Aims The increasing cost and incidence of non-specific chronic low back pain means that many physiotherapists are reconsidering the management of this condition. The primary aim of this study was to examine spinal mobility, aerobic capacity and functional movement screen in patients with non-specific chronic low back pain. The secondary aim was to determine the factors affecting the disability level. Methods Participants aged between 18–65 years old diagnosed with non-specific chronic low back pain for >3 months were recruited as a study group, while those without low back pain in the last 3 months were the control group. Outcome measures included the Functional Movement Screen for functional movement, the 2-Minute Step Test for aerobic capacity, the Spinal Mouse for spinal mobility and Oswestry Disability Index for disability level. Results A total of 60 participants, 30 people with non-specific chronic low back pain (42.7 ± 10.6 years) and 30 people without low back pain (42.0 ± 7.3 years), were included in this study. There were statistically significant differences in the total sagittal plane angle (P<0.001), total frontal plane angle (P=0.03), 2-Minute Step Test (P<0.001) and Functional Movement Screen (P<0.001) scores between groups. Pain and aerobic capacity explained 42.4% of the variance as determinants of disability in the study group. Conclusions In people with non-specific chronic low back pain, sagittal and frontal plane range of motion and aerobic capacity were decreased and their functional movements were impaired. Pain intensity and aerobic capacity affect the disability level of non-specific chronic low back pain. Implications for practice People with non-specific chronic low back pain have reduced spinal mobility, aerobic capacity and functional movement. These parameters should be included when determining treatment programmes. At the same time, the level of disability can be reduced by decreasing pain intensity and increasing aerobic capacity of people with low back pain.

Prenatal and progressive coenzyme Q10 administration to mitigate muscle dysfunction in mitochondrial disease.

ADCK genesencode aarF domain-containing mitochondrial kinases involved in coenzyme Q (CoQ) biosynthesis and regulation. Haploinsufficiency of ADCK2 in humans leads to adult-onset physical incapacity with reduced mitochondrial CoQ levels in skeletal muscle, resulting in mitochondrial myopathy and alterations in fatty acid β-oxidation. The sole current treatment for CoQ deficiencies is oral administration of CoQ10, which causes only partial recovery with postnatal treatment, underscoring the importance of early diagnosis for successful intervention. We used Adck2 heterozygous mice to examine the influence of this gene on muscle structure, function and regeneration throughout development, growth and ageing. This investigation involved techniques including immunohistochemistry, analysis of CoQ levels, mitochondrial respiratory content, muscle transcriptome analysis and functional tests. We demonstrated that Adck2 heterozygous mice exhibit defects from embryonic development, particularly in skeletal muscle (1102 genes deregulated). Adck2 heterozygous embryos were 7% smaller in size and displayed signs of delayed development. Prenatal administration of CoQ10 could mitigate these embryonic defects. Heterozygous Adck2 mice also showed a decrease in myogenic cell differentiation, with more severe consequences in 'aged' mice (41.63% smaller) (P<0.01). Consequently, heterozygous Adck2 mice displayed accelerated muscle wasting associated with ageing in muscle structure (P<0.05), muscle function (less grip strength capacity) (P<0.001) and muscle mitochondrial respiration (P<0.001). Furthermore, progressive CoQ10 administration conferred protective effects on mitochondrial function (P<0.0001) and skeletal muscle (P<0.05). Our work uncovered novel aspects of CoQ deficiencies, revealing defects during embryonic development in mammals for the first time. Additionally, we identified the gradual establishment and progression of the deleterious Adck2 mouse phenotype. Importantly, CoQ10 supplementation demonstrated a protective effect when initiated during development.

Thermal Threat Monitoring Using Thermal Image Analysis and Convolutional Neural Networks

Monitoring of the vital signs or environment of disabled people is currently very popular because it increases their safety, improves their quality of life and facilitates remote care. The article proposes a system for automatic protection against burns based on the detection of thermal threats intended for blind or visually impaired people. Deep learning methods and CNNs were used to analyze images recorded by mobile thermal cameras. The proposed algorithm analyses thermal images covering the field of view of a user for the presence of objects with high or very high temperatures. If the user’s hand appears in such an area, the procedure warning about the possibility of burns is activated and the algorithm generates an alarm. To achieve this effect, the thermal images were analyzed using the 15-layered convolutional neural network proposed in the article. The proposed solution provided the efficiency of detecting threat situations of over 99% for a set of more than 21,000 images. Tests were carried out for various network configurations, architecture and both the accuracy and precision of hand detection was 99.5%, whereas sensitivity reached 99.7%. The effectiveness of burn risk detection was 99.7%—a hot object—and the hand appeared simultaneously in the image. The presented method allows for quick, effective and automatic warning against thermal threats. The optimization of the model structure allows for its use with mobile devices such as smartphones and mobile thermal imaging cameras.

Cognitive, affective, and normative factors affecting digital insurance adoption among persons with disabilities: A two-stage SEM-ANN analysis

This study evaluates the determinants of digital insurance adoption among persons with disabilities (PWDs) using the cognitive, affective, and normative (CAN) model. The study considers (i) cognitive factors such as perceived credibility, perceived knowledge, perceived usefulness, perceived complexity, and facilitating conditions; (ii) affective factors including technology anxiety and technology pleasure; and (iii) normative factors encompassing social influence. Moreover, it explores the relationship between perceived complexity and behavioral intention (BI) to adopt digital insurance among PWDs, as mediated by perceived knowledge. This study employs a two-stage hybrid structural equation modeling–artificial neural network (SEM-ANN) approach to test the hypothesis, and data from 323 physically challenged participants were collected. Empirical results show that all factors, except for perceived complexity and technological anxiety, significantly predict BI adoption of digital insurance among PWDs, whereas perceived usefulness was found to have the highest impact on BI. Although perceived complexity affects perceived knowledge, it does not significantly mediate the relationship between complexity and BI. This study expands on the CAN model and provides practical insights for PWDs in adopting digital insurance.

Persons with Disabilities (PWD) as patient educators: Effects on medical student attitudes

Persons with Disabilities (PWD) as patient educators: Effects on medical student attitudes

Health disparities and injection drug use behaviors among adults with and without disabilities in the National Survey on drug use and health, 2015–2019

BackgroundLittle is known about the prevalence of injection drug use in people with disabilities (PWD) when compared by disability type and to other adults without disabilities. Objective or hypothesisThe prevalence of past-year injection drug use will be higher in adults with a reported disability than adults without any reported disability. MethodsThis study consisted of secondary analyses of data from the 2015–2019 National Survey of Drug Use and Health. The analytic sample comprised 214,505 US adults. Self-reported past-year injection drug use represented the outcome of interest. Disability status and socioeconomic characteristics were conceptualized as predictors, and sex and age were used as controls. ResultsPast-year prevalence of self-reported injection drug use was 0.24 % (95 % CI, 0.22–0.27) in adults without a disability but 0.66 % (95 % CI, 0.59–0.73) in adults with a disability. All disability types examined were associated with increased odds of reporting past-year injection drug use, but the strongest association was observed for disability related to difficulty concentrating (AOR, 4.90; 95 % CI, 3.92–6.14). Adjusted odds of past-year methamphetamine injection were more than three times as high in adults with a disability, compared to those without a disability (AOR, 3.21; 95 % CI, 2.37–4.33) and more than two times as high in adults with a disability for cocaine injection (AOR, 2.77; 95 % CI, 1.84–4.15). ConclusionDisability status is associated with injection of various types of drugs, and a variety of disability types are associated with higher odds of injection drug use.

Physical Activity Among Adults With Mobility Disability: Insights From 2019 Behavioral Risk Factor Surveillance System

Physical Activity Among Adults With Mobility Disability: Insights From 2019 Behavioral Risk Factor Surveillance System

Movement-to-music Intervention Improves Lower Extremity Function In People With Mobility Disabilities: A Randomized Controlled Study

Movement-to-music Intervention Improves Lower Extremity Function In People With Mobility Disabilities: A Randomized Controlled Study

Real-Time Home Automation System Using BCI Technology.

A Brain-Computer Interface (BCI) processes and converts brain signals to provide commands to output devices to carry out certain tasks. The main purpose of BCIs is to replace or restore the missing or damaged functions of disabled people, including in neuromuscular disorders like Amyotrophic Lateral Sclerosis (ALS), cerebral palsy, stroke, or spinal cord injury. Hence, a BCI does not use neuromuscular output pathways; it bypasses traditional neuromuscular pathways by directly interpreting brain signals to command devices. Scientists have used several techniques like electroencephalography (EEG) and intracortical and electrocorticographic (ECoG) techniques to collect brain signals that are used to control robotic arms, prosthetics, wheelchairs, and several other devices. A non-invasive method of EEG is used for collecting and monitoring the signals of the brain. Implementing EEG-based BCI technology in home automation systems may facilitate a wide range of tasks for people with disabilities. It is important to assist and empower individuals with paralysis to engage with existing home automation systems and gadgets in this particular situation. This paper proposes a home security system to control a door and a light using an EEG-based BCI. The system prototype consists of the EMOTIV Insight™ headset, Raspberry Pi 4, a servo motor to open/close the door, and an LED. The system can be very helpful for disabled people, including arm amputees who cannot close or open doors or use a remote control to turn on or turn off lights. The system includes an application made in Flutter to receive notifications on a smartphone related to the status of the door and the LEDs. The disabled person can control the door as well as the LED using his/her brain signals detected by the EMOTIV Insight™ headset.

Inequalities changes in health services utilization among middle-aged and older adult disabled people in China: based on CHARLS 2011-2018.

Multiple intersections, including socioeconomic inequalities, influence health equity for disabled people and sub-populations. However, this association has not been sufficiently analyzed among Chinese-impaired persons. This study aimed to investigate the health services utilization and inequalities in middle and older adult persons with disabilities and subgroups. The China Health and Retirement Longitudinal Study (CHARLS) database in 2011, 2013, 2015, and 2018 were used. Health services utilization was measured by outpatient, inpatient, and self-treatment service utilization. Types of disabilities were classified into six categories. The pooled cross-section regression, concentration index, horizontal inequity index, and concentration index decomposition were used to evaluate inequalities and explore their main contributing factor. The utilization and non-utilization of healthcare services showed variations across years (p < 0.05). The CIs and HIs for inpatient health service utilization were positive for all years and disability types. The total CIs of inpatient utilization were the highest (0.248). The highest disparities in utilization of inpatient services were for physical disabilities (0.4515 for CI in 2011), and the highest in self-treatment services were for intellectual disability (0.1538 for CI in 2011). The expenditure factor was the main contributor to inequalities. Chronic disease, educational level, and health insurance factors also contribute to the utilization inequalities. Policies should promote medical insurance and assistance for disabled people with serious impairment and poor. It is crucial to improve the provision of basic medical services, including meeting the demand for varied disabilities and the accessibility of facilities and equipment to enhance the access and well-being of people with disabilities.

"Now We Can Speak": Wheelchair Sport Participation in Areas of Armed Conflict.

This study sought to understand the lived experiences of wheelchair basketball athletes from low- and middle-income countries of recent or current armed conflict and the meaning that they ascribed to their participation. Wheelchair basketball athletes (N = 108) from eight national teams participated in semistructured focus-group interviews. Study data were analyzed thematically using an interpretive descriptive approach. Three themes were developed: "I can do anything I want; not only basketball," self-concept changes through sport participation; "Now they see me as a respectable person,"societal belonging through sport; and "I have motivated other disabled people," influence on nonparticipating disabled persons. The findings indicated that participation in wheelchair sports may help disabled persons see themselves as capable individuals on the court and in aspects of daily living, perhaps even peer role models for other disabled persons in their communities and countries.

Physical Activity And Sedentary Behavior In Older Adults With Risk For Mobility Disability

Physical Activity And Sedentary Behavior In Older Adults With Risk For Mobility Disability

What can I do for my low back pain? The Work In Progress questionnaire!

There is growing evidence on Commitment Therapy for people with low back pain (LBP). A self-reported questionnaire is lacking which evaluates commitment by relying on the most recommended actions, the most important core outcome domains, and the most evidenced treatment options. To describe the development and psychometric validation of the Work In Progress (WIP) questionnaire. Development and psychometric validation of the WIP questionnaire in the context of people with LBP, as a means to evaluate Commitment. Outpatient facilities. People with LBP. The new instrument was created by item generation and selection. Face validity, appropriateness, acceptability and feasibility were investigated. Psychometric testing was carried out in a cross-sectional study and included: 1) exploratory factor analysis; 2) reliability by internal consistency (Cronbach's alpha) and test-retest measurement (Intra-class Correlation Coefficient, ICC<inf>2.1</inf>); and 3) construct validity by hypothesis testing the correlation of the WIP questionnaire with the Pain Catastrophizing Scale (PCS), the Oswestry Disability Index (ODI), and a pain intensity Numerical Rating Scale (NRS) (Pearson's r correlations). The WIP questionnaire was successfully developed based on international guidelines and the testing of face validity, appropriateness, acceptability and feasibility were satisfactory. The instrument was administered to 102 people with LBP (39 females, mean age of 49.7±14.6 years [range 20-80], pain median duration of 42.1 weeks [range 3-360]). Factor analysis revealed a two-factor 10-item solution (57% of explained variance). The internal consistency was good (α=0.70-85) and test-retest assessment was excellent (ICC<inf>2.1</inf>=0.91-94). Construct validity was good, as ≥75% of hypotheses were confirmed. The WIP questionnaire is a self-reported tool to evaluate commitment in persons with LBP showing satisfactory psychometric properties. It can be recommended for clinical and research purposes. This study adds original new data to the existing knowledge in the field of Commitment within the bio-psychosocial paradigm for disabled people. It is expected to contribute to the evaluative, clinical and rehabilitative approach of individuals with low back pain.

The Political Economy of Disability and the Nursing Home Industry in the United States

While the mass of Covid-19 related deaths in nursing homes has begun to draw attention to the corruption of the industry, the existing literature focuses primarily on the post-productive population (the elderly), or on the unpaid and underpaid care workers, while the discussion of the young and disabled, making up over 15% of residents in U. S. nursing homes, is largely absent. What can a Marxist analysis of disability tell us about both the nature of disability oppression and of the nursing home industry in the United States? Why are 16.9% of nursing home residents young disabled people? How are nursing homes in the U. S. funded? What political conclusions can we draw from this analysis? Building on the work of the late disabled socialist activist Marta Russell, I argue that the trapping of young disabled people in nursing homes is a result of their absorption by the nursing home industry due to capitalism's “compulsory unemployment” of the disabled and the segregation of those who cannot produce surplus value (Russell, 2019). Furthermore, private nursing homes do not “extract” from the disabled, as some have argued, as surplus value can only be extracted from the living labor of nursing-home and other workers. The incorporation of the non-working, institutionalized disabled into class struggle, then, is the only path to ending capitalist exploitation of the entire working class.

Trends and Factors Affecting Functional Limitations on Activities of Daily Living Performance Among Korean Adults With Disabilities, 2008-2020: A Longitudinal Study.

Loss of the ability to perform activities of daily living (ADLs) leads to negative health outcomes such as reduced quality of life, institutionalization, and mortality. In Korea, the proportion of older adults with disabilities is increasing along with rapid population aging. Therefore, providing a comprehensive approach to the prevention and management of ADL limitations in people with disabilities is necessary. This can be accomplished by understanding the trends and factors affecting these limitations over time. This study was developed to examine the longitudinal trend and factors affecting ADL limitations over time among people with disabilities in Korea. Data from 346 people with disabilities in the 2008-2020 Korean Welfare Panel Study were used. Bivariate analysis and a Kendall trend test were performed to determine the longitudinal trends for ADL limitations, and multiple logistic regression was used to evaluate whether relevant variables could predict these limitations. The prevalence of ADL limitations among people with disabilities increased by 16.5% over the 12 years of the study. The highest rate of increase in these limitations over time was found in people with mental disorders (27.8%), those over 65 years of age (27.3%), and those with depression (25.6%). In multiple logistic regression, the odds ratios of the variables were slightly different at each survey wave. However, severe disability and low educational level were consistently found to be associated with ADL limitations over time. The findings provide evidence of a significant relationship between level of disability and/or educational status and ADL limitations in people with disabilities in Korea. To prevent the development of ADL limitations in people with disabilities, comprehensive identification of longitudinal trends and factors affecting ADL limitations is necessary. Early intervention, including integrated services such as home rehabilitation services to prevent ADL limitations, especially for disabled people with severe disabilities and low educational levels, has the potential to delay ADL limitations.

An Archaeology of Disability: A Dialogic Essay

An Archaeology of Disability is a research station designed for the Venice Biennale, Architettura 2021 by David Gissen, Jennifer Stager, and Mantha Zarmakoupi and exhibited later at La Gipsoteca di Arte Antica of Pisa in 2022, at the Canellopoulos Museum of Athens in 2023, and at the Archaeological Museum of Thessaloniki in 2024. The research station works with languages and forms used by contemporary disabled people to reproduce elements—a ramp, a seat, an art gallery—from the ancient Acropolis in Athens that vanished long ago and that have little or no extant material forms. Among the many people who contributed to the research station are two performers, Christopher Tester and Pia Hargrove, who performed, respectively, the ekphrastic film and audio description Sēmata (Signs) (2021). The following dialogic essay draws on conversations with the curators and performers led by Brooke Holmes and Pasquale Toscano. This dialogic form surfaces some of the collaborative aspects of the research station to highlight the ways in which such collaboration brings different lenses to antiquity.

The Path Towards Personal Growth in Spousal Caregiving

Caregiver support is necessary for many long-term ill or disabled people to enable them to live at home. However, the impact of this care relationship on the caregiver is still partly unknown. This article focuses on the process of achieving personal growth in spousal caregiving. The aim of our study was to conduct an integrative literature review to describe the aspects associated with achieving personal growth as well as to analyze the relationship between the aspects involved. The thematic analysis method was used with inductive content classification to modify the themes. The analysis highlighted three main aspect categories connected with achieving personal growth: the means, coping styles, and personal or caregiving resources. In addition, the path from adversities and challenges towards personal growth and positive experiences in spousal caregiving was revealed by analyzing the relationship between the identified aspects. We found that the means, based on social support and self-care, help caregivers to adopt positive coping strategies, reframing, and resilience, which are associated with achieving personal growth. Also, personal or caregiving resources, such as meaningful caring experiences, religiosity, and spirituality, hope, positive personality characteristics, family functioning, and disease severity of the care recipient, were associated with achieving growth. Finally, our findings suggest that it is important to further study the path towards personal growth in spousal caregiving and to find the best possible ways to support caregivers in difficult moments and periods of caregiving.