Calculating the social impact of home automation for people with disability: A social return on investment study.

INTRODUCTION: Home automation can deliver important outcomes for people with disabilities, including enhanced independence. Despite the millions of dollars spent on home automation in Australia and other developed nations, to date, there has been no economic evaluation of this type of assistive technology. METHOD: A social return on investment analysis of home automation study was undertaken. Primary data were collected using qualitative interviews with home automation consumers and other key stakeholders, including occupational therapists, a spinal rehabilitation physician, peer support advocate, and managers and technical personnel from home automation providers (n = 17). The analysis was supported by (1) secondary data from a scoping review on outcomes from home automation and (2) additional literature searches to identify suitable financial proxies and to make estimates of the proportion of home automation users expected to experience each outcome. A scenario approach was used with three home automation scenarios developed with increasing complexity and costs to calculate the social return on investment. RESULTS: Eight outcomes from the use of home automation were identified, including reduced reliance on carers and family members, increased independence, and improved energy and comfort. The social return on investment ranged from $38.80 (low cost) to $15.10 (high cost) for every $1 invested across a 10-year benefit period, with the financial proxy for reduced care attendant hours contributing the most to the social return ratio. Even the highest cost scenario was repaid in social value within the first year of the benefit period. CONCLUSION: This study suggests that home automation represents a sound investment and has a significant impact on the overall quality of life of people with disabilities. Focusing on the financial savings in care attendant hours alone should be compelling evidence for funders to recognise home automation's value and continue to fund this assistive technology. CONSUMER AND COMMUNITY INVOLVEMENT: A consumer representative was a member of the project steering group, which supported the research team at all stages of the project. PLAIN LANGUAGE SUMMARY: When people get injured, their disability can stop them doing things around the home that they used to be able to do. Technology can help people with disabilities do things like open and close doors and turn off taps by pressing a button, so they do not have to wait for someone to help them. This technology can be expensive, but no one has looked at if it is worth the money. We spoke to some people with disabilities who used this type of technology, and they told us their lives were better now they used this technology. For example, they told us they were able to do things for themselves, they did not need carers as much, and they had better mental health. We spoke to businesses about the costs of different types of technology that can be used in the home. We then put a dollar value on the ways people with disabilities told us their lives were better. For example, for better mental health, we worked out how much it would cost to see a psychologist for 1 year. We found that the dollar value of the ways in which people with disabilities' lives were improved was at least 15 times more than the costs of the technology. This study therefore shows that this technology is worth the money and improves the lives of people with disabilities following serious injury.

Financial inclusion for people with disability: a scoping review.

BACKGROUND: Financial exclusion is a human rights issue affecting health equity. Evidence demonstrates that financial exclusion is exacerbated for people with disability and those in low- to middle-income countries (LMIC). Barriers to financial access include limited demand for services, banking inadequacies in catering to people with disability, and insufficiently accessible information technologies (ICT) and infrastructure. OBJECTIVES: This scoping review sought to identify barriers to and facilitators of financial inclusion for people with disability in LMIC. As a secondary objective, the study explored the potential of financial education and ICT utilisation as viable strategies for enhancing financial inclusion. METHODS: This review utilised the Arksey and O'Malley framework and PRISMA Checklist for systematic literature examination and data extraction. The WHO's Environmental Factors guided the analysis to propose potential interventions and to generate recommendations. RESULTS: The review analysed 26 publications from various global regions and fields including finance, business, technology, health and disability policy. It identified consistent financial inclusion barriers for people with disability, resulting in a set of global recommendations across attitudes, environment, technology, services, and policy. CONCLUSIONS: Recommendations include using ICT, digital innovation and multi-stakeholder collaboration to address the financial barriers experienced by people with disability. These efforts, rooted in social justice, aim to include people with disability in LMIC as valued financial sector participants, promoting health and equity.

Main findings: There are global access barriers and enablers to financial inclusion for people living with disability. Recommendations to improve access include countering stigma and attitudinal barriers, engaging in user centred design of financial services,providing financial education and ensuring accessibility of assistive technology and ICT, along with the physical environment of the bank.Added knowledge: This study reviews the literature and offers a global overview of financial inclusion for people with disabilities, along with recommendations for universally applicable actions to enhance access.Global health impact for policy and action: Identifying barriers to financial inclusion and suggesting strategies to overcome them provides valuable guidance for policymakers and advocates working to improve access to financial services for people with disability.

Perspectiva econômica do mercado de inovação em tecnologia assistiva: cenário nacional e projeções mundiais / Economic perspective of the assistive technology innovation market: national scenario and environmental projections

Objetivo: A tecnologia assistiva (TA) busca suprir ou reduzir o impacto das deficiências na execução de tarefas da vida cotidiana. Embora muitas pessoas necessitem de TA, em 2021, a OMS estimou que apenas uma em cada dez pessoas tinha acesso a ela. Com a oferta retraída e a demanda em alta, observou-se um movimento mundial crescente de inovações em TA e a abertura de um cenário de oportunidades para esse mercado. O objetivo deste artigo é avaliar o mercado de TA no Brasil e as projeções futuras, no cenário mundial. Métodos: A pesquisa foi realizada em três etapas. Primeiramente, foi realizado um estudo bibliográfico do Livro Branco da Tecnologia Assistiva no Brasil (2017), para reconhecimento dos desafios do mercado brasileiro. Em seguida, foi realizado um estudo sobre o cenário de crédito nacional, com foco em financiamento de TA. Para compreensão do mercado mundial, foi realizada uma pesquisa nos sites de análise de mercado de TA. Resultados: Há escassez de TA no Brasil. Os principais fornecedores são pequenas e médias empresas, e são escassos os incentivos fiscais e de crédito, assim como os investimentos em pesquisa, desenvolvimento e inovação. Em escala mundial, o mercado de TA foi avaliado em US$ 21,95 bilhões de dólares em 2022, devendo atingir o valor de US$ 31,22 bilhões de dólares até o ano de 2030. Conclusão: O mercado mundial de TA está em franca expansão e apresenta grande potencial de abertura para novos mercados. Esse cenário reflete um momento de oportunidades de negócio para as empresas nacionais.

Objective: Assistive Technology (AT) seeks to overcome or reduce the impact of deficiencies when performing everyday tasks. Although many people needed AT, in 2021, the WHO estimated that only one in ten people had access. With reduced supply and rising demand, a growing global movement of AT innovations was inspired, opening up a scenario of opportunities for this market. The objective of this study is to evaluate the AT market in Brazil and future projections on the global stage. Methods: The research was carried out in three stages. Firstly, a bibliographical study of the "White Book of Assistive Technology in Brazil" was carried out to recognize the challenges of the Brazilian market. Next, a study was carried out on the national credit scenario, focusing on TA financing. To understand the global market, research was carried out on TA market analysis websites. Results: There is a shortage of AT in Brazil. The main suppliers are small and medium-sized companies, and tax and credit incentives, as well as investments in Research, Development and Innovation, are scarce. On a global scale, the AT market was valued at US$ 21.95 billion in 2022, and is expected to reach a value of US$ 31.22 billion by the year 2030. Conclusion: The global AT market is in rapid expansion and presents great potential for opening up new markets. This scenario reflects a moment of business opportunities for national companies.

A survey of the assistive technology experience of older adults in Tompkins County, NY.

Purpose: To understand the assistive product (AP) related needs, unmet needs, demands and barriers of older adults (OA) this study addresses older adults in Tompkins County, NY.Methods: This quantitative cross-sectional descriptive research study used the World Health Organization's rapid Assistive Technology Assessment (rATA). A convenience sample of adults 65 or older in Tompkins County, NY. were surveyed to understand their need for AP, access to it and satisfaction with it.Results: The mean age of the 102 respondents was 73 (SD=6.91). Ninety-five % of participants reported currently using an AP. The findings reveal that while OA are using AP in their everyday lives, barriers to getting the AP that they need remain. While 49% of participants had difficulty with their cognition, the use of AP for cognitive support was only reported by 10 % of the participants. Additionally, there are many different types of AP being used by older adults. These products not only assist users with impairments included on the survey such as hearing, vision, mobility, etc. but with other concerns such as comfort, safety, and injury prevention. One limitation of our study was that we utilized a convenience snowball method to recruit participants in a local area and thus the findings cannot be generalized beyond the study.Conclusion: OA identify both the need for AP that they do not have and a variety of barriers including lack of knowledge and funding for AP that interferes with their obtaining it. Ongoing research is needed to further understand the AT related needs of this growing population as there are many different areas in rehabilitation where work is needed to increase access to AP.

Increasing awareness of options, improving funding, designing assistive products (APs) that are safe, and destigmatising the need for APs for older adults (OAs) are critical for those who work in rehabilitation.Continuing research that describes and documents the changing assistive technology needs of the OA population is critical as this group continues to grow and change.In this study, more OAs reported having cognitive disabilities than other impairments. Increasing access to APs for this group is important.

Digital tools to support technology-enabled budget management in people with acquired brain injury: a rapid review.

People with acquired brain injuries (ABI) face financial challenges that affect their daily lives. Managing finances is a crucial activity that can help avoid social isolation. However, this task becomes difficult for people with ABI because of their cognitive impairments. Recent advances in digital technology can help people with ABI manage their finances more effectively. This study aims to identify and describe available digital tools that can help ABI in budget management, and identify their effectiveness, barriers and facilitators to implementation. To address this issue, we conducted a rapid review of academic databases followed by a modified Google/Google Scholar search to identify the digital tools to support budgeting tasks (DBT) used and tested by people with ABI. Our rapid review included only two articles on the use of DBT. The first study showed that common portable electronic devices were acceptable and desirable as memory and organisational aids for people with ABI. The second study documented the development of a DBT and the perception of users (research participants) who found it appealing and user-friendly. However, for both articles, the technologies used are outdated and lack information on barriers and facilitators to using DBT. In conclusion, this literature review revealed that digital technologies have the potential to support budget management in people with ABI, but technology needs to be made available on the market to benefit the users. Further research and development are needed to create new ways to help people with brain injuries manage their budgets.

Our study showed limited literature involving appropriate digital tools to support budgeting task (DBT) to meet the needs of people with acquired brain injury (ABI) to manage their budgets. Therefore, further research is encouraged to develop digital tools adapted to the budgeting needs and cognitive impairments of people with ABI and their socio-cultural environment.Our paper provides recommendations to develop human-centred digital solutions to help people with ABI manage their budgets, that are accessible, reliable and sustainable. Mixed methods and mix of methods are highly recommended in this regard.

A parametric 3D printed assistive device for people with cerebral palsy - assessment of outcomes and comparison with a commercial counterpart.

This paper presents the use of a parametric design platform and 3D printing to create personalized assistive devices (ADs) for individuals with cerebral palsy, specifically a fork/spoon holder. Five subjects participated in the study, each receiving a customized device to fit their dominant hand, and they tested both the 3D printed device and a commercially available one. The devices were evaluated based on functionality and satisfaction using two standard clinical questionnaires (IPPA and QUEST 2.0). The results showed that neither the 3D printed nor the commercial device provided substantial benefits, but the questionnaires provided valuable feedback on areas for improvement. The study highlights the need for highly personalized solutions in ADs, which could be addressed by 3D printing. A configurator for generating production files from a parametric model could facilitate personalization, but a large number of model versions should be available to meet individual needs. Future research could explore clinical evaluations and guide the development of efficient and effective frameworks for digital fabrication in terms of clinically feasible AD model sourcing.

* 3D printing can be a method of creating assistive devices with dimensions fitting the user.* Standard questionnaires for measuring the effectiveness and satisfaction may efficiently identify shortcomings and suggest improvements.* Each person may have individual requirements, which calls for a large database of solutions in order to meet the person's needs.

Teachers' and Parents' Assessment of Challenges in Children Exhibiting Sensory Seeking Behavior and Possible Effects of the Use of Ball Vests: A Pre-Post Study.

Children with dysfunction in sensory processing (DSP) may experience challenges, which might affect their participation in activities and potentially also their further development. This study examined the challenges of children with DSP who exhibit sensory seeking behavior, the differences in these challenges between boys and girls, and the possible effects of their use of ball vests. The challenges of 70 pupils (aged 6-12 years) exhibiting sensory seeking behavior were assessed by their parents (n = 66) and teachers (n = 60) by surveys containing items from the 'Strengths and Difficulties Questionnaire' (SDQ) and the 'Five to Fifteen' (FTF) questionnaire. Differences in the SDQ/FTF scores between boys and girls were explored using chi-square analysis. The potential effects of the ball vest were assessed using a study-specific follow-up survey. Linear mixed model regression analysis was used to examine associations between the extent of use of the vest and the assessed effects. The pupils were assessed for challenges that interfered with their learning (62%), forming friendships (51.7%), and the classroom environment (56.9%). After three weeks, the parents found that some pupils had improved regarding attention (39%), body perception (34%), and hyperactivity and impulsivity (33%). The teachers reported that 30% of the pupils had improved their coping skills in learning.

Evaluation of providers' assistive technology service delivery practices in Pakistan.

PURPOSE: Globally, one in three individuals needs at least one assistive product. The primary objective of this study was to conduct a survey of Pakistani rehabilitation service providers to determine what proportion provide assistive technology and if their characteristics (including geographical region, education, and experience) are associated with adherence to the service delivery process. The secondary objective was to determine if individuals that provide assistive technology adhere to a standard assistive technology service delivery process. The tertiary objective was to determine if the providers that adhered to a standard delivery process had characteristics that differed from the rest of the service providers. MATERIALS AND METHODS: An online survey composed of multiple-choice questions was distributed to physiotherapists, community-based healthcare workers, and related rehabilitation professions through a convenience sampling method. SPSS Statistics was used to develop correlation matrices to determine Pearson's coefficient of number of steps, education level, experience level and continuing education received. RESULTS: There were 71 respondents from 4 Pakistani provinces. 53.5% of respondents stated they provide assistive technology. There was participation in most steps of the service delivery process. There is weak correlation between number of steps and education level, number of steps and experience level, and number of steps and continuing education received. CONCLUSIONS: While the majority of respondents provide assistive technology, a significant proportion (46.5%) don't. This may suggest there is a need for additional advocacy and awareness raising of the benefits of and how to access assistive technology in Pakistan.

Implications for RehabilitationPakistan implemented a Rapid Assistive Technology Assessment and determined that only 22% of the population that needs an assistive device has had their needs met.From a relatively small sample, this study investigated if there is a presence of assistive technology service delivery in Pakistan and whether traditional education, experience, or continuing education promotes participation in the assistive technology service delivery process.This study found a presence of assistive technology service delivery in Pakistan, but found weak correlations between participation in the service delivery process with traditional education, experience, and continuing education.These findings suggest that there is room for additional advocacy and awareness training on assistive technology in Pakistan.

The IDEAL PROCESS for developing Assistive Technology policy.

Policy development and implementation are key to improving access to Assistive Technology (AT). In this paper, we describe a strength-based framework for doing this at national level. We used an action research approach, with the United Nations Conventions on the Rights of Persons with Disability (UNCRPD) as the primary frame of reference. Primary data were collected using the World Health Organisation's rapid Assistive Technology Assessment (rATA). We describe the process of applying our emergent framework and how our findings support it. We identified seven guiding principles for effective policy process: Participatory, Resource aware, Outcomes focused, Collaborative, Evidence-informed, supporting good practices, and System strengthening - which can be summarized by the acronym PROCESS. Five crucial building blocks for effective AT policy development emerged: Identification of the assistive technology ecosystem, Demography of disability and AT use, Evaluation of inclusion and participation in existing policy, Alignment with UNCRPD and Sustainable Development Goals (SDGs), and Locality of implementation - which can be summarized with the acronym IDEAL. The IDEAL PROCESS incorporates key content building blocks and core process principles, constituting a systematic framework for guiding the development of context sensitive AT policy and a strength-based pathway to improving access AT.

Assistive technology unmet need in Indonesia: challenges and opportunities for enhancing equitable access.

PURPOSE: To analyze the rapid Assistive Technology Assessment (rATA) data and identify challenges and opportunities for improving access to assistive technology products (AP) in Indonesia. MATERIALS AND METHODS: An explanatory sequential mixed-methods design consisting of a quantitative survey and a qualitative interview study was used. The rATA survey was administered to households in two randomly sampled provinces to collect data on AP met and unmet need. Descriptive statistics was used to analyze the survey data. Qualitative data were collected from unstructured videorecorded interviews with rATA policymakers. Interview transcripts were coded and analyzed using thematic analysis. RESULTS: On average, data from rATA respondents (n = 11,300) revealed 60% of AP unmet need. A high proportion of funding sources came from the private sector, and contributions from the government remained low. Affordability and funding were the main barriers to access. From the policymaker interviews (n = 5), four essential themes emerged, i.e., "resources and workforce", "funding", "laws and policies", and "guidelines and standards". From each theme, key challenges and opportunities were identified. CONCLUSIONS: Affordability remained a major challenge, in part because government-sponsored funding was still inadequate, forcing people with low financial status to self-produce AP. One potential opportunity would be to localize AP production and improve local workforce training. Integrated national funding schemes and intersectoral coordination could accelerate improvement in meeting AP unmet need. This study may provide evidence of current challenges and opportunities to help improve the field of rehabilitation through enhanced access to AP services in Indonesia.

IMPLICATIONS FOR REHABILITATIONA high assistive technology product (AP) unmet need due to low affordability and limited funding may prevent people with disabilities from receiving appropriate rehabilitation with the goal of improved quality of life.Evidence shows key barriers to AP service provision, and such evidence can be viewed as an opportunity for stakeholders to develop actionable strategies to improve access nationwide.Potential strategies such as local workforce capacity building, integrated national funding schemes, and improved government coordination may help enhance equitable access to AP for all.

Evaluation of the Effectiveness of Assistive Technology for Executive Function Support for People With Acquired Brain Injury: Protocol for Single-Case Experimental Designs.

BACKGROUND: Executive function, including prospective memory, initiating, planning, and sequencing everyday activities, is frequently affected by acquired brain injury (ABI). Executive dysfunction necessitates the use of compensatory cognitive strategies and, in more severe cases, human support over time. To compensate for the executive dysfunction experienced, growing options for electronic mainstream and assistive technologies may be used by people with ABI and their supporters. OBJECTIVE: We outline the study protocol for a series of single-case experimental designs (SCEDs) to evaluate the effectiveness of smart home, mobile, and/or wearable technologies in reducing executive function difficulties following ABI. METHODS: Up to 10 adults with ABI who experience executive dysfunction and have sufficient cognitive capacity to provide informed consent will be recruited across Victoria and New South Wales, Australia. Other key inclusion criteria are that they have substantial support needs for everyday living and reside in community dwellings. On the basis of the participant's identified goal(s) and target behavior(s), a specific electronic assistive technology will be selected for application. Both identification of the target behavior(s) and selection of the assistive technology will be determined via consultation with each participant (and their key support person, if applicable). The choice of SCED will be individualized for each participant based on the type of technology used in the intervention, the difficulty level of the behavior targeted for change, and the anticipated rate of change. For each SCED, repeated measurements of the target behavior(s) during the baseline condition will provide performance data for comparison with the performance data collected during the intervention condition (with technology introduced). Secondary outcome measures will evaluate the impact of the intervention. The protocol includes 2 customizable Microsoft Excel spreadsheets for electronic record keeping. RESULTS: Recruitment period is June 2022 through March 2024. Trial results for the individual participants will be graphed and analyzed separately using structured visual analysis supplemented with statistical analysis. Analysis will focus on important features of the data, including both within- and between-phase comparisons for response level, trend, variability, immediacy, consistency, and overlap. An exploratory economic evaluation will determine the impact on formal and informal support usage, together with quality of life, following the implementation of the new technological intervention. CONCLUSIONS: The study has been designed to test the cause-effect functional relationships between the intervention-in this case, electronic assistive technology-and its effect in changing the target behavior(s). The evaluation evidence gained will offer new insights into the application of various electronic assistive technologies for people who experience executive dysfunction following ABI. Furthermore, the results will help increase the capacity of key stakeholders to harness the potential of technology to build independence and reduce the cost of care for this population. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000835741, https://www.anzctr.org.au/ACTRN12622000835741.aspx. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48503.

Assistive technology usage, unmet needs and barriers to access: a sub-population-based study in India.

Background: Assistive technology (AT) is essential to minimize functional limitations. The current study aimed to estimate the prevalence of needs, met and unmet needs for AT, and barriers to accessing AT among a subnational population in India. Methods: This cross-sectional study was conducted in eight districts, representing four zones of India, using the WHO Rapid Assistive Technology Assessment (rATA) tool. The tool was administered by trained staff using read aloud technique. Multi-stage cluster random sampling was used, as well as the probability proportional to size, to select smaller administrative units from the larger ones. Findings: In total, 8486 participants were surveyed out of 8964 individuals enumerated with a response rate of 94.6%. The sample prevalence of at least one difficulty was 31.8% (2700), with 6.3% (532) having severe or total difficulties. The sample prevalence for AT need was 27.8% (2357) with an estimated population prevalence of 24.5% (95% CI: 23.5-25.4). Similarly, the sample prevalence of unmet needs was 9.7% (823) with an estimated population unmet needs of 8.0% (95% CI: 7.43-8.60). The unmet needs among persons with severe or total difficulties was 52.3% (278/532), and was higher among females, rural residents, and older persons. Spectacles were the most used products, followed by canes/sticks, tripods, and quadripods. Nearly two-thirds of AT users purchased assistive products at their own expense, particularly from the private sector. The inability to afford AT (36.9%) was the most common barrier. Interpretation: The results show that the need for AT was substantial in the study population, the highest being for seeing difficulties. The unmet needs are higher in females, older population, rural residents, and persons having serious difficulties. While the majority of users have to make out-of-pocket payments to obtain AT, inability to afford and limited availability were the common barriers among those with unmet needs. Funding: This research is non-commercial, and was conducted in the interest of public health. The authors have not declared any specific grant for this research.

Digital Enabling Assistive Technology Through the Provision Lens - A Global Perspective in a Nordic Context.

The Nordic healthcare system is well-established, taxation-based, and locally administered, featuring person-centered care as a social welfare pillar. Public provision of assistive technology and welfare technology within healthcare systems means every citizen has equal access to services. But how well are policies and procedures keeping pace with demographic changes and technology developments?. This study critically analyses qualitative data from 24 stakeholders involved in municipal-level procurement and allocation of assistive and welfare technology in Sweden with a specific focus on emerging digital technology. An extant analysis framework was used: the World Health Organization-GATE 5P framework for strengthening access to AT. Recommendations are made for agile procurement and an outcome-based decision frame. The voice of the AT user may be a valuable addition to inform policy.

AI-assisted ethics? considerations of AI simulation for the ethical assessment and design of assistive technologies.

Current ethical debates on the use of artificial intelligence (AI) in healthcare treat AI as a product of technology in three ways. First, by assessing risks and potential benefits of currently developed AI-enabled products with ethical checklists; second, by proposing ex ante lists of ethical values seen as relevant for the design and development of assistive technology, and third, by promoting AI technology to use moral reasoning as part of the automation process. The dominance of these three perspectives in the discourse is demonstrated by a brief summary of the literature. Subsequently, we propose a fourth approach to AI, namely, as a methodological tool to assist ethical reflection. We provide a concept of an AI-simulation informed by three separate elements: 1) stochastic human behavior models based on behavioral data for simulating realistic settings, 2) qualitative empirical data on value statements regarding internal policy, and 3) visualization components that aid in understanding the impact of changes in these variables. The potential of this approach is to inform an interdisciplinary field about anticipated ethical challenges or ethical trade-offs in concrete settings and, hence, to spark a re-evaluation of design and implementation plans. This may be particularly useful for applications that deal with extremely complex values and behavior or with limitations on the communication resources of affected persons (e.g., persons with dementia care or for care of persons with cognitive impairment). Simulation does not replace ethical reflection but does allow for detailed, context-sensitive analysis during the design process and prior to implementation. Finally, we discuss the inherently quantitative methods of analysis afforded by stochastic simulations as well as the potential for ethical discussions and how simulations with AI can improve traditional forms of thought experiments and future-oriented technology assessment.

Survey on the Acceptance of Ambient Sensors in Solo and Older Couple-Only Households in Japan.

For this study, an online survey was conducted to discover the preferences of older adults when they used sensors in their households, rather than the preferences of the researchers who developed them. The sample size was 400 Japanese community-dwelling people aged 65 years and older. The numbers of samples for men and women, household composition (single-person/couple-only household), and younger senior (younger than 74 years old) and older senior (older than 75 years old) were equally assigned. The survey results showed that "informational security" and "constancy of life" were considered more important than other factors when installing sensors. Furthermore, looking at the results regarding the type of sensors that face resistance, we found that both cameras and microphones were evaluated as facing slightly strong resistance, while doors/windows, temperature/humidity, CO2/gas/smoke, and water flow were evaluated as not facing such strong resistance. The elderly who are likely to need sensors in the future also have various attributes, and the introduction of ambient sensors in elderly households may be further advanced by recommending applications that are easy to introduce based on the attributes of the target population, rather than discussing all of them in general.

Participatory Action Design and Engineering of Powered Personal Transfer System for Wheelchair Users: Initial Design and Assessment.

Caregivers that assist with wheelchair transfers are susceptible to back pain and occupational injuries. The study describes a prototype of the powered personal transfer system (PPTS) consisting of a novel powered hospital bed and a customized Medicare Group 2 electric powered wheelchair (EPW) working together to provide a no-lift solution for transfers. The study follows a participatory action design and engineering (PADE) process and describes the design, kinematics, and control system of the PPTS and end-users' perception to provide qualitative guidance and feedback about the PPTS. Thirty-six participants (wheelchair users (n = 18) and caregivers (n = 18)) included in the focus groups reported an overall positive impression of the system. Caregivers reported that the PPTS would reduce the risk of injuries and make transfers easier. Feedback revealed limitations and unmet needs of mobility device users, including a lack of power seat functions in the Group-2 wheelchair, a need for no-caregiver assistance/capability for independent transfers, and a need for a more ergonomic touchscreen. These limitations may be mitigated with design modifications in future prototypes. The PPTS is a promising robotic transfer system that may aid in the higher independence of powered wheelchair users and provide a safer solution for transfers.

A scoping review to explore the health, social and economic outcomes of home automation for people with disability.

PURPOSE: People with disability often require long-term care. Long-term care is changing with the availability and advances in cost and function of technologies, such as home automation. Home automation has the potential to reduce paid carer hours and can potentially offer many benefits to people with a disability. The aim of this scoping review is to identify the health, social and economic outcomes experienced by people living with a disability who use home automation. MATERIALS AND METHODS: Two electronic databases were searched by title and abstract to identify international literature that describes home automation experiences from the perspectives of people with disability. A thematic approach was taken to synthesise the data to identify the key outcomes from home automation. RESULTS: The review identified 11 studies reporting home automation outcomes for people living with a disability. Seven outcomes were associated with home automation: independence, autonomy, participation in daily activities, social and community connectedness, safety, mental health, and paid care and informal care. CONCLUSION: Advances in technology and changes in funding to support people living with a disability have made access to home automation more readily available. Overall, the study findings showed that there is a range of potential benefits of home automation experienced by individuals living with a disability.Implications for RehabilitationA wide range of outcomes have been evaluated following the installation of home automation systems for people with disability.Key outcomes evaluated to date include independence, autonomy, participation, safety, mental health, and reduced need for paid carers.Outcomes of home automation appear to be connected; for example, improved participation may lead to improved mental health.

Development of the national priority assistive product list in Malawi.

PURPOSE: In 2016 WHO launched the priority assistive products list (APL) consisting of 50 products and recommended that using this as a reference, countries should develop their own contextually relevant national APLs. This paper describes the development of Malawi's APL. METHODS: Two hundred and ninety-six persons with disabilities participated in a rapid Assistive Technology Assessment (rATA) survey. Six focus group discussions (FGDs) with people with various types of disabilities were conducted. The rATA questionnaire and FGDs collected data on assistive products (APs) participants used, APs they needed and the challenges they experienced. Data collection was done in six districts spread across the three regions in Malawi. All age groups were included in the survey. Persons with disabilities aged less than 18 participated but went with their guardians. All persons who participated in this study provided consent. Survey and FGDs results were presented at an APL consensus meeting with policymakers, service providers, disabled peoples' organizations and development partners in the disability sector. Based on the results and further discussions, a consensus was reached on the priority APs for Malawi. RESULTS: More than a third of respondents used wheelchairs (32%), followed by auxiliary crutches (25%), walking sticks (13%), reading glasses (11%), prosthesis (10%), elbow crutches (9%) and orthosis (8%). There is also a high demand for products such as pull-up underwear (incontinence products) (79%), hearing aids (70%), reading glasses (59%) and diapers (63%). After intensive discussions during a consensus meeting, an agreement was reached on the 22 priority APs for Malawi. CONCLUSION: There is a wide range of APs being used by people with different functional limitations in Malawi. There is also a demand for APs that are not readily available. When developing an APL, the list should include products in use, those in demand, and those recommended by service providers.Implications for rehabilitationFollowing the development of the priority assistive products list (APL) by WHO, member states should develop their own contextually based APL.The development of the APL should be based on research evidence.All key stakeholders including persons with disabilities and other functional limitations, government, and development partners should participate in this process.The APL should be part of the national health system or community services.The Department of Disability and Elderly Affairs in the Ministry of Gender, Community Development, being the Government of Malawi line ministry coordinating disability issues participated actively in this study including inviting participants in the stakeholders' validation workshop.

Experimental Evaluation of EMKEY: An Assistive Technology for People with Upper Limb Disabilities.

Assistive technology can help people with disabilities to use computers more effectively and can enable them to access the same information and resources as people without disabilities. To obtain more insight into the factors that can bring about the design of an Emulator of Mouse and Keyboard (EMKEY) to higher levels of user satisfaction, an experimental study was conducted in order to analyse its effectiveness and efficiency. The experimental study involved 27 participants (Mage = 20.81, SD = 1.14) who performed three experimental games under different conditions (using the mouse and using EMKEY with head movements and voice commands). According to the results, the use of EMKEY allowed for the successful performance of tasks such as matching stimuli (F(2,78) = 2.39, p = 0.10, η2 = 0.06). However, the execution times of a task were found to be higher when using the emulator to drag an object on the screen (t(52,1) = -18.45, p ≤ 0.001, d = 9.60). These results indicate the effectiveness of technological development for people with upper limb disabilities; however, there is room for improvement in terms of efficiency. The findings are discussed in relation to previous research and are based on future studies aimed at improving the operation of the EMKEY emulator.

Toward explainable AI-empowered cognitive health assessment.

Explainable artificial intelligence (XAI) is of paramount importance to various domains, including healthcare, fitness, skill assessment, and personal assistants, to understand and explain the decision-making process of the artificial intelligence (AI) model. Smart homes embedded with smart devices and sensors enabled many context-aware applications to recognize physical activities. This study presents XAI-HAR, a novel XAI-empowered human activity recognition (HAR) approach based on key features identified from the data collected from sensors located at different places in a smart home. XAI-HAR identifies a set of new features (i.e., the total number of sensors used in a specific activity), as physical key features selection (PKFS) based on weighting criteria. Next, it presents statistical key features selection (SKFS) (i.e., mean, standard deviation) to handle the outliers and higher class variance. The proposed XAI-HAR is evaluated using machine learning models, namely, random forest (RF), K-nearest neighbor (KNN), support vector machine (SVM), decision tree (DT), naive Bayes (NB) and deep learning models such as deep neural network (DNN), convolution neural network (CNN), and CNN-based long short-term memory (CNN-LSTM). Experiments demonstrate the superior performance of XAI-HAR using RF classifier over all other machine learning and deep learning models. For explainability, XAI-HAR uses Local Interpretable Model Agnostic (LIME) with an RF classifier. XAI-HAR achieves 0.96% of F-score for health and dementia classification and 0.95 and 0.97% for activity recognition of dementia and healthy individuals, respectively.