Assistive technologies for severe and profound hearing loss: Beyond hearing aids and implants.

Assistive technologies (ATs) offer capabilities that were previously inaccessible to individuals with severe and profound hearing loss who have no or limited access to hearing aids and implants. This literature review aims to explore existing ATs and identify what still needs to be done. It is found that there is a lack of focus on the overall objectives of ATs. In addition, several other issues are identified, i.e. only a very small number of ATs developed within a research context have led to commercial devices, and there is a predisposition to use the latest expensive technologies and a tendency to avoid designing products universally. Finally, the further development of plug-ins that translate the text content of a website to various sign languages is needed to make information on the internet more accessible.

Systematic review: Investigating the effectiveness of assistive technology to enable internet access for individuals with deafblindness.

The purpose of this study is to systematically review published evidence regarding the development, use, and effectiveness of assistive devices and technol ogies that enable internet access for individuals who are deafblind. Eight electronic research databases (CINAHL, Embase, Engineering Village MEDLINE, PsycINFO, PubMed, Cochrane Library, and Web of Science) and three clinical trials registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) were searched.Seven articles met the inclusion criteria for this systematic review. The assistive technologies described were in the preliminary stages of development, with only three of the technologies having undergone any testing. The effectiveness of all seven assistive technologies was quantified in this review based on the proposed impacts of internet access on the domains of the World Health Organization's International Classification of Functioning, Disability and Health framework.Internet access technologies for individuals with deafblindness are in the early stages of development and are targeted toward specific functions of the internet. It is imperative that future device development and evaluation seek input from persons who are deafblind. There is also a need to address the gap between academic research, which seeks to develop assistive technology to access the internet and the translation into real-world use of this technology.

Origins and consequences of technology acquirement by independent-living seniors: towards an integrative model.

BACKGROUND: Living independently can be challenging for seniors. Technologies are expected to help older adults age in place, yet little empirical research is available on how seniors develop a need for technologies, how they acquire these technologies, and how these subsequently affect their lives. Aging is complex, dynamic and personal. But how does this translate to seniors' adoption and acceptance of technology? To better understand origins and consequences of technology acquirement by independent-living seniors, an explorative longitudinal qualitative field study was set up. METHODS: Home visits were made to 33 community-dwelling seniors living in the Netherlands, on three occasions (2012-2014). Semi-structured interviews were conducted on the timeline of acquirements, and people and factors involved in acquirements. Additionally, participants were interviewed on experiences in using technologies since acquirement. Thematic analysis was employed to analyze interview transcripts, using a realist approach to better understand the contexts, mechanisms and outcomes of technology acquirements. RESULTS: Findings were accumulated in a new conceptual model: The Cycle of Technology Acquirement by Independent-Living Seniors (C-TAILS), which provides an integrative perspective on why and how technologies are acquired, and why these may or may not prove to be appropriate and effective, considering an independent-living senior's needs and circumstances at a given point in time. We found that externally driven and purely desire-driven acquirements led to a higher risk of suboptimal use and low levels of need satisfaction. CONCLUSIONS: Technology acquirement by independent-living seniors may be best characterized as a heterogeneous process with many different origins, pathways and consequences. Furthermore, technologies that are acquired in ways that are not congruent with seniors' personal needs and circumstances run a higher risk of proving to be ineffective or inappropriate. Yet, these needs and circumstances are subject to change, and the C-TAILS model can be employed to better understand contexts and mechanisms that come into play.

Universal Design and Welfare Technology.

The paper presents the background for the increased interest for and use of welfare technology. It discusses current definitions of welfare technology and suggests a typology of this technology based on the different definitions. It compares the definitions with that of assistive technology and endeavors to draw a clearer limit between them, in particular related to possibilities to utilize the principle of universal design on welfare technology. The issue of operationalization requirements of universal design to welfare technology through standardization is also discussed. Finally, the paper suggests what elements should be part of a new definition of welfare technology.

Assistive technology devices for toileting and showering used in spinal cord injury rehabilitation - a comment on terminology.

A review of assistive technologies, products and devices for toileting and showering identified at least 15 separate terms across all studies, with another two identified in subsequent studies. Terms are often used interchangeably, and are often not defined or described. Inconsistencies in terminology affect the quality of evidence available to policy makers, researchers and clinicians. Researchers are encouraged to provide clear definitions and descriptions of assistive technologies, products and devices for toileting and showering under investigation. Implications for Rehabilitation At least 17 different terms have been identified for assistive technologies, products and devices for toileting and showering. Inconsistencies in terminology make comparisons between studies difficult, and therefore affect the quality of evidence available to policy makers, researchers and clinicians. Providing clear definitions and descriptions of assistive technologies, products and devices for toileting and showering under investigation is encouraged.

[Analysis of using assistive devices by patients suffering from cerebral palsy - preliminary report]. / Analiza stosowanego zaopatrzenia ortopedycznego przez chorych na mózgowe porazenie dzieciece - doniesienie wstepne.

UNLABELLED: Cerebral palsy (CP) is still significant health and social issue in the world. Adults who suffer from that illness have problem with mobility which make their functioning much harder. Common symptoms include spasticity, chronic pain of musculoskeletal system, disturbance of sensation, epilepsy or mental retardation. AIM: The aim of the study was analysis of assistive devices used by patients with CP through childhood and adulthood. The results were compared with the situation in this field of CP patients in other countries. MATERIALS AND METHODS: The study involved 30 patients with CP in age between 20-43 living in Poznan and under the care of Occupational Therapy Workshop and Enviromental Self-help Houses. The research method was questionnaire which was directed to caregivers of adults with CP. They were asked about diagnosis, accompanying symptoms as well as assistive devices used during childhood and adulthood. RESULTS: During childhood wheelchair and standing frame were used the most often while during adulthood the most common were also the first mentioned above as well as rehabilitation lift. Although unfavourable evaluation of fitting assistive devices, majority of caregivers of CP sufferer claimed that there was varying improvement in patients motor functionality. CONCLUSIONS: Comprehensive rehabilitation and assistive devices are necessary for patients with CP during adulthood not less than during childhood. Wheelchairs are even more essential for adults than for children.

A Unified Semantic Framework for the description of assistive technologies.

This paper presents the Semantic Alignment Tool, a unified, classified, ontological framework, for the description of assistive solutions that comprises information from different sources automatically. The Semantic Alignment Tool is a component of the Cloud4All/GPII infrastructure that enables users to add and/or modify descriptions of assistive technologies and align their specific settings with similar settings in an ontological model based on ISO 9999. The current work presents the interaction of the Semantic Alignment Tool with external sources that contain descriptions and metadata for Assistive Technologies (ATs) in order to achieve their synchronization in the same semantic model.

Pruning a decision tree for selecting computer-related assistive devices for people with disabilities.

Many disabled individuals lack extensive knowledge about assistive technology, which could help them use computers. In 1997, Denis Anson developed a decision tree of 49 evaluative questions designed to evaluate the functional capabilities of the disabled user and choose an appropriate combination of assistive devices, from a selection of 26, that enable the individual to use a computer. In general, occupational therapists guide the disabled users through this process. They often have to go over repetitive questions in order to find an appropriate device. A disabled user may require an alphanumeric entry device, a pointing device, an output device, a performance enhancement device, or some combination of these. Therefore, the current research eliminates redundant questions and divides Anson's decision tree into multiple independent subtrees to meet the actual demand of computer users with disabilities. The modified decision tree was tested by six disabled users to prove it can determine a complete set of assistive devices with a smaller number of evaluative questions. The means to insert new categories of computer-related assistive devices was included to ensure the decision tree can be expanded and updated. The current decision tree can help the disabled users and assistive technology practitioners to find appropriate computer-related assistive devices that meet with clients' individual needs in an efficient manner.

Integrating medical, assistive, and universally designed products and technologies: assistive technology device classification (ATDC).

INTRODUCTION: ISO26000:2010 International Guidance Standard on Organizational Social Responsibility requires that effective organizational performance recognize social responsibility, including the rights of persons with disabilities (PWD), engage stakeholders and contribute to sustainable development. Millennium Development Goals 2010 notes that the most vulnerable people require special attention, while the World Report on Disability 2011 identifies improved data collection and removal of barriers to rehabilitation as the means to empower PWD. BACKGROUND: The Assistive Technology Device Classification (ATDC), Assistive Technology Service Method (ATSM) and Matching Person and Technology models provide an evidence-based, standardized, internationally comparable framework to improve data collection and rehabilitation interventions. The ATDC and ATSM encompass and support universal design (UD) principles, and use the language and concepts of the International Classification of Functioning, Disability and Health (ICF). PURPOSE: Use ATDC and ICF concepts to differentiate medical, assistive and UD products and technology; relate technology "types" to markets and costs; and support provision of UD products and technologies as sustainable and socially responsible behavior. CONCLUSION: Supply-side and demand-side incentives are suggested to foster private sector development and commercialization of UD products and technologies. Health and health-related professionals should be knowledgeable of UD principles and interventions.

Assistive technology device classification based upon the World Health Organization's, International Classification of Functioning, Disability and Health (ICF).

PURPOSE: To develop an assistive technology device classification (ATDC) consistent with the Assistive Technology Act (ATA2004), Americans with Disabilities Act (ADA2008), International Classification System of Functioning, Disability and Health (ICF), International Classification of Disease, Ninth Revision-Clinical Modification (ICD-9-CM) and American Medical Association's Current Procedural Terminology (CPT). BACKGROUND: Current assistive technology device (ATD) classifications include: the National Classification System for Assistive Technology Devices and ATSs (RTI/NCS) published in 2000; ISO 9999: technical aids for persons with disabilities - classification and terminology (ISO 9999) published in 1992, 1998, 2002 and 2007 and ICF-based AT classification (ICF/AT2007) published in 2009. OBJECTIVES: To derive 'requirements' for ATD classification from the ATA2004, ADA2008, ICF, ICD-9-CM and CPT. Review the ATD classifications and online databases against requirements. Construct the ATDC to be consistent with all requirements and demonstrate with examples. RESULTS: Existing ATD classifications and online databases are inconsistent with requirements. The ATDC is consistent and has inclusion and exclusion criteria, classification rules, employs ICF coding, extendable hierarchy and language and uses standard device naming conventions. Conclusion. The ATDC has broad application to: provision of AT ATSs (ATSs), characterisation and analysis of AT industries, Federally sponsored research pertaining to AT development and commercialisation, and Federal health insurance scope of benefits.

Development and evaluation of a new taxonomy of mobility-related assistive technology devices.

OBJECTIVE: This article reports on the development of a new taxonomy for mobility-related assistive technology devices. DESIGN: A prototype taxonomy was created based on the extant literature. Five mobility device experts were engaged in a modified Delphi process to evaluate and refine the taxonomy. RESULTS: Multiple iterations of expert feedback and revision yielded consensual agreement on the structure and terminology of a new mobility device taxonomy. The taxonomy uses a hierarchical framework to classify ambulation aids and wheeled mobility devices, including their key features that impact mobility. Five attributes of the new taxonomy differentiate it from previous mobility-related device classifications: (1) hierarchical structure, (2) primary device categories are grouped based on their intended mobility impact, (3) comprehensive inclusion of technical features, (4) a capacity to assimilate reimbursement codes, and (5) availability of a detailed glossary. CONCLUSIONS: The taxonomy is intended to support assistive technology outcomes research. The taxonomy will enable researchers to capture mobility-related assistive technology device interventions with precision and provide a common terminology that will allow comparisons among studies. The prominence of technical features within the new taxonomy will hopefully promote research that helps clinicians predict how devices will perform, thus aiding clinical decision making and supporting funding recommendations.

Multiple sclerosis and mobility-related assistive technology: systematic review of literature.

Multiple sclerosis (MS) causes a wide variety of neurological deficits, with ambulatory impairment the most obvious cause of disability. Within 10 to 15 years of disease onset, 80% of persons with MS experience gait problems due to muscle weakness or spasticity, fatigue, and loss of balance. To facilitate mobility, persons with MS frequently use mobility assistive technology (MAT), such as canes, crutches, walkers, wheelchairs, and scooters. We systematically reviewed the published literature on MAT use among persons with MS. We used electronic reference lists such as Ovid MEDLINE and PubMed to search the literature. We located 50 articles that met the initial criteria of providing good evidence of the types of MAT devices and their benefits for individuals with MS. A limited number of articles with higher levels of evidence was found regarding benefits of MAT use specifically for persons with MS. Evidence-based literature provides the basis for the strongest method of measurable clinical performance; therefore, having a strong research study design is vital to the justification of MAT prescription and reimbursement decisions. However, a paucity of studies with higher levels of evidence-based practice exists.

Mobility-related assistive technology device classifications: implications for outcomes research.

This article evaluates six mobility-related device classifications for their ability to support assistive technology outcomes research. Our evaluation considered classifications that had been created for various purposes, including those created to support third-party reimbursement decisions, consumer education and safety, and research. Classifications were excluded if their scope was limited to a single mobility device domain. The six classifications were analyzed according to a common framework: (1) purpose, (2) completeness, (3) granularity, and (4) research applications. Although each classification addresses three principal mobility device domains (ambulation aids, manual wheelchairs, and powered mobility devices), the analysis revealed a range of detail with which each domain is described. Some classifications were hampered by their use of unclear idiosyncratic terminology, whereas others conflated multiple device features within device categories. The analysis suggests that existing classifications do not fully meet the needs of assistive technology outcomes researchers. Creation of a common taxonomy of mobility devices is needed to serve the needs of the assistive technology outcomes research field.

Nanotecnología: presente y futuro de las ciencias de la salud visual / Nanotechnology: The Present and Future of Visual Health Science

La nanotecnología viene perfilándose como una ciencia aplicada a la industria y a la medicina. El rastreo y manipulación de materiales y procesos a escala nanométrica (la mil millonésima parte de un metro), será instrumental en la detección precisa y la intervención oportuna de una variedad de enfermedades oftalmológicas y en el diagnóstico de anomalías visuales. Vitrectomías guiadas por robot, implantes bioeléctricos en retina y nanolentes son sólo algunos de los avances prometedores en el campo de la salud visual.

Assistive technology use among adolescents and young adults with spina bifida.

OBJECTIVES: We sought to determine the use of assistive technology among a population of individuals with spina bifida. METHODS: We performed a descriptive analysis of individuals aged 13 to 27 years diagnosed with myelomeningocele (n=348) using data obtained from an existing database at Children's Hospital and Regional Medical Center, Seattle, Washington. We summarized disease characteristics, utilization of assistive technology, community and self-care independence, and other variables. RESULTS: Eighty-four percent of the respondents lived with at least 1 of their natural parents. Fifty-seven percent used wheelchairs, 35% used braces, and 23% used walking aids. Independent self-care was a common skill, but 72% reported limited participation in structured activities. Half were aged 18 years or older; of those, only 50% had completed high school and 71% were unemployed. Those aged younger than 18 years were all still in school (100%). CONCLUSIONS: Adolescents and young adults with spina bifida rely on assistive technology and specialized care routines to maintain their health. Assistive technology use for mobility is common; little is known about secondary complications associated with use of these technologies or the use of assistive technology to address learning disabilities and other societal barriers. Underutilization of assistive technology could delay successful transitions to independent living and community participation.

Sources of payment for assistive technology: findings from a national survey of persons with disabilities.

This article provides an overview of who pays for the most commonly used assistive technology devices, special adaptations, and environmental accommodations by persons with disabilities in the United States. The latest findings from the 2001 survey of Use and Need of Assistive Technology and Information Technology by Persons With Disabilities in the United States conducted by the National Institute on Disability and Rehabilitation Research, Rehabilitation Engineering and Assistive Technology Society of North America, and the University of Michigan will be presented and compared to findings from earlier research and reviews of the literature. A modified discriminant function analysis was performed to determine the interaction between the source of payment for assistive technology used by persons with disabilities. In the sample of 1,414 such persons, 901 were found to use some form of assistive technology in their daily lives. Ten distinct sources of payment were specified. Respondents were able to mention up to three sources of payment for each example of assistive technology used. A total of 1,877 sources were mentioned. Overall, the most mentioned payment source was self or other family member in household, accounting for nearly 40% of all sources mentioned. The variables tested were found to have varying levels of interactive potency. Occupational status, education level, severity of impairment, opinion as to the effectiveness of assistive technology, and personal income were significant, whereas age, family income, opinion as to improvement over the past decade, and race were statistically unrelated to source of payment. From the perspective of relative discrimination on the basis of payment source, Medicare stands as the lone significant discriminant source of payment. The authors offer a summary and conclusion based on an integrated view of all available sources of information about payment.

Adaptations of mouthguards for patients with special needs.

The adaptations and applications of mouthguard appliances are many and varied, with uses ranging from protective to therapeutic. These modifications serve the individual needs of patients. This requires problem-solving based on combining form and function with the skills of the dentist.