Design after design to bridge between people living with cognitive or sensory impairments, their friends and proxies

A carer or teacher often plays the role of proxy or spokesperson for a person living with an intellectual disability or form of cognitive or sensory impairment. Our research undertook co-design with people living with cognitive and sensory impairments and their proxies in order to explore new ways of facilitating communication. We developed simple functioning interactive prototypes to support people with a diverse range of competencies to communicate and explore their use. Deployment of the prototypes enabled use, appropriation and design after design by our two participant groups; adults living with cognitive or sensory impairments and children identified with language delays and autism spectrum disorder. The prototypes supported concrete expression of likes, dislikes, capabilities, emotional wants and needs and forms of expression that hitherto had not been fostered, further informing design. Carers and designers were surprised at the ways in which the technology was used and how it fostered new forms of social interaction and expression. We elaborate on how design after design can be an effective approach for engaging people living with intellectual disabilities, giving them greater capacity for expression and power in design and offering the potential to expand and deepen their social relationships.

Way-Finding in the Built Environment

The Way-fi nding in the Built Environment project is a worldwide review identifying those way-fi nding systems and technologies that could be used to make it easier and safer for people with a sensory impairment (and in particular a vision impairment) to fi nd their way around buildings and large public spaces. The project makes recommendations on how these technologies and systems may be incorporated, by law or otherwise, into Australia’s building and construction practice. Way-fi nding aims to ensure that people with a sensory impairment know where they are in a building or an environment, where their desired location is, and how to get there from their present location. It is unlawful to discriminate against people with a disability under the Disability Discrimination Act 1992.

Co-morbidity of depression and anxiety in common age-related eye diseases : a population-based study of 662 adults

This study examined the prevalence of co-morbid age-related eye disease and symptoms of depression and anxiety in late life, and the relative roles of visual function and disease in explaining symptoms of depression and anxiety. A community-based sample of 662 individuals aged over 70 years was recruited through the electoral roll. Vision was measured using a battery of tests including high and low contrast visual acuity, contrast sensitivity, motion sensitivity, stereoacuity, Useful Field of View, and visual fields. Depression and anxiety symptoms were measured using the Goldberg scales. The prevalence of self-reported eye disease [cataract, glaucoma, or age-related macular degeneration (AMD)] in the sample was 43.4%, with 7.7% reporting more than one form of ocular pathology. Of those with no eye disease, 3.7% had clinically significant depressive symptoms. This rate was 6.7% among cataract patients, 4.3% among those with glaucoma, and 10.5% for AMD. Generalized linear models adjusting for demographics, general health, treatment, and disability examined self-reported eye disease and visual function as correlates of depression and anxiety. Depressive symptoms were associated with cataract only, AMD, comorbid eye diseases and reduced low contrast visual acuity. Anxiety was significantly associated with self-reported cataract, and reduced low contrast visual acuity, motion sensitivity and contrast sensitivity. We found no evidence for elevated rates of depressive or anxiety symptoms associated with self-reported glaucoma. The results support previous findings of high rates of depression and anxiety in cataract and AMD, and in addition show that mood and anxiety are associated with objective measures of visual function independently of self-reported eye disease. The findings have implications for the assessment and treatment of mental health in the context of late-life visual impairment...

Music, rhythm, rise time perception and developmental dyslexia: Perception of musical meter predicts reading and phonology

Introduction: Rhythm organises musical events into patterns and forms, and rhythm perception in music is usually studied by using metrical tasks. Metrical structure also plays an organisational function in the phonology of language, via speech prosody, and there is evidence for rhythmic perceptual difficulties in developmental dyslexia. Here we investigate the hypothesis that the accurate perception of musical metrical structure is related to basic auditory perception of rise time, and also to phonological and literacy development in children. Methods: A battery of behavioural tasks was devised to explore relations between musical metrical perception, auditory perception of amplitude envelope structure, phonological awareness (PA) and reading in a sample of 64 typically-developing children and children with developmental dyslexia. Results: We show that individual differences in the perception of amplitude envelope rise time are linked to musical metrical sensitivity, and that musical metrical sensitivity predicts PA and reading development, accounting for over 60% of variance in reading along with age and I.Q. Even the simplest metrical task, based on a duple metrical structure, was performed significantly more poorly by the children with dyslexia. Conclusions: The accurate perception of metrical structure may be critical for phonological development and consequently for the development of literacy. Difficulties in metrical processing are associated with basic auditory rise time processing difficulties, suggesting a primary sensory impairment in developmental dyslexia in tracking the lower-frequency modulations in the speech envelope. © 2010 Elsevier.

Chemotherapy in the elderly

The number of elderly patients with malignancy is growing and is likely to have a major impact on resources, quality of care, health economics and treatment options. Decisions regarding treatment options with chemotherapy are limited by the scarcity of data specifically addressing the issues regarding chemotherapy in the elderly. The problem is further confounded by issues such as co morbidity, poly-pharmacy, cognitive impairments, emotional problems, functional limitations, sensory impairment and a lack of social support. Ageing is associated with specific physiologic changes in functional status, organ function and drug pharmacokinetics. Optimising cancer care and chemotherapy delivery in the elderly requires a better understanding of the specific pharmacokinetic and pharmacodynamic issues and administration of chemotherapy in this age group. Elderly participation in clinical trials and specific research is essential to guide treatment decisions and further research is required to provide evidence-based models to guide treatment decisions. In an Australian setting, the development of a geriatric oncology specific group as a means of facilitating collaboration with geriatricians, development of specific elderly research programs and clinical trials, education and development of treatment guidelines would further improve outcomes of our elderly patients undergoing cancer treatment.

Critical engagement with insider accounts of inclusive schooling

Engaging critically with insider accounts of inclusive schooling, the thesis provides an opportunity to understand the entangled, multiple, and often contradictory discourses that comprise day-to-day experiences of "inclusion" for young people with impairments. The work forming the majority of this thesis is a collection of journal papers.

Parental effects improve escape performance of juvenile reef fish in a high-CO2 world

Rising CO2 levels in the oceans are predicted to have serious consequences for many marine taxa. Recent studies suggest that non-genetic parental effects may reduce the impact of high CO2 on the growth, survival and routine metabolic rate of marine fishes, but whether the parental environment mitigates behavioural and sensory impairment associated with high CO2 remains unknown. Here, we tested the acute effects of elevated CO2 on the escape responses of juvenile fish and whether such effects were altered by exposure of parents to increased CO2 (transgenerational acclimation). Elevated CO2 negatively affected the reactivity and locomotor performance of juvenile fish, but parental exposure to high CO2 reduced the effects in some traits, indicating the potential for acclimation of behavioural impairment across generations. However, acclimation was not complete in some traits, and absent in others, suggesting that transgenerational acclimation does not completely compensate the effects of high CO2 on escape responses.

Interacción con juguetes para usuarios con discapacidad usando equipos con S.O. Android

El proyecto realizado, trata de una aplicación desarrollada en la plataforma Android, orientada a personas con algún tipo de discapacidad sensorial o psíquica. Dicha aplicación fomenta el uso y la integración de dispositivos móviles en este tipo de sector de población. Está pensada, para que, un usuario con discapacidad, pueda interactuar con ella y de forma transparente a él, se ha creado un sistema mediante el cual, se registra todo el comportamiento que ese usuario ha tenido durante el tiempo de uso de la aplicación, con el fin de llevar un seguimiento del mismo; evaluar si existen cambios en él; determinar si son necesarios algunos cambios en la aplicación que favorezcan una mejoría en cuanto al uso y consecución de resultados en el paciente, etc. Se ha combinado el uso de una aplicación instalada sobre un sistema operativo de libre distribución, concretamente Android, con un juguete de código abierto, como es Sphero. Eso ha permito el desarrollo de una aplicación perfectamente ajustada a los requisitos funcionales definidos, con una robustez y eficiencia similar a una aplicación de sistemas operativos móviles cerrados. Es importarte remarcar, que la primera finalidad de este proyecto es ofrecer la posibilidad de usar un juguete, como Sphero, que está orientado a un sector de población sin discapacidad, haciendo uso de cualquier dispositivo móvil, a personas con diferentes grados de discapacidad sensorial, motora y psíquica. Siempre clarificando, que no existe la posibilidad de usar esta aplicación para cualquier tipo y grado de discapacidad, ya que, ello supondría, un proyecto de una envergadura enorme. El hecho de usar un dispositivo móvil, es un derecho, que todos tenemos. Y por ello, se espera que tras la lectura y comprensión de este proyecto, se motive a los lectores a seguir desarrollando aplicaciones para que cualquier usuario, con discapacidad o no, tenga las mismas oportunidades de interactuación con dispositivos móviles. The carried out project, is an application developed on the Android platform , aimed at people with some kind of sensory or mental disability . This application encourages the use and integration of mobile devices in this type of population sector. It is designed to be interacted by a disable person and transparently to that user, it has been created a system by which all behavior, that user has had during the time of use of the application, is recorded, that’s to keep track of it ; assess whether there are changes in it, determine if changes are needed in the application that favor an improvement in the use and achieving patient outcomes , etc. . It has combined the use of an application installed on an open source operating system, namely Android, an open source toy , as is Sphero . That has made it possible to develop an application perfectly adjusted to the functional requirements defined with a robustness and efficiency similar to a mobile OS application closed. It is important to note, that the first aim of this project is to offer the possibility of using a toy, like Sphero , which is geared to a sector of the population without disabilities , using any mobile device , for people with different degrees of sensory impairment , motor and mental . Always clarifying that there is no possibility to use this application for any type and degree of disability, because the magnitude of the project would have been infinitely greater. The fact of using a mobile device, is a right we all have. And so, it is expected that upon reading and understanding of this project, motivate readers to continue developing applications for any user , disabled or not, have the same opportunities for interaction with mobile devices .

Caractérisation d'une entité neurologique émergente au sein du cheptel ovin québécois

Cette étude vise à caractériser le «crampage», une entité relativement nouvelle dans l’industrie ovine au Québec. Les signes cliniques se manifestent au pas, par une hyperflexion (hanche, grasset, jarret), d’un ou des deux membres pelviens. Cinq agneaux naturellement affectés et cinq agneaux appariés cliniquement normaux ont été soumis à des examens physique, neurologique et orthopédique, à des techniques d’imagerie avancée (tomodensitométrie, résonance magnétique), à des tests électrodiagnostiques (électromyogramme, vitesses de conduction nerveuse motrice et sensitive) puis à une nécropsie. Des hématologies, biochimies ainsi que des analyses du liquide céphalorachidien ont également été réalisées. Les résultats ont été comparés entre les groupes (affectés/cliniquement normaux). Il a été constaté à la tomodensitométrie que la surface du canal vertébral mesurée au niveau de la deuxième vertèbre lombaire était inférieure dans le groupe des agneaux affectés (p=0.045). Aucune répercussion n’a été constatée sur le segment de moelle épinière correspondant. La racine S2, quant à elle, était plus grêle dans le groupe des agneaux affectés (p=0.01). À l’issue de cette étude, une cause orthopédique, musculaire ou neurologique consécutive à une lésion structurale de la moelle épinière a été écartée. Il pourrait s‘agir d’une atteinte sensitive de la racine S2 altérant la sensation dans le membre affecté, toutefois, une anomalie fonctionnelle cérébrale ou de la moelle épinière dans le renflement lombaire, est également à considérer. Sans anomalie musculaire, l’appellation «crampage» est inexacte. Nous proposons de la remplacer par des termes plus descriptifs comme «syndrome d’hyperflexion» ou «high stepping gait».

Caractérisation d'une entité neurologique émergente au sein du cheptel ovin québécois

Cette étude vise à caractériser le «crampage», une entité relativement nouvelle dans l’industrie ovine au Québec. Les signes cliniques se manifestent au pas, par une hyperflexion (hanche, grasset, jarret), d’un ou des deux membres pelviens. Cinq agneaux naturellement affectés et cinq agneaux appariés cliniquement normaux ont été soumis à des examens physique, neurologique et orthopédique, à des techniques d’imagerie avancée (tomodensitométrie, résonance magnétique), à des tests électrodiagnostiques (électromyogramme, vitesses de conduction nerveuse motrice et sensitive) puis à une nécropsie. Des hématologies, biochimies ainsi que des analyses du liquide céphalorachidien ont également été réalisées. Les résultats ont été comparés entre les groupes (affectés/cliniquement normaux). Il a été constaté à la tomodensitométrie que la surface du canal vertébral mesurée au niveau de la deuxième vertèbre lombaire était inférieure dans le groupe des agneaux affectés (p=0.045). Aucune répercussion n’a été constatée sur le segment de moelle épinière correspondant. La racine S2, quant à elle, était plus grêle dans le groupe des agneaux affectés (p=0.01). À l’issue de cette étude, une cause orthopédique, musculaire ou neurologique consécutive à une lésion structurale de la moelle épinière a été écartée. Il pourrait s‘agir d’une atteinte sensitive de la racine S2 altérant la sensation dans le membre affecté, toutefois, une anomalie fonctionnelle cérébrale ou de la moelle épinière dans le renflement lombaire, est également à considérer. Sans anomalie musculaire, l’appellation «crampage» est inexacte. Nous proposons de la remplacer par des termes plus descriptifs comme «syndrome d’hyperflexion» ou «high stepping gait».

The Autistic Behavioural Indicators Instrument (ABII) : development and instrument utility in discriminating autistic disorder from speech and language impairment and typical development

The Autistic Behavioural Indicators Instrument (ABII) is an 18-item instrument developed to identify children with Autistic Disorder (AD) based on the presence of unique autistic behavioural indicators. The ABII was administered to 20 children with AD, 20 children with speech and language impairment (SLI) and 20 typically developing (TD) children aged 2-6 years. Results indicated that the ABII discriminated children diagnosed with AD from those diagnosed with SLI and those who were TD, based on the presence of specific social attention, sensory, and behavioural symptoms. A combination of symptomology across these domains correctly classified 100% of children with and without AD. The paper concludes that the ABII shows considerable promise as an instrument for the early identification of AD.

Functional magnetic resonance imaging of impaired sensory prediction in schizophrenia.

IMPORTANCE: Forward models predict the sensory consequences of planned actions and permit discrimination of self- and non-self-elicited sensation; their impairment in schizophrenia is implied by an abnormality in behavioral force-matching and the flawed agency judgments characteristic of positive symptoms, including auditory hallucinations and delusions of control. OBJECTIVE: To assess attenuation of sensory processing by self-action in individuals with schizophrenia and its relation to current symptom severity. DESIGN, SETTING, AND PARTICIPANTS: Functional magnetic resonance imaging data were acquired while medicated individuals with schizophrenia (n = 19) and matched controls (n = 19) performed a factorially designed sensorimotor task in which the occurrence and relative timing of action and sensation were manipulated. The study took place at the neuroimaging research unit at the Institute of Cognitive Neuroscience, University College London, and the Maudsley Hospital. RESULTS: In controls, a region of secondary somatosensory cortex exhibited attenuated activation when sensation and action were synchronous compared with when the former occurred after an unexpected delay or alone. By contrast, reduced attenuation was observed in the schizophrenia group, suggesting that these individuals were unable to predict the sensory consequences of their own actions. Furthermore, failure to attenuate secondary somatosensory cortex processing was predicted by current hallucinatory severity. CONCLUSIONS AND RELEVANCE: Although comparably reduced attenuation has been reported in the verbal domain, this work implies that a more general physiologic deficit underlies positive symptoms of schizophrenia.