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Research & humanities in medical education (RHiME)

DHALIWAL, Upreet
et al
March 2014

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Research and Humanities in Medical Education (RHiME) is an open access, peer-reviewed online journal with the vision to blend humanities with the sciences in medical education. It aims to encourage contributions from and discussion between teachers and students, doctors and patients, the sick and their care-providers, and between health policy makers and policy users

Evolution of community physiotherapy in India

RAJAN, Pavithra
2014

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Despite the urgent need for physiotherapy services for underprivileged communities, Community Physiotherapy is not a sought-after specialisation in India. Physiotherapists tend to serve in institutions rather than at community level, as a result of which this field of healthcare has stagnated. This article, based on an interview with one of the country’s eminent community physiotherapists, gives a first person account of the evolution of community physiotherapy in India and provides qualitative inputs to deal with the prevalent issues. While the need for services has increased, there has been no matching growth in the pool of physiotherapists willing to work in the community. Several recommendations have been made, including changes in approach to community physiotherapy by both physiotherapists as well as community organisations in India.

Caregiver’s Involvement in Early Intervention for Children with Communication Disorders

MALAR, G
SREEDEVI, N
SURESH, C
2014

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Purpose: Since very young people benefit from early identification of communication disorders, the primary caregivers (generally the parents) become the fulcrum of the intervention services provided. This article deals with the measures taken to empower caregivers, as part of the early intervention services offered at the All India Institute of Speech & Hearing (AIISH) in Mysore city in India, and the impact this has had on their wards’ progress.

 

Method: A survey was conducted among the caregivers of 205 clients who availed of early intervention services. Five-pronged data were collected, pertaining to family demographic details, early intervention measures for their children with communication disorders, type and intensity of caregiver empowerment measures provided along with early intervention services, resultant caregiver participation in the education and training of their wards, and the consequent development in children with communication disorders. The mutual influences among these factors were analysed using simple correlation measures.

 

Results: The findings revealed that informal, but continuous and consistent efforts to empower parents, such as counselling and guidance, had a better impact. Empowered caregivers in turn contributed towards the education and training of their children with communication disorders, resulting in improved development of their wards’ communication skills and academic achievements.

 

Conclusion: The evidence adds strength to recommendations that caregiver empowerment and participation need to become integral components of early intervention services for young children with special needs.

India’s Disability Policy – Analysis of Core Concepts of Human Rights

O'DOWD, J
MANNAN, H
MCVEIGH, J
2014

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Purpose: To analyse India’s National Policy for Persons with Disabilities (2006), using a Human Rights approach.

 

Method: A framework analysis was carried out using EquiFrame, which analyses policies for inclusion and quality of Core Concepts of Human Rights and inclusion of Vulnerable Groups.

 

Results: India’s National Policy for Persons with Disabilities scored 67% for Core Concept Coverage, 24% for Core Concept Quality and 42% for Vulnerable Group Coverage. This gave the policy an overall ranking of Low quality.

 

Conclusions: The current policy for persons living with disabilities in India would benefit from being updated to encompass the Core Concepts of Human Rights.

Presentation and Impact of Pain in Persons with Post-Polio Syndrome: A Cross-sectional Survey Study

SHETH, M S
GHOGHARI, B
VYAS, N J
2014

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Purpose: It is a common and well‐recognised phenomenon that functional deterioration occurs many years after people are affected by poliomyelitis infection. This study aims to determine the presentation of pain in subjects with post-polio syndrome (PPS) and also the correlation between severity of pain and interference in activities of daily living (ADL).

 

Method: A cross-sectional survey was conducted among 72 persons with PPS in Gujarat state in India. Each one was given a self-administered questionnaire which included an 11‐point Numeric pain rating scale (NRS) for intensity of pain, questions about site, duration and diurnal variation of pain, and an 11‐point Numeric pain rating scale for pain interference.

 

Results: The study showed that 17 persons (24%) had only joint pain, 28 (39%) had only muscular pain and 27 (37%) had both joint as well as muscular pain. The highest number of subjects or 34 persons (47%) had knee pain, followed by 24 (33%) with shoulder pain, 21% with hip and 19% with low back pain. Muscle pain was maximum in arm musculature, as reported by 33 persons (45%), followed by pain in leg and foot muscles among 25 (36%) and 17 (23%) persons, respectively. Maximum number of subjects or 31% had pain while working which was relieved by rest, while 28 % had pain which continued all day. 43% experienced more pain in winter while 57% had no seasonal variation in pain. 30 persons (42%) had severe pain, 26 had moderate pain and only 16 had mild pain. Mean pain intensity was 5.88 ±1.52. Interference in ADL on NRS was 4.72 ±2.70. Interference in ADL and pain intensity were found to be positively correlated with Pearson’s co-efficient r=0.6295(p<0.0001).

 

Conclusion: The majority of those who had recovered from polio experienced increased or new symptoms and problems in ADL, muscle pain, joint pain, and difficulties in walking.

Mapping report of physical rehabilitation services in Afghanistan, Bangladesh, Odisha (India) and Sri Lanka

AXELSSON, Charlotte
2014

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This report presents a mapping (situational analysis) of the physical rehabilitation sector in the three countries and the Odisha state in India completed as part of Handicap International’s three year regional program in South Asia “Towards Disability Inclusive Development through a Strengthened Rehabilitation Sector in South Asia”. The aim of this mapping is improve the availability of information on the physical rehabilitation sector and to have an overview of the needs and unmet needs for physical rehabilitation

Fact sheet : refugees with disabilities

WOMEN’S REFUGEE COMMISSION
2014

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This factsheet highlights the issue of disabilities among refugees and conflict-affected population. It emphasizes actions undertaken by the Women’s Refugee Commission (WRC) and highlights their next steps in disability inclusion

Note: Also available in easy read format

Inclusive disaster risk management : a framework and toolkit

FERRETTI, Silva
KHAMIS, Marion
2014

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This framework and toolkit have been designed to support practitioners in challenging and deepening inclusiveness in their work. They have been designed in simple language, so the resource should be easy to adapt for the use of field staff as a complement to existing manuals and operational resources on DRM. The practical framework contains the following sections:introduction, framework for inclusive DRM, levels of achievements, and assessing inclusiveness, using the framework for,  annexes and Q&A. Throughout the resource, related resources and checklists are provided and the toolbox features cartoons, tools catalogue, learning pills, case studies, poster and 4D lenses. These resources are useful for practitioners who want to develop an understanding of inclusive DRM framework and to learn how to practically assess inclusiveness in in ongoing DRM situations

Inclusion of youth with disabilities: The business case

INTERNATIONAL LABOUR ORGANISATION
January 2014

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This is a how-to guide for companies interested in integrating youth with disabilities into their workforce. "This guide is based on initiatives that are currently tried out by ten companies to employ youth with disabilities in eight countries (Brazil, Chile, China, India, Norway, Republic of Serbia, Singapore and the United States). Good practices and useful insights are identified and explained through first-hand accounts. First, the business case for employing youth with disabilities is made. This section will highlight how two companies benefited from initiatives to employ youth with disabilities. Next, four reoccurring good practices that were cited in the featured cases are given particular consideration:

  • partner with an organization that specializes in disability services;
  • provide (when necessary) disability-accessible skills training;
  • offer recruitment and job placement services;
  • embrace a policy of inclusion and non-discrimination"

Performing the Stare in Indra Sinha’s Animal’s People

CHATTOPADHYAY, Sagarika
NAYAK, Amarjeet
2014

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This article intends to explore the materiality of disability through the notions of staring and bodies, as existing in the case of disability. The dynamic interactions that flow back and forth between the starer and the staree are inverted as the scales of who is staring and who is stared at are occasionally found to be at crossroads with the colonial or masculine gaze. This problematises the stare and its valorization within the field of disability as well as its valence with other kinds of gazes. This article shows how the ‘disabled’ person does not depend upon the able in conferring meaning upon itself in a society saturated with assumptions of ableism and that claims to own the power over the other in exercising the stare, demanding a story, and using language to assert itself. It raises questions around what disability is about and its notional creation in an able society. A slip often occurs from notional disablism to a notional ableism, with both categories being the subjects of a cultural construction. And this slip indicates the liminal space that disabled subjects often occupy while performing acts in their everyday life. The setting for this article is the powerful novel of Animal’s People and its intrepid hero Animal whose life is explored in a search of some answers to the questions raised here.

 

Disability and the Global South (DGS), 2014, Vol. 1 No. 1

Globalizing psychiatry and the case of ‘vanishing’ alternatives in a neo- colonial state

DAVAR, Bhargavi
2014

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Analysing ‘modernity’ in India is a complex exercise, as the movement of the ‘modern’ is locally determined and may be non-linear at different sites and contexts. General medicine and psychiatry are illustrative of the difference in how ‘patienthood’ has been historically constructed, with each wave of ‘modernisation’ changing the subjecthood of the ‘mentally ill’. Unlike the public health sector in India, the mental health sector is driven by the ‘mental asylum’ archetype, continuing through late colonial times into contemporary science in refurbished designs. A related set of changes also concomitantly happened in the domain of indigenous healing, with each epistemic shift pushing this domain to the margins of knowledge and healing practice. The paper is set against the time period covering 1850s until recently (2014).

 

Disability and the Global South, 2014, Vol. 1 No. 2

Faith Healing in India: The Cultural Quotient of the Critical

SIDDIQUI, Sabah
LACROIX, Kimberly
DHAR, Anup
2014

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We have had two ‘cultures of critique'. One is where critique of a culture's own principles is generated internally. The other is when critique is mounted from the outside. This paper is an attempt to shore up the two-fold nature of both culture of critique and critique of culture through a close examination of an extant and entrenched cultural practice provisionally called ‘faith healing' in its interlocution with western mental health models that are incumbent upon the Indian setting. This paper will explore what critical theory may need to consider in the context of India. Would it need a cultural turn, a culturalising? What is meant by culturalising? Would ‘culturalising', in turn, be premised on a bidirectional or dual critique, that is, a critique of both the West's hegemonic principles as well as principles that hegemonize the East, emanating from either the West or from the East? What relation would critique set up with an existing culture and cultural practice? What relation would culture set up with an existing culture of critique? In the process, this paper is also an attempt to inaugurate and locate the beginning coordinates of a critique of critique through the turn to culture in conditions called ‘faith healing'. The paper is also about the tense and troubled dialogue between the current globalization of certain frameworks in mental health, and local (faith-based) practices of health and healing that have survived in India; survived even in mutation and transformation, through colonialism, civilizing mission, welfarism and developmentalism. How would the knowledge and practice of mental health take shape in India – a landscape crisscrossed by on the one hand, aggressively modern institutions of mental health science and on the other, extant and surviving institutions of faith-based healing practices? While we remain critically mired in faith-based practices, while we cannot but be critical of some faith-based practices, we also cannot announce the silent demise of all Other imaginations of health and healing and let One global discourse take hold of all cultures. Hence, perhaps the need for what we have called the difficult ‘dual critique’. For critique also means an account of and an attention to experience and practice; an account formulated on its own terms and not on terms put in place by globalizing discourses. 

 

Disability and the Global South, 2014, Vol. 1 No. 2

Disability and the Global South, 2014, Vol. 1, No. 2 - Special issue: Globalising Mental Health or Pathologising the Global South? Mapping the Ethics, Theory and Practice of Global Mental Health

2014

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Articles include:

  • EDITORIAL Globalising Mental Health or Pathologising the Global South? Mapping the Ethics, Theory and Practice of Global Mental Health
  • How ‘evidence-based’ is the Movement for Global Mental Health?
  • Reciprocity in Global Mental Health Policy
  • Culture, Politics and Global Mental Health
  • Globalizing psychiatry and the case of ‘vanishing’ alternatives in a neo- colonial state
  • Faith Healing in India: The Cultural Quotient of the Critical
  • Mental Health Care, Diagnosis, and the Medicalization of Social Problems in Ukraine
  • Passive-Aggressive: Māori Resistance and the Continuance of Colonial Psychiatry in Aotearoa New Zealand
  • Neurasthenia Revisited: Psychologising precarious labor and migrant status in contemporary discourses of Asian American nervousness
  • Tools for the journey from North to South: A collaborative process to develop reflexive global mental health practice

Disability, poverty, and livelihoods guide : guidance from Trickle Up

SANSON, Jo
FELIX, Michael
November 2013

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"This guide is intended to encourage and assist organizations seeking to include people with disabilities in their economic strengthening and livelihood programs. It contains lessons for organizations that aim to move households out of poverty, [and] those that seek to economically and socially empower particularly vulnerable members of poor household"

Evaluation of Environmental Barriers faced by Wheelchair Users in India

DEVI, S
GOYAL, S
RAVINDRA, S
2013

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Purpose: Environmental factors restrict the extent to which people with disabilities can participate in society. The reduction of environmental barriers will increase their participation in the social, educational and vocational spheres of life. With the use of a valid and reliable tool - the Craig Hospital Inventory of Environmental Factors (CHIEF) questionnaire - this study aimed to evaluate the environmental barriers faced by wheelchair users in Bangalore city, India.

 

Method: A convenience sample of 100 wheelchair users, between 16 and 40 years of age, and working in different institutions in Bangalore, participated in the study. The CHIEF questionnaire was administered to each participant. It consisted of multiple questions pertaining to the 5 components of environmental barriers faced by wheelchair users: Accessibility, Accommodation, Resource availability, Social support and Equality. Percentage values for the responses in each component were calculated.

 

Results: The results showed that 52% of wheelchair users faced problems in Accessibility on a daily basis, and 77% of them felt the problem was big. With respect to Accommodation, 41% faced problems once a month and 50% of them felt that this was a big problem. The maximum percentage of participants did not face problems in Resource availability (43%), Social support (50%) and Equality (59%), and therefore these aspects were not felt to be a big problem.

 

Conclusion: An understanding of the environmental barriers faced by wheelchair users can provide guidance in mapping policies and strengthening laws which would help to improve their quality of life.

Disability, CBR and inclusive development (DCID), 2013, Vol. 24 No. 4

2013

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Original Research Articles

  • Impact of Community-based Rehabilitation on Persons with Different Disabilities
  • Empowerment in Community-based Rehabilitation and Disability-inclusive Development
  • Caregiver's Involvement in Early Intervention for Children with Communication Disorders
  • The Relationship Between Gross Motor Function and Quality of Life Among Children with Cerebral Palsy
  • India’s Disability Policy – Analysis of Core Concepts of Human Rights
  • Presentation and Impact of Pain in Persons with Post-Polio Syndrome: A Cross-sectional Survey Study

Brief reports

  • Barriers and Facilitators to Family-centred Paediatric Physiotherapy Practice in the Home setting: A Pilot Study

Experiential Accounts

  • Total Hip Arthroplasty Rehabilitation in Cambodia

Mainstreaming disability and ageing in water, sanitation and hygiene sector

JONES, Hazel
September 2013

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This report presents the findings of a desk study that provided an overview of the current state of disability and ageing issues in WASH, from the perspective of the WASH sector. Both disabled and older people were looked at together, because many frail older people, although they may reject the label ‘disabled’, experience impairments that limit their daily activities, which result in them facing similar kinds of barriers to accessing WASH

Inclusive disaster and emergency management for persons with disabilities : a review of needs, challenges, effective policies, and practices

RAJA, Deepti Samant
NARASIMHAN, Nirmita
2013

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This report provides an introduction into the needs of persons with disabilities in disasters and emergencies and reviews the challenges, effective policies and practices of inclusive disaster and emergency management.  It compiles international mandates and guidelines, strategies and practices for inclusive disaster management and gives an overview of the disaster and emergency management process and how persons with disabilities can be affected at each stage.  This report highlights the importance of information and communication technologies throughout the process and provides related case studies

Social Skills Training of Children with Learning Disability

BHAN, S
FAROOQUI, Z
2013

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Purpose: The ability to recognise emotions in oneself and in others is a fundamental prerequisite to function successfully in the social world. Emotion recognition deficit in people with learning disability may therefore be an important contributory factor to deficits in social skills and poor social adaptation. This study aimed to examine the level of emotional understanding in students with learning disabilities (LD).

 

Method: A pre-test, post-test equivalent groups design was adopted for this study. The focus was on identification of emotions through verbal and pictorial situations, and the appropriate expression of emotions. Training was provided to enhance the emotional understanding of students through the use of ‘I C ME’ module. The 6 emotions addressed in this study were anger, excitement, embarrassment, jealousy, love and anxiety. 30 children with LD, in the age group of 9-12 years, were selected for the study.

 

Results: It was seen that while children with LD had difficulty in the identification of an emotion, they found it more difficult to express the emotion in a socially appropriate way. The post-test results indicated that the training provided to the students significantly improved their emotional understanding.

 

Conclusions: The students learnt about the 6 emotions (anger, excitement, embarrassment, love, jealousy, and anxiety), the vocabulary associated with these emotions, and also the appropriate way to express, self-monitor and self-regulate each emotion.

 

Limitations: Intervention was done for only 6 emotions

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