The Challenges of Living with Disabilities in Connecticut

The UCONN Master of Public Health Program’s Practicum Project The Practicum Project is a supervised service-learning experience that integrates curriculum with hands-on experience in a public health setting. All 2nd year students are expected to work collaboratively in assessing the extent, causes and public health responses to a selected public health problem confronting citizens of Connecticut. The focal topic for the 2007 Project was The Challenges of Living with Disabilities in Connecticut. During this past spring, 17 students of our program, working alongside 50 communitybased stakeholders across Connecticut, completed 1,800 hours of service-learning in pursuit of answers to the following questions: • How is the concept of disability defined by various health and social service providers? • What are the estimated numbers of persons living with disabilities in Connecticut and what is the range of their disabling conditions? • What arrays of services are in place to facilitate the full integration of persons with disabilities into their communities? • What opportunities exist to expand our understanding of the challenges faced by persons living with disabilities and promote public policy on their behalf? This occasion and the accompanying report marks the completion of the 3rd in a series of practicum project reports by UCONN MPH students. Through their combined efforts, students gained experience and skill addressing one of the most significant public health issues of our time; they gained insight into the breadth and capacity of our public health system and established invaluable relationships with public health practitioners, agencies and institutions around the state. Their report documents a rich campus-community partnership to advance public health goals.

Use of pneumococcal vaccine in people with chronic disease in United States

Objective. The risk of complications and deaths related to pneumococcal infections is high among high risk population (i.e. those with chronic diseases such as diabetes or asthma), despite current immunization recommendations. The aim of this study is to evaluate the use of pneumonia vaccine in adults with and without diabetes or asthma by year of age and whether immunization practices conform to policy recommendations. ^ Methods. Data were drawn from 2005 Behavioral Risk Factor Surveillance Study. Age specific estimated counts and proportions of pneumonia vaccination status were computed. The association of socio-demographic factors with vaccination status was estimated from multiple logistic regression and results were presented for adults (18-64yrs) and elderly (65 or older). ^ Results. Overall 12.3% of the adults and 61.5% of elderly reported ever received pneumonia vaccine. 66.8% of diabetics and 72.6% of asthmatics received the vaccine among elderly. 33.4% of diabetics and 21.6% of asthmatics received the vaccine among adults. These numbers are far away from Healthy people 2010 objective coverage rates of 90% for elderly and 60% for high risk adults. Though diabetes was one of the recommendations for the pneumonia vaccine still the status was less than 70% even at older ages. Although asthma was not an indication for pneumonia vaccine, asthmatics still achieved 50% level by an early age of 60 and reached up to 80% at as early as 75 years. In those having both asthma and diabetes, although the curve reaches to 50% level at a very early age of 40yrs, it is not stable until the age of 55 and percentages reached to as high as 90% in older ages. Odds of receiving pneumonia vaccine were high in individuals with diabetes or asthma in both the age groups. But the odds were stronger for diabetics in adults compared to those in the elderly [2.24 CI (2.08-2.42) and 1.32 CI (1.18-1.47)]. The odds were slightly higher in adults than in elderly for asthmatics [1.92 CI (1.80-2.04) and 1.73 CI (1.50-2.00)].The likelihood of vaccination also differed by gender, ethnicity, marital status, income category, having a health insurance, current employment, physician visit in last year, reporting of good to excellent health and flu vaccine status. ^ Conclusion. There is a very high proportion of high risk adults and elderly that remain unvaccinated. Given the proven efficacy and safety of vaccine there is a need for interventions targeting the barriers for under-vaccination with more emphasis on physician knowledge and practice as well as the recipient attitudes.^

Identification of maltreatment type in children with disabilities using the National Child Abuse and Neglect Data System (NCANDS)

This study was a retrospective design and used secondary data from the National Child Abuse and Neglect Data System (NCANDS), provided by the National Data Archive on Child Abuse and Neglect Family Life Development Center administered by Cornell University. The dataset contained information for the year 2005 on children from birth to 18 years of age. Child abuse and neglect for disabled children, was evaluated in-depth in the present study. Descriptive and statistical analysis was performed using the children with and without disabilities. It was found that children with disabilities have a lower rate of substantiation that likely indicates the interference of reporting due to their handicap. The results of this research demonstrate the important need to teach professionals and laypersons alike on how to recognize and substantiate abuse among disabled children.^

Vocational guidance in people with special educational needs as the result of visual impairment during the transition stage from high school to advanced education

This work proposes to seek for the factors related to the choices that people with special educational needs make as the result of the visual impairment, during the transition stage from high school to advanced education. Therefore, we have taken into consideration that Vocational Guidance and the transition towards adulthood get specific characteristics in case of visually impaired young people, particularly in what's related to continue with advanced education. The focus of this work is to be able to clarify the existence of factors that make this transition stage easier or harder, through the observation of visually impaired and blind people who complete high school. This matter has aroused interest and concern about the strategies to follow to ensure the successful entrance and remaining in the selected advanced education. However, if we don?t know the factors involved in the described fact, it's difficult to design an appropriate intervention strategy. Then, in order to take acknowledge about the specific issues of visually impaired young people who complete high school, we chose a special school for this disability and some students who will join this project

Vocational guidance in people with special educational needs as the result of visual impairment during the transition stage from high school to advanced education

This work proposes to seek for the factors related to the choices that people with special educational needs make as the result of the visual impairment, during the transition stage from high school to advanced education. Therefore, we have taken into consideration that Vocational Guidance and the transition towards adulthood get specific characteristics in case of visually impaired young people, particularly in what's related to continue with advanced education. The focus of this work is to be able to clarify the existence of factors that make this transition stage easier or harder, through the observation of visually impaired and blind people who complete high school. This matter has aroused interest and concern about the strategies to follow to ensure the successful entrance and remaining in the selected advanced education. However, if we don?t know the factors involved in the described fact, it's difficult to design an appropriate intervention strategy. Then, in order to take acknowledge about the specific issues of visually impaired young people who complete high school, we chose a special school for this disability and some students who will join this project

Vocational guidance in people with special educational needs as the result of visual impairment during the transition stage from high school to advanced education

This work proposes to seek for the factors related to the choices that people with special educational needs make as the result of the visual impairment, during the transition stage from high school to advanced education. Therefore, we have taken into consideration that Vocational Guidance and the transition towards adulthood get specific characteristics in case of visually impaired young people, particularly in what's related to continue with advanced education. The focus of this work is to be able to clarify the existence of factors that make this transition stage easier or harder, through the observation of visually impaired and blind people who complete high school. This matter has aroused interest and concern about the strategies to follow to ensure the successful entrance and remaining in the selected advanced education. However, if we don?t know the factors involved in the described fact, it's difficult to design an appropriate intervention strategy. Then, in order to take acknowledge about the specific issues of visually impaired young people who complete high school, we chose a special school for this disability and some students who will join this project

Understanding HCI policy in Spain in the context of acces

Spain pioneered policies related to disability and accessibility, especially in the physical environment. The first major piece of legislation was Act 13/1982 on the Social Integration of People with Disabilities. The law was published just a few years after the reinstitution of democracy in Spain in 1977 and the approval of the Spanish Constitution in 1978. Act 13/1982 is a general law that applies accessibility to social services and education, as well as to workplace and physical accessibility. This law targeted first and foremost the social integration of people with disabilities, and it was a significant success, especially in the field of employment, as it made it mandatory for private companies and public administrations to employ a certain percentage of persons with disabilities. This greatly increased the employability of people with disabilities, as highlighted in a document celebrating 30 years of Act 13/1982. Over the past 20 years, policy makers have also focused on accessibility to information and communication technologies (ICT), developing first the national computing accessibility standards and then specialized legislation. Initially, Spanish activities were mostly national but have now gained an international dimension. All these initiatives are strongly related to the discipline of human-computer interaction, as the key component of an accessible system is its user interface.

Performance assessment of an architecture with adaptative interfaces for people with special needs

People in industrial societies carry more and more portable electronic devices (e.g., smartphone or console) with some kind of wireles connectivity support. Interaction with auto-discovered target devices present in the environment (e.g., the air conditioning of a hotel) is not so easy since devices may provide inaccessible user interfaces (e.g., in a foreign language that the user cannot understand). Scalability for multiple concurrent users and response times are still problems in this domain. In this paper, we assess an interoperable architecture, which enables interaction between people with some kind of special need and their environment. The assessment, based on performance patterns and antipatterns, tries to detect performance issues and also tries to enhance the architecture design for improving system performance. As a result of the assessment, the initial design changed substantially. We refactorized the design according to the Fast Path pattern and The Ramp antipattern. Moreover, resources were correctly allocated. Finally, the required response time was fulfilled in all system scenarios. For a specific scenario, response time was reduced from 60 seconds to less than 6 seconds.

Interacción desde dispositivos Android vía Bluetooth, con juguete teledirigido, para su uso por personas con discapacidad

El Proyecto Fin de Carrera, con título, "Interacción desde dispositivos Android vía Bluetooth, con juguete teledirigido, para su uso por personas con discapacidad" pretende completar la primera versión de la aplicación sobre dispositivo Android para manejar un juguete teledirigido añadiendo nuevas formas de interactuar con el dispositivo Android. Para este caso, el juguete teledirigido es el mismo: el robot esférico llamado Sphero. Dicho robot posee una interfaz a través de la cual puede recibir instrucciones, y mediante las cuales, se puede poner en movimiento o iluminarse con diferentes colores. Esta ampliación facilitará la interacción del usuario con el dispositivo Android, además de ampliar la funcionalidad hacia la inversa: recibir los movimientos del robot Sphero en el dispositivo Android cuando es manejado con la mano. Completando la primera versión, como cumplimiento de este Proyecto Fin de Carrera, se han realizado una serie de mandos nuevos, los cuales abarcan desde el manejo del robot por instrucciones de voz, movimientos del dispositivo Android desde el que se ejecuta, describir una trayectoria dibujada previamente en el dispositivo Android, o, realizar una serie de movimientos corregidos mediante la aplicación gracias a los límites de movimientos para un usuario concreto que pueden introducirse. Además, completando lo anteriormente escrito, se ha desarrollado una aplicación web que registrará todos los datos de uso del juguete, la cual, explota una base de datos que almacena toda interacción con el juguete. Estos datos estarán asociados a un usuario, debido a que la aplicación Android debe perfilarse para el uso de un usuario concreto. El perfilado de usuario se ha completado añadiendo una serie de información que puede ser útil para la persona que analice el comportamiento de una persona con discapacidad que utilice la aplicación. Por último, se ha realizado un estudio de elementos externos que puedan facilitar la interacción con los dispositivos Android a personas que sufran alguna discapacidad. ABSTRACT. The Thesis, titled "Interaction from Android devices via Bluetooth, with remote control toy, for use by people with disabilities" project aims to complete the first version of the application on Android device to manage a remote control toy adding new ways of interacting to Android device. For this case, the remote control toy is the same: the spherical robot called Sphero. This robot has an interface through which it can receive instructions, and by means of which can be set in motion or illuminated with different colors. This expansion will facilitate user interaction with the Android device, and extend the functionality to reverse: receiving Sphero robot movements in the Android device when handled by hand. Completing the first version, in fulfillment of this Thesis, there have been a number of new controls, which range from control of robot by voice instructions, movements Android device from which it runs, describe a path drawn previously on your Android device, or perform a series of movements corrected by applying through limits of movement for a particular user can be made. Besides completing the above written, has developed a web application that will record all data on use of the toy, which exploits a database that stores all interaction with the toy. These data will be associated with a user, because the Android application should be outlined for the use of a particular user. The user profile is completed by adding a range of information that can be useful for the person to analyze the behavior of a disabled person to use the application. Finally, a study was made of external elements that can facilitate interaction with Android devices to people who suffer from a disability.

Enhancing web-based learning resources with quizzes through an Authoring Tool and an Audience Response System

Quizzes are among the most widely used resources in web-based education due to their many benefits. However, educators need suitable authoring tools that can be used to create reusable quizzes and to enhance existing materials with them. On the other hand, if teachers use Audience Response Systems (ARSs) they can get instant feedback from their students and thereby enhance their instruction. This paper presents an online authoring tool for creating reusable quizzes and enhancing existing learning resources with them, and a web-based ARS that enables teachers to launch the created quizzes and get instant feedback from the class. Both the authoring tool and the ARS were evaluated. The evaluation of the authoring tool showed that educators can effectively enhance existing learning resources in an easy way by creating and adding quizzes using that tool. Besides, the different factors that assure the reusability of the created quizzes are also exposed. Finally, the evaluation of the developed ARS showed an excellent acceptance of the system by teachers and students, and also it indicated that teachers found the system easy to set up and use in their classrooms.

Using cloud technologies for engaging people with cultural heritage

Cultural heritage is an important asset of Europe which is largely underexplored. One of the main reasons is that the general public do not really incorporate cultural activities in their life style. Currently, curators and professionals in the heritage sector face the toughest challenges on how to attract, engage and retain visitors of heritage institutions (libraries, museums, archives and historical societies). TAG CLOUD FP7 European project seeks to overcome this situation and promote lifelong engagement with culture by personalising the visitors? cultural experiences through cloud technologies.

Validación de un marco abierto accesible de tercera generación para la integración nativa de productos de apoyo en tecnologías de la información y la comunicación

Las personas con discapacidad a menudo se encuentran con problemas de acceso a las Tecnologías de la Información y la Comunicación (TIC), debido a diseños y desarrollos que no tienen en cuenta sus diferencias funcionales, y en consecuencia se encuentran en riesgo de exclusión social. Cada vez es más común encontrar productos de apoyo que permitan utilizar diferentes tecnologías (ordenadores, Internet, dispositivos móviles), pero muchos de ellos no se encuentran integrados debido a que funcionan esencialmente modificando la plataforma donde están instalados, siendo soluciones de acceso de segunda generación. Más allá del desarrollo de los productos de apoyo, que sin duda ha evolucionado positivamente en los últimos años, cabe resaltar que existe una falta de herramientas y de aproximación holística que ayuden a los desarrolladores y diseñadores hacer las TIC accesibles. Esta tesis doctoral pretende validar la hipótesis de que una metodología holística de desarrollo de aplicaciones y productos de apoyo TIC, llamada Marco Abierto Accesible, facilita el desarrollo y la integración de modo nativo de la accesibilidad en las aplicaciones y productos apoyo, independientemente de la tecnología utilizada, dando lugar a soluciones de acceso de tercera generación que permitan mejorar la utilización de dichas aplicaciones por parte de personas con discapacidad. Este trabajo se ha desarrollado en el marco del proyecto AEGIS (del inglés, open Accessibility Everywhere: Groundwork, Infrastructure, Standards), que fue parcialmente financiado por la Comisión Europea (CE) bajo el VII Programa Marco y tuvo una duración de cuatro años. La metodología para el diseño, desarrollo y validación seguida en esta tesis es una adaptación de dos metodologías de diseño existentes (el Diseño Centrado en el Usuario y el Diseño Orientado a Metas), la implementación del Marco Abierto Accesible y el uso de diferentes técnicas de validación. Además se ha desarrollado un marco metodológico de entrenamiento para minimizar el efecto que tiene la curva de aprendizaje cuando los usuarios prueban por primera vez las soluciones desarrolladas. En esta tesis se presenta el Marco Abierto Accesible aplicado a las TIC en las tres áreas en las que se desarrolla este trabajo: ordenadores, Internet y dispositivos móviles, partiendo de las necesidades y problemas que tienen los usuarios con discapacidad en el uso de las TIC. Diferentes instanciaciones del Marco Abierto Accesible se definen en las tres áreas TIC mencionadas anteriormente y se describen varios ejemplos de sus implementaciones particulares. Los resultados de las evaluaciones de las implementaciones particulares con usuarios finales y expertos, una vez discutidos y contrastados con las hipótesis, sirven para probar la validez del Marco Abierto Accesible para la integración nativa de productos de apoyo en Tecnologías de la Información y la Comunicación. Finalmente, se presentan las líneas de investigación y trabajo futuro en el área de la accesibilidad en las TIC. ABSTRACT People with disabilities often encounter problems of access to Information and Communications Technology (ICT), due to design and developments that do not take into account their functional differences and therefore put them at risk of social exclusion. It is increasingly common to find assistive products that allow to use different technologies (computers, Internet, mobile devices), but many of them are not well integrated because they work essentially modifying the platform where they are installed, beeing the second-generation access solutions. Beyond the assistive product development, which has certainly evolved positively in recent years, it is notable that there is a lack of tools and holistic approach to help developers and designers make accessible ICT. This doctoral thesis aims to validate the hypothesis that a holistic approach to application development and assistive ICT products, called Open Accessibility Framework, facilitates the development and integration of native accessible applications and assistive products, regardless of the technology used, resulting in third-generation access solutions that improve the use of such applications by people with disabilities. This work was developed under the AEGIS project (open Accessibility Everywhere: Groundwork, Infrastructure, Standards), which was partially funded by the European Commission (EC) under the Seventh Framework Programme and lasted four years. The methodology for the design, development and validation followed in this thesis is an adaptation of two existing design methodologies (User Centered Design and Goal Oriented Design), the implementation of the Open Accessibility Framework and the usage of different validation techniques. A training methodological framework ha also been developed to minimize the effect of the learning curve when users first try the solutions developed. This thesis presents the Open Accessibility Framework applied to ICT in three areas in which this work is developed: computers, Internet and mobile devices, based on the needs and problems of the disabled users in the use of ICT. Different instantiations of the Open Accessibility Framework are defined in the three aforementioned ICT areas and various examples of its particular implementations are described. The results of the evaluations of the particular implementations which have been carried with end users and experts, once discussed and contrasted with the hypotheses, have been used to test the validity of the Open Accessibility Framework for the native integration of assistive products in Information and Communications Technology. Finally, the future research lines and future work in the area of ICT accessibility are presented.

Sistema multiplataforma de gestión integral de huertos urbanos

En este Proyecto Fin de Grado se construirá una herramienta de gestión integral de centros hortícolas donde una serie de huertos cuidados por personas en situación de discapacidad son alquilados a terceros. Esta iniciativa se lleva a cabo gracias a la iniciativa “La Huerta de Montecarmelo” de la Fundación Carmen Pardo-Valcarce de Madrid. Este proyecto es el resultado de la colaboración entre la Escuela Técnica Superior de Ingeniería de Sistemas Informáticos y la Fundación, a través de un programa de Prácticas Externas que duró doce meses. Por una parte, tras años de trabajo en esta Obra Social, se encontró que muchos de los clientes, pasado el verano, se desvinculaban de las tareas y del medio. A fin de solucionar esos problemas, se propuso construir una aplicación web, comunicada con otros dispositivos, como Smartphones, permitiendo un flujo de trabajo más ágil y notificando a los arrendatarios de cada cambio en sus huertos, por ejemplo: fotos recientes, notificaciones de recolecta o futuros cursos. El proyecto se llevó a cabo con éxito a lo largo de 2012 y 2013. Abstract In this Final Degree Project we build a complete horticulture center management tool where a set of gardens, which are kept by people with disabilities, are leased to third parties. This project is carried out within the La Huerta Montecarmelo initiative of the Carmen Pardo-Valcarce Foundation in Madrid. The project was the result of collaboration between the School of Computer Systems Engineering of the Technical University of Madrid and that Foundation through an External Practices program that lasted twelve months. By one hand, over the years of Social Work in this initiative, it was found that some clients after spring were easily disconnected from the tasks involved to the garden. By the other, all the management of more than two hundred of gardens becomes a very complex task due to lots of paperwork. To solve these problems and more, we proposed to build a web application, relying on other devices, such as Smartphones, allowing a more agile workflow and notifying customers of any change related to its garden, for example: recent photographs, notifications of harvest or future courses. The project was successfully carried out throughout 2012 and 2013.

Non-pharmacological interventions to reduce the risk of diabetes in people with impaired glucose regulation : a systematic review and economic evaluation

Peer reviewed

Potential Benefit of Singing for People with Parkinson’s Disease : A Systematic Review

Acknowledgements including sources of support This study was not supported by any particular grant or funding source. The senior author MSB, an epidemiologist with research experience in PD, wishes to thank clinician authors JB, RAA and SMB for their invaluable contributions. JB is a retired health professional with long-standing experience in community health. RAA and SMB are qualified and practising speech and language therapists and RAA specialises in adult neurological disorders. Additionally, we thank Dr Katherine Deane of the University of East Anglia for expert input regarding the Threats to Validity quality tool, on which she was the lead developer.