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Strengthening rehabilitation in health emergency preparedness, readiness, response and resilience: policy brief

Pete Skelton
et al
July 2023

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Strengthening rehabilitation in health emergency preparedness, response, and resilience: policy brief outlines the evidence for rehabilitation in emergencies and the need for greater preparedness of rehabilitation services. It shows how existing guidelines support the integration of rehabilitation in emergencies and sets out the steps that decision-makers can take to better integrate rehabilitation into health emergency preparedness and response.

Case studies are provided from Japan, Nepal, Phillipines, Australian and Sweden

The Globalization of the Diabetes Epidemic

BONNEAU, Claire
2021

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As globalization continues to bring everyone and everything closer together, not all of the trade-offs are necessarily positive. As we export our unique cultures and experiences around the globe, we also increase the spread of chronic health problems.

For much of the 20th century, a person’s likelihood of developing a chronic health disease like type II diabetes depended on the wealth of the country they lived in equally as much as their own biology and genetic factors. In wealthy, developed countries, people are much more likely to survive to old age and eventually pass away from diseases of affluence — chronic diseases like cancer, heart disease, and diabetes that primarily impact the ageing population. In contrast, people living in developing nations are much more likely to experience malnourishment, violence, and communicable diseases that have a major impact on their overall health and quality of life.

This distinction has proven to be true across many developed countries, including globalization giants like the United States. Even in the more economically disadvantaged areas of America, hardly anyone dies as a result of communicable diseases like tuberculosis, a disease that is still a serious problem in lesser developed nations. Alternatively, in low to middle-income countries, these types of health concerns are still a going concern. Alongside the increased risk of encountering a communicable disease, people living in these areas are also at a higher risk for developing diseases of affluence such as type II diabetes. In this way, people living in developing nations are more likely to experience cancer while also battling cholera infections, and someone living with diabetes is also more likely to be struggling with chronic malnourishment. This lack of distinction between diseases of affluence and communicable diseases puts people living in developing nations at a disadvantage.

In this new global landscape of health and disease, the impact of diabetes is truly overwhelming. Since 1980, the number of people living with diabetes has almost doubled from 152 million to between 285-347 million (1). As a result of this dramatic increase, health spending and global costs have also had to increase to meet the growing demand for care. In 2019, it is estimated that diabetes caused over 760 billion USD in health expenditures, making up about 10% of all global spending on adults (2).

As the prevalence of diabetes continues to grow around the world, we need to shift our attention to finding global solutions to this invisible epidemic. Understanding the connection between obesity, globalization, and diabetes is a great starting point in order to tackle this ever-growing global health problem.

COVID-19 Resources and templates

MOTIVATION AUSTRALIA
October 2020

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Links to resources on information about COVID-19 for the general public and also specifically for health workers are provided. Links are provided for country specific information.

A COVID safe workplace plan template and a COVID workplace attendance register template have been developed to help health services and departments in the Pacific region to plan for and prevent the spread of COVID-19 in their workplace.

 

The temporalities of supported decision-making by people with cognitive disability

WIESEL, Ilan
SMITH, Elizabeth
BIGBY, Christine
THEN, Shih-Ning
DOUGLAS, Jacinta
CARNEY, Terry
2020

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In many societies, people with cognitive disability have been pre- sumed to lack reasoned decision-making capacity. Consequently, substituted decision-making laws and practices have traditionally authorised some people such as parents, guardians or medical professionals, to make decisions on their behalf. Several countries are now moving towards an alternative supported decision-making paradigm whereby people with different cognitive abilities are supported to make decisions that reflect as much as possible their ‘will, preferences and rights’. In this paper we examine how geo- graphical thinking about temporalities might illuminate some of the legal, ethical and practical complexities of supported decision- making. The paper draws on qualitative data from interviews with people with intellectual disabilities or acquired brain injury, and those who support them in making decisions. We examine how temporal scales and boundaries shape the determination of decision-making capacity; how decision-makers’ ‘will and preferences’ are interpreted by supporters; and how the labour of support for decision-making is organised. We argue that further geographical engagement with supported decision-making can help significantly advance this important disability rights agenda.

Work capacity assessments and efforts to achieve a job match for claimants in a social security setting: an international inventory

SENGERS, Johan H
AMBA, Femke I
BROUWER, Sandra
STAHL, Christian
2020

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Purpose: Many high-income countries are witnessing a shift of focus on eligibility for disability benefits towards promotion of work reintegration. However, little is known about how countries assess work cap- acity, and how a job match is then obtained. The current study aims to compare work capacity assess- ments and available efforts to achieve a job match in eight high-income OECD countries.

 

Methods: A survey was conducted among key stakeholders concerning organization of work capacity assessments in social security settings, and efforts made to obtain a job, across eight OECD countries: Australia, Denmark, Finland, Iceland, Sweden, the Netherlands, the United Kingdom and the United States. 

 

Results: In most countries, work capacity is assessed at several time points, with variations in moments and in information used for job matching. In countries obtaining information on personal and work levels, the search to find a job match usually begins with the persons who have disabilities.

 

Conclusion: Although a shift towards a holistic focus in work capacity assessment has been recognized, medical factors still prevail. Limited emphasis is placed on the implications of functional limitations for the possibilities of work. A holistic approach to assessment needs to be coupled with holistic support measures through provision of coordinated and high quality job matching services.

Disability Royal Commission: WWDA’s Response to Group Homes Issues Paper

SANDS, Therese
July 2020

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In 2020 the Disability Royal Commission released an issues paper on group homes. The issues paper asked 10 questions based on some of the key issues and barriers experienced by people with disability living in Group Homes.

This is Women With Disabilities Australia (WWDA) response to the issues paper which highlights key recommendations to improve the lives and experiences of people with disability living in group homes. The recommendations stem from the following key areas:

  • Living independently and being in the community
  • Intersectionality
  • Ableism, segregation and violence
  • Exposing and responding to violence, abuse, neglect and exploitation

Understanding paid support relationships: possibilities for mutual recognition between young people with disability and their support workers

ROBINSON, Sally
GRAHAM, Anne
FISHER, Karen R
NEALE, Kate
DAVY, Laura
JOHNSON, Kelley
HALL, Ed
2020

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The quality of paid relationships is key for effective support, yet little is known about how people receiving and providing sup- port understand and experience the relationship. This paper reports on recent research that explored the role of relationships with paid support workers in strengthening the rights and well- being of young people with cognitive disability in Australia. The research used photo-rich participatory methods with 42 pairs of young people and their support workers and drew on Honneth’s recognition theory to specifically explore experiences of being valued, respected and cared about in their work together. The findings point to the importance of these con- nected aspects of recognition in paid support relationships, highlighting both the presence and absence of these, as well as experiences of misrecognition. The implications of recognition for strengthening support need close consideration in an inter- national context characterised by personalisation of support, resource constraints and inquiries into poor practice.

Use of technology by orientation and mobility professionals in Australia and Malaysia before COVID-19

DEVERELL, Lil
BHOWMIK, Jahar
LAU, Bee Theng
AL MAHMUD, Abdullah
SUKUNESAN, Suku
ISLAM, Fakir M Amirul
MCCARTHY, Chris
MEYER, Denny
2020

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Purpose

Orientation and Mobility (O&M) professionals teach people with low vision or blindness to use specialist assistive technologies to support confident travel, but many O&M clients now prefer a smartphone. This study aimed to investigate what technology O&M professionals in Australia and Malaysia have, use, like, and want to support their client work, to inform the development of O&M technologies and build capacity in the international O&M profession.

 

Materials and Methods

A technology survey was completed by professionals (n = 36) attending O&M workshops in Malaysia. A revised survey was completed online by O&M specialists (n = 31) primarily in Australia. Qualitative data about technology use came from conferences, workshops and interviews with O&M professionals. Descriptive statistics were analysed together with free-text data.

 

Results

Limited awareness of apps used by clients, unaffordability of devices, and inadequate technology training discouraged many O&M professionals from employing existing technologies in client programmes or for broader professional purposes. Professionals needed to learn smartphone accessibility features and travel-related apps, and ways to use technology during O&M client programmes, initial professional training, ongoing professional development and research.

 

Conclusions

Smartphones are now integral to travel with low vision or blindness and early-adopter O&M clients are the travel tech-experts. O&M professionals need better initial training and then regular upskilling in mainstream O&M technologies to expand clients’ travel choices. COVID-19 has created an imperative for technology laggards to upskill for O&M tele-practice. O&M technology could support comprehensive O&M specialist training and practice in Malaysia, to better serve O&M clients with complex needs.

The outcomes of individualized housing for people with disability and complex needs: a scoping review

OLIVER, Stacey
Gosden-Kaye, Emily Z
WINKLER, Dianne
DOUGLAS, Jacinta M
2020

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PURPOSE: Worldwide, disability systems are moving away from congregated living towards individualized models of housing. Individualized housing aims to provide choice regarding living arrangements and the option to live in houses in the community, just like people without disability. The purpose of this scoping review was to determine what is currently known about outcomes associated with individualized housing for adults with disability and complex needs.

 

METHODS: Five databases were systematically searched to find studies that reported on outcomes associated with individualized housing for adults (aged 18–65 years) with disability and complex needs.

 

RESULTS: Individualized housing was positively associated with human rights (i.e., self-determination, choice and autonomy) outcomes. Individualized housing also demonstrated favourable outcomes in regards to domestic tasks, social relationships, challenging behaviour and mood. However, outcomes regarding adaptive behaviour, self-care, scheduled activities and safety showed no difference, or less favourable results, when compared to group homes.

 

CONCLUSIONS: The literature indicates that individualized housing has favourable outcomes for people with disability, particularly for human rights. Quality formal and informal supports were identified as important for positive outcomes in individualized housing. Future research should use clear and consistent terminology and longitudinal research methods to investigate individualized housing outcomes for people with disability.

Interventions for anxiety in mainstream school-aged children with autism spectrum disorder (ASD)

HILLMAN, Kylie
DIX, Katherine
AHMAD, Kashfee
LIETZ, Petra
TREVITT, Jenny
ULJAREVIC, Mirko
VIVANTE, Giacomo
HEDLEY, Darren
May 2020

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Anxiety is a common problem in school-aged children with autism spectrum disorder (ASD). Cognitive behavioural therapy (CBT) and other psychosocial interventions have been developed as alternatives to pharmacological intervention to treat anxiety in students with ASD.

 

This Campbell systematic review examines the effects of interventions for reducing anxiety in school-aged children with autism spectrum disorder, compared to treatment-as-usual. The review summarises evidence from 24 studies using an experimental or quasi-experimental design.

 

Twenty-four studies, involving 931 school-aged children with ASD (without co-occurring intellectual disability) and clinical anxiety, are summarised in this review. The studies were experimental or quasi-experimental control-treatment trials, deemed to be of sufficient methodological quality and with reduced risk of bias. Studies spanned the period 2005 to 2018 and were mostly carried out in Australia, the UK and the USA.

Examined interventions ranged across clinical, school-based, or home-based settings, with group or individual treatment formats. Twenty-two of the studies used a CBT intervention. One study used peer-mediated theatre therapy and one study examined the benefits of Thai traditional massage for reducing anxiety. Most interventions involved parents/caregivers and were conducted face-to-face.

 

Campbell Systematic Reviews, Volume16, Issue2, June 2020, e1086

 
https://doi.org/10.1002/cl2.1086

 

Life altering effects on children when a family member has an acquired brain injury; a qualitative exploration of child and family perceptions

DAWES, Kate
CARLINO, Ashley
VAN DER BERG, Maayken
KILLINGTON, Maggie
May 2020

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Objective: To investigate the impact of familial acquired brain injury on children and adult family members, including their views of the support provided, gaps and recommendations for future interventions.

 

Research design: Qualitative exploratory study using a phenomenological approach.

 

Method: Twenty-six participants were recruited from 12 families across the South AustralianBrain Injury Rehabilitation Service (SABIRS) and external community brain injury agencies in Adelaide, South Australia. Sixteen children aged 5–18 participated through ten semi-structured interviews. Ten adults attended six interviews. Following transcription and member checking, thematic analyses occurred with pooled data from all interviews undergoing open, axial and selective coding.

 

Main results: Analyses revealed four main themes: (1) help parents help their children, (2) improve family functioning by giving children meaningful roles, (3) staff: don’t leave children “in the dark,” and (4) support for children is not one size fits all.

 

Conclusions: Children and adults reported significant gaps in support offered by acute and brain injury services after familial acquired brain injury. Children and adults need to receive intervention in addition to the patient. To fill identified gaps, participants recommended more input by clinical staff including the use of technology; specifically, the development of age-appropriate applications, educational videos and interactive games.

Disability Royal Commission: WWDA’s response to education and learning issues paper

SANDS, Therese
April 2020

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In 2019 the Disability Royal Commission released an issues paper on education and learning. The issues paper asked 13 questions based on some of the key issues and barriers experienced by students with disability.

Women With Disabilities Australia (WWDA) have now submitted their response to the issues paper which highlights key recommendations to improve the lives and experiences of students with disability. The recommendations stem from the following key areas:

  • Inclusive education
  • Intersectionality
  • Inequality and discrimination underpin violence
  • Restrictive practices – torture and ill-treatment
  • Exposing violence – desegregated data and intersectionality
  • Building strengths through inclusive education

Coronavirus (COVID-19) translated resources

WOMEN WITH DISABILITIES AUSTRALIA (WDDA)
March 2020

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WWDA has produced an Easy English ‘What is Coronavirus‘ document for women or girls with a disabiliity to explain some key facts about COVID-19 in a simple way.

The document is available in 11 different languages (each as a PDF or Accessible Word DOC)

Catering for ‘very different kids’: distance education teachers’ understandings of and strategies for student engagement

HARRIS, Lois
DARGUSCH, Joanne
AMES, Kate
BLOOMFIELD, Corey
2020

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Compulsory distance education has always sought to be inclusive, providing educational opportunities for K-12 students unable to attend mainstream, face-to-face schools for medical, geographical, or personal reasons. However, how to effectively engage these diverse learners has remained a perpetual challenge, with a need for further investigation into the nature of student engagement with compulsory school distance contexts and how teachers can best support it. This qualitative study used focus groups (n=2 groups, n=16 participants) to examine teacher definitions and student engagement strategies within eKindy-12 distance education in Queensland, Australia. Categorical analysis was conducted using a priori codes for definitions, focusing on four previously established engagement types (i.e. behavioural, emotional, cognitive, and agentic engagement), and in vivo codes for strategies. Teacher definitions focused strongly on behavioural engagement, but most also contained elements of emotional and cognitive engagement; agentic engagement was only occasionally evidenced via practice descriptions. Teachers described engaging students by: building relationships, creating a safe classroom environment through differentiation, using inclusive technological tools to facilitate interaction and monitor progress, making learning fun and relevant, drawing on school-wide pedagogical frameworks and teaching strategies, and encourage self-regulation. Findings suggest distance education teachers face unique challenges around evidencing engagement and supporting student agency.

Storying disability’s potential

WHITBURN, Ben
GOODLEY, Dan
2019

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In this paper, we weave in and out of theory and narrative in order to consider the potential of disability and its relationship to knowledge construction. We consider theories to be stories that one can tell about the world. And these theories are enlivened by other stories that we tell about ourselves and the world around us. As disability researchers, we explore the ways in which disability becomes known in the world and we do so through our own tales and theoretical narratives of knowing disability. In telling stories, then, we break down artificial boundaries between theory and narrative. And in theorising our stories – and storying our theories – we seek to explore the potential of disability to unsettle and challenge exclusionary curriculum. This textual assemblage traverses diverse themes including diagnosis, school programming, welfare, transportation, social interaction and access.

Gender, sexuality and relationships for young Australian women with intellectual disability

O’SHEA, A
FRAWLEY, P
2019

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Gender has often been overlooked in the lives of people with intellectual disability, resulting in a limited understanding and service response. This is in part due to a lack of knowledge about the way people with intellectual disability negotiate and build a gendered identity. In this article we present research undertaken with six young women with an intellectual disability who worked with the first researcher to co-develop some stories from their lives. We show how, facilitated by an innovative method which focused on meaningful engagement, the women told stories of richly gendered lives and subjectivities. Their stories showed how gender can be a desired and productive subjectivity, and how consideration of gender can help to identify resistance and agency in their lives. Their stories illustrate how gender is necessary in forming a comprehensive understanding of the lives of women with intellectual disability.

Sport coaches as policy actors: an investigation of the interpretation and enactment of disability and inclusion policy in swimming in Victoria Australia

HAMMOND, Andrew M
PENNEY, Dawn
JEANES, Ruth
2019

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This paper draws upon education policy sociology, and sport coaching literature, in critically examining sport coaches as policy actors. Stephen Ball and colleagues’ conceptualisation of different policy actor positions and roles provided the framework for research that investigated how eight professional swimming coaches in Victoria, Australia, interpreted and enacted disability and inclusion policy. A discourse analysis of semi-structured interviews with the eight coaches reveals the complexities associated with how and why different coaches interpret and enact disability and inclusion policy imperatives in different ways in their specific club contexts. Data are presented that shows coaches adopting multiple and hybrid policy actor positions and roles as disability and inclusion policy was interpreted, translated and ultimately, expressed as pedagogic rules and practices. Our discussion brings to the fore questions about power, agency and control in coaching, while highlighting both limits and possibilities for the enactment of inclusive disability sport policies by swimming coaches working in Victoria, Australia. In conclusion we suggest that this research illustrates that coaches are capable of enacting social change, and have some agency to do so, but at the same time appear constrained by established discourses that shape policy and give important direction to pedagogic practice. We advocate that further in-depth research is required into the coaching policy-practice nexus, particularly as it relates to the advancement of equity and inclusion.

Interpretative accounts of work capacity assessment policy for young adults with disabilities

STAFFORD, Lisa
MARSTON, Greg
BEATSON, Amanda
CHAMORRO-KOC, Marianella
DRENNAN, Judy
2019

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Young adults with disabilities are a specific target of the welfare-to-work policy introduced by many OECD countries over the past decade. The implementation of these policies is a significant concern for service delivery organisations and advocates in Australia and internationally due to complex intersecting structural barriers that persist for many young adults with disabilities. A particular focus of this article is work capacity assessments. Drawing on socio-political theories and interpretive policy analysis, the 22 in-depth interviews with personnel from service delivery organisations and advocacy organisations reveal how the deemed capacity to work process is not only interpreted as flawed, but the current policy approach disables young adults, perpetuates stigma, and creates division between service users and service providers. The accounts reinforce the need to contest such assessments and instead turn towards a rights-based capability approach permitting young adults with disability self-determination over their education-to-employment pathway.

A Document Review of Exclusionary Practices in the Context of Australian School Education Policy

IACONO,Teresa
KEEFFE, Mary
KENNY, Amanda
MCKINSTRY, Carol
2019

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Internationally, there is a commitment to inclusive education for students with disability. In Australia, equality of access to mainstream schools is a key policy feature, with educational exclusion of children with disability being unlawful. In this review, the aim was to identify and analyze contemporary documents that point to failures in inclusive policy and legislation in Australia and the state of Victoria by demonstrating educational exclusion of school students with disability. A search of the gray literature was conducted to identify relevant documents from 2010 to 2017. Reference lists of retrieved documents were also searched for other sources. The review included 23 documents and findings demonstrated that the needs of children and families are often not met, with a disconnection evident between inclusive educational policy, legislation, and practices that exclude children with disability from mainstream education. Restrictive practices and gatekeeping act to dissuade families from enrolling children in mainstream education, with many seeking enrolment in special schools. However, concerns with special school practices, such as the use of restrictive interventions have been documented. Parents have resorted to homeschooling, with associated emotional and economic consequences. Tensions between schools and parents were evident, with parents not always having the opportunity to be fully involved in decision-making processes and planning. The key finding of this review was a clear gap between policy and legislative intentions and practices in schools. Lack of clarity on reasonable adjustments and an underpinning research evidence base to policy results in schools being left to develop their own practices. Strong leadership is needed from principals, and a whole of school commitment, to traverse policy practice gaps that continue to impact on the ability of children with disability to be well-supported in accessing mainstream schools.

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