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Nationwide implementation of a national policy for evidence-based rehabilitation with focus on facilitating return to work: a survey of perceived use, facilitators, and barriers

BJORK BRAMBERG, Elisabeth
JENSEN, Irene
KWAK, Lydia
October 2018

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Aim: The aim is to assess whether the national policy for evidence-based rehabilitation with a focus on facilitating return-to-work is being implemented in health-care units in Sweden and which factors influence its implementation.

 

Methods: A survey design was used to investigate the implementation. Data were collected at county council management level (process leaders) and clinical level (clinicians in primary and secondary care) using web surveys. Data were analyzed using SPSS, presented as descriptive statistics.

 

Results: The response rate among the process leaders was 88% (n = 30). Twenty-eight percent reported that they had already introduced workplace interventions. A majority of the county councils’ process leaders responded that the national policy was not clearly defined. The response rate among clinicians was 72% (n = 580). Few clinicians working with patients with common mental disorders or musculoskeletal disorders responded that they were in contact with a patient’s employer, the occupational health services or the employment office (9–18%). Nearly, all clinicians responded that they often/always discuss work-related problems with their patients.

 

Conclusions: The policy had been implemented or was to be implemented before the end of 2015. Lack of clearly stated goals, training, and guidelines were, however, barriers to implementation.

Including children with disabilities in preschool education. Experiences of Plan International Mozambique

PLAN INTERNATIONAL
August 2018

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Between 2015 and 2017, Plan International Mozambique worked together with communities supporting 106 preschools in rural Mozambique. In late 2016, an approach was piloted in 18 community-based preschools to support them to be disability-inclusive. The overall goal was to increase the number of children with disabilities enrolled in Early Childhood Care and Education (ECCE) centres delivering quality early learning opportunities. The pilot took place over a 12 month period. Summarised findings about the current status of inclusion in preschool programmes run by Plan International Mozambique, case studies and lessons learned about the inclusion of children with disabilities in these programmes are provided.  

 

They describe five aspects that need to be considered to remove barriers and ensure that children with disabilities can access and benefit from early childhood education:

1. Work directly with the parents of children with disabilities

2. Address individual physical and medical needs of children with disabilities

3. Build the skills and confidence of caretakers

4. Equip and build a strong implementing team

5. Build evidence on what is happening and what (doesn’t) work

Promote, Protect and Monitor 2017 Update survey on Article 33 (2) of the Convention on the Rights of Persons with Disabilities

AICHELE, Valentin
August 2018

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Article 33 (2) of the CRPD requires state parties to have a structural framework in place to promote, protect and monitor the implementation of the Convention on the Rights of Person with Disabilities (CRPD) at the national level. This “2017 Update Survey”, conducted by the German Institute for Human Rights, was done to identify the current situation how state parties implement these provisions. National Human Rights Institutions (NHRIs) from all continents participated in the survey. A comparison of the results of the 2017 Update Survey with those of similar survey conducted in 2011 indicates that there is a positive trend towards the strengthening of the role of National Human Rights Institution in the context of the CRPD in terms of numbers – either as the bearers of sole responsibility or responsibility shared with others. 

Annexes are provided containing concluding observations, the questionnaire used and a table of survey responses.

Young persons with disabilities: Global study on ending gender-based violence, and realising sexual and reproductive health and rights

McCLOSKEY, Megan
MEYERS, Stephen
July 2018

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This study provides an analysis on the situation of young persons with disabilities concerning discrimination and gender-based violence, including the impact on their sexual and reproductive health and rights. It also provides an assessment of legal, policy and programming developments and specific good practices in service delivery as well as best-standard prevention and protection measures. Finally, policy and programming recommendations are provided to assist in greater promotion of the rights of young persons with disabilities, with a particular emphasis on preventing and responding to gender-based violence, and realizing sexual and reproductive health and rights.

Bridging the Gap: Examining disability and development in four African countries. The case for equitable education

GROCE, Nora
et al
June 2018

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Over the course of a three-year project the Leonard Cheshire Research Centre worked with research teams in four countries: Kenya, Sierra Leone, Uganda and Zambia to better understand the relationship between disability and development in each country across four domains: education, health, labour markets and social protection. This mixed methods research used a range of interrelated components, including policy and secondary data analysis, a household survey of 4,839 households (13,597 adults and 10,756 children), 55 focus group discussions and 112 key informant interviews across the four countries. 

 

This report explores key findings in relation to education. Key findings discussed include school attendance, cost of education, inability to learn and gap in educational attainment.

Disability inclusion and accountability framework

McCLAIN-NHLAPO, Charlotte
et al
June 2018

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The main objective of the Disability Inclusion and Accountability Framework is to support the mainstreaming of disability in World Bank activities. It lays out a road map for (a) including disability in the Bank's policies, operations and analytical work, and (b) building internal capacity for supporting clients in implementing disability-inclusive development programs. The primary target audience of the Framework is Bank staff but it is also relevant to the Bank's client countries, development partners and persons with disabilities. The framework provides four main principles for guiding the World Bank’s engagement with persons with disabilities: nondiscrimination and equality, accessibility, inclusion and participation, and partnership and collaboration. 

 

The appendices to this framework highlight key areas in which the Bank can have a significant impact on the inclusion, empowerment, and full participation of persons with disabilities. These areas include transport, urban development, disaster risk management, education, social protection, jobs and employment, information and communication technology, water sector operations, and health care. 


Report No. 126977
 

Challenges and priorities for global mental health in the Sustainable Development Goals (SDG) era

ACADEMY OF MEDICAL SCIENCES
June 2018

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Published in 2011, the Grand Challenges in Global Mental Health initiative provided a framework to guide the research needed to improve treatment and prevention of mental health disorders and expand access to mental health services. At the Academy’s workshop on global mental health participants reflected on progress since 2011, focusing on specific life-course stages, and identified priorities for research in treatment and prevention, as well as enduring challenges and emerging opportunities

Assistive technology products: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit

SMITH, Roger O
SCHERER, Marcia J
COOPER, Rory
BELL, Diane
HOBBS, David A
PETTERSSON, Cecilia
SEYMOUR, Nicky
BORG, Johan
JOHNSON, Michelle J
LANE, Joseph P
SUJATHA, S
RAO, PVM
OBIEDAT, Qussai M
MACLACHLAN, Malcolm
BAUER, Stephen
2018

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This paper is based on work from the Global Research, Innovation, and Education on Assistive Technology (GREAT) Summit that was coordinated by WHO’s Global Cooperation on Assistive Technology (GATE). The purpose of this paper is to describe the needs and opportunities embedded in the assistive product lifecycle as well as issues relating to the various stages of assistive product mobilization worldwide.

The paper discusses assistive technology product terminology and the dangers of focusing on products outside the context and rolling out products without a plan. Additionally, the paper reviews concepts and issues around technology transfer, particularly in relation to meeting global needs and among countries with limited resources. Several opportunities are highlighted including technology advancement and the world nearing a state of readiness through a developing capacity of nations across the world to successfully adopt and support the assistive technology products and applications.

The paper is optimistic about the future of assistive technology products reaching the people that can use it the most and the excitement across large and small nations in increasing their own capacities for implementing assistive technology. This is expressed as hope in future students as they innovate and in modern engineering that will enable assistive technology to pervade all corners of current and potential marketplaces. Importantly, the paper poses numerous topics where discussions are just superficially opened. The hope is that a set of sequels will follow to continue this critical dialog.

Learning From Experience: Guidelines for locally sourced and cost-effective strategies for hygiene at home for people with high support needs.

World Vision/CBM Australia
May 2018

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This learning resource is the result of a partnership between World Vision Australia and CBM Australia that aims to improve inclusion of people with disabilities in World Vision’s Water, Hygiene and Sanitation (WASH) initiatives, including in Sri Lanka. The guidelines are based on experiences and observations from World Vision’s implementation of the Rural Integrated WASH 3 (RIWASH 3) project in Jaffna District, Northern Province, funded by the Australian Government’s Civil Society WASH Fund 2. The four year project commenced in 2014. It aimed to improve the ability of WASH actors to sustain services, increase adoption of improved hygiene practices, and increase equitable use of water and sanitation facilities of target communities within 11 Grama Niladari Divisions (GNDs) in Jaffna District.

To support disability inclusion within the project, World Vision partnered with CBM Australia. CBM Australia has focused on building capacities of partners for disability
inclusion, fostering connections with local Disabled People’s Organisations, and providing technical guidance on disability inclusion within planned activities. World Vision also partnered with the Northern Province Consortium of the Organizations for the Differently Abled (NPCODA) for disability assessment, technical support and capacity building on inclusion of people with disabilities in the project.

HYGIENE AT HOME FOR PEOPLE WITH HIGH SUPPORT NEEDS
This document is one of two developed in the Jaffna District and describes strategies that used to assist households and individuals in hygiene tasks at home. The strategies were designed to be low cost and were developed using locally available materials and skills in the Jaffna District of Sri Lanka.

NOTE: The development of this learning resource was funded by the Australian Government's Civil Society WASH Fund 2.

Digital Accessibility Toolkit

CBM
May 2018

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The purpose of this toolkit is to share a selection of tools and recommendations pertaining to the accessibility of Information and Communication Technologies (ICT). Based on international standards and a scan of available technologies, these tools and recommendations are intended to contribute to the social and economic inclusion of persons with disabilities by ensuring that information is equitably accessible.

The goals of this toolkit are:

  • To outline the key international frameworks around digital accessibility and why it is critical for inclusion of persons with disabilities.
  • To link people with tools, practice examples, free online training, and other resources so that their practice is digitally accessible.
  • To ensure that digital accessibility is an inherent aspect of daily practice.
  • To align the practices of those working with and for CBM. 

This toolkit is intended to be used as a guide and practice resource by people working with and for CBM so that we produce accessible digital content and communications, and place accessibility at the centre of our ICT procurement processes. We hope that the toolkit will be a resource for the wider community of persons with disabilities, Disabled People’s Organisations (DPOs), and nongovernmental organisations (NGOs).

Community mental health: Theory, practices and perspectives

WYNGAERDEN, Francois
May 2018

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Mental health problems are commonplace and affect more than one in four people worldwide. They are responsible for a quarter of all disabilities. This document aims to provide a basis for exploring these concepts as part of more in-depth work, including an update of the 2011 mental health framework document.

 

A seminar was held in Kigali, Rwanda on 7 - 9 December 2017. It brought together 45 participants from 12 countries to think about and discuss community mental health concepts and practices. The objectives of this document are twofold:

• Set out analysis by an external expert, with a focus on community mental health at HI, in light of the literature and concepts and practices within the sector

• Undertake preliminary work to identify new concepts for implementation, based on the aspects covered in the seminar, as part of ongoing in-depth work in this area, including the updating of the 2011 mental health framework document.

 

Case histories from Rwanda, Lebanon and Madascagar are given. There is an extensive bibliography in the Annex

 

This document is intended for HI and partner staff members who work in the mental health and psychosocial support sector. It is also intended for HI staff working on mental health strategy. It can also be used to feed into the work of field staff developing, implementing and assessing mental health and psychsocial support programmes

Budgeting of pre-school education for children with disabilities in the municipalities of Elbasan and Korca

KOLPEJA, Vilma
May 2018

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The study on the budgeting of preschool education for children with disabilities was conducted in the municipalities of Elbasan and Korça. It is structured into 5 chapters. Following the introduction (Chapter 1) and the description of the methodology (Chapter 2), Chapter 3 provides the legal and institutional context of inclusive education as well as the crosscutting with the territorialadministrative reform (of 2014) and decentralization. Chapter 4 argues the need for inclusive pre-school education from child rights approach and of longterm economic benefits. This chapter identifies and describes in detail the educational services, rehabilitation services and support services that facilitate the inclusion of children of children with disabilities (0-6 years) in the inclusive preschool education. This chapter provides also information on the number of 0-6 year old children with disabilities, public education structures that apply inclusive pre-school education and the number of children with access to these structures.. Chapter 5 describes and analyzes the funding aspect of inclusive education in the two municipalities under the study.

Maintaining professional integrity: experiences of case workers performing the assessments that determine children’s access to personal assistance

HULTMAN, Lill
FORINDER, Ulla
FUGL-MEYER, Kerstin
PERGERT, Pernilla
2018

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This qualitative study explores Swedish case workers experiences of decision making regarding disabled children's right to obtain assistance in their everyday life whereby they can live independently in the community. Data collection included seven focus-group interviews and 11 complementary individual interviews with case workers from different agencies responsible for decisions regardig access to personal assistance. Grounded theory methodology was used. Compromised professional integrity under shifting conditions emerged as a main concern and maintaing professional integrity was used as an approach to resolve it. The case workers are maintaining professional integrity by applying different strategies; struggling with division of responsibility, bureaucratizig, and justifying and protecting. The results indicate that present application of assessment criteria in combination with the utilization of precedent rulings has made it difficult for the case workers to make decisions that provide children access to assistance. Current practice raises questions about the case workers perspectives of professionalism.

Kinect4FOG: monitoring and improving mobility in people with Parkinson’s using a novel system incorporating the Microsoft Kinect v2

AMINI, Amin
BANITSAS, Konstantinos
YOUNG, William R
2018

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Parkinson’s is a neurodegenerative condition associated with several motor symptoms including tremors and slowness of movement. Freezing of gait (FOG); the sensation of one’s feet being “glued” to the floor, is one of the most debilitating symptoms associated with advanced Parkinson’s. FOG not only contributes to falls and related injuries, but also compromises quality of life as people often avoid engaging in functional daily activities both inside and outside the home. In the current study, we describe a novel system designed to detect FOG and falling in people with Parkinson’s (PwP) as well as monitoring and improving their mobility using laser-based visual cues cast by an automated laser system. The system utilizes a RGB-D sensor based on Microsoft Kinect v2 and a laser casting system consisting of two servo motors and an Arduino microcontroller. This system was evaluated by 15 PwP with FOG. Here, we present details of the system along with a summary of feedback provided by PwP. Despite limitations regarding its outdoor use, feedback was very positive in terms of domestic usability and convenience, where 12/15 PwP showed interest in installing and using the system at their homes.

‘It’s my home and your work’: the views of a filmed vignette describing a challenging everyday situation from the perspective of people with intellectual disabilities

HELLZEN, Ove
HAUGENES, Marit
ØSTBY, May
2018

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Purpose: Examining everyday challenges in the interactions between people with intellectual disabilities and their staff, as seen from the user’s perspective, is an important perspective in health care research. Involving people with intellectual disabilities as so-called co-researchers is a relatively unexplored research strategy. In this paper, co-researchers participated in all the steps of the research process, from planning to reporting, in addition to the written reporting of the findings. The aim of this study was to explore how people with intellectual disabilities experienced a filmed vignette of an everyday situation.

 

Method: Based on audio-recorded and transcribed individual and focus-group interviews with people with intellectual disabil- ities, performed by co-researchers with intellectual disabilities together with researchers, qualitative content analysis was used.

 

Results: The analysis reveals three themes: “being emotionally touched”, “being aware of the other”, and “being unclear”.

 

Conclusions: The results are discussed in light of normalization and participation in society with independence and one’s own decision-making. Regarding the care of people with intellectual disabilities, the main finding is the need to focus not only on greater involvement of this population in their own daily lives, but also to teach self-determination skills. Another finding is the importance of involving people with intellectual impairment as co-researchers.

Aligning with the flow of control: A grounded theory study of choice and autonomy in decision-making practices of people with intellectual disabilities

CAREY, Eileen
2018

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Purpose: Choice and autonomy are recognized as values facilitating genuine self- determination. Subsequently greater understanding of these concepts in decision-making practices of adults with intellectual disabilities is required.

 

Aims: The twofold aim of this research study was to ascertain the core concern (most important issue) for adults with intellectual disabilities as they make choices and exercise autonomy and to develop a theory explaining how these adults attempt to resolve their core concern.

 

Methods: This research study undertaken in a single organization in the Republic of Ireland applied classic-grounded theory methods. Participants included twelve adults who were attending day services and accessing a variety of other organizational services. Interviews were undertaken, between January 2012 and September 2013, in different contexts on up to 4 occasions (46 interviews). Data analysis utilized concurrent processes of constant comparative analysis.

 

Results: The main issue of concern for these participants was ‘control’ in environments that were controlling of them and they responded by ‘aligning with the flow of control’ explained by how they framed control, emotionally connected and adjusted in compliance situations.

 

Conclusions: This theory offers a conceptual delineation of the way adults with intellectual disabilities manage the daily tensions and harmonies in decision-making.

Strengthening participation of people with disabilities in leadership roles in developing countries

PRICE, Roz
April 2018

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Evidence on strategies/pathways for strengthening people with disabilities’ leadership in political and public life, at all levels of governance (formal and informal) is reviewed.

Topics discussed concerning participation in political and public life include: UNCRPD; barriers; strategies to support inclusive electoral and political processes; womens empowerment; capacity building and training; the role of disability movements and DPOs; affirmative action and quotas; election observation and increasing the visibility of people with disabilities 

 

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Developing inclusive practices through action learning: Inclusive education cross-country peer-review of Bangladesh (Hope project) and Indonesia (IDEAL project)

GRIMES, Peter
HEIJNEN-MAATHUIS, Els
April 2018

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The aim of the review was to create a capacity building and professional learning opportunity based on inclusive education experience and expertise in another context. The background, methodology, findings of the study are enclosed within the document. Specific objectives include: (1) to create focused peer-to-peer sharing and learning opportunities across countries, (2) record key strategies, opportunities, remaining challenges and achievements, (3) document lessons learned for targeted quality improvements during the last year of each project, and (4) use information collected for developing a responsible, phased exit strategy for 2018.

Disability and inclusive education - A stocktake of education sector plans and GPE-funded grants

BANHAM, Louise
PAPAKOSTI, Elena
et al
March 2018

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This report was commissioned by the Global Partnership for Education’s Secretariat to take stock of how disability and inclusive education are included in education sector plans in 51 countries, including GPE-funded programs, such as education sector program implementation grants, program documents, implementation progress reports education sector analysis, if applicable, and other relevant GPE program documents.

This report documents progress and highlights the need to step up support to GPE partner countries on disability and inclusive education, to improve consideration of issues around disability and inclusion in education sector analysis and sector planning processes to better promote the achievement of GPE 2020 strategic goal 2, and to fulfill the transformative vision of Agenda 2030

Good practice guide: embedding inclusion of older people and people with disabilities in humanitarian policy and practice Lessons learnt from the ADCAP programme

AKERKAR, Supriya
BHARDWAJ, Rhea
2018

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This guide shares good practices and challenges that have emerged through the experience of the Age and Disability Capacity Programme (ADCAP) implementing partners, in embedding inclusion of older people and people with disabilities within their humanitarian policies and practices. All mainstream and specialist organisations engaged in humanitarian responses can learn and benefit from this experience. This guide complements the ‘Humanitarian inclusion standards for older people and people with disabilities’ (see Appendix 4), by documenting practices that will help humanitarian organisations to systematically include older people and people with disabilities.

Nine change themes that reflect successful inclusion practices emerging from the ADCAP experience are presented. Each theme includes analysis — using examples of action from ADCAP implementing organisations, a set of good practice action points, and case studies detailing how change was brought about in different implementing organisations

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