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Association of anxiety and depression with physical and sensory functional difficulties in adults in five population-based surveys in low and middle-income countries

WALLACE, Sarah
MACTAGGART, Islay
MORGON BANKS, Lena
POLACK, Sarah
KUPER, Hannah
June 2020

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The aim of this study was to assess the association between anxiety and depression with physical and sensory functional difficulties, among adults living in five low and middle-income countries (LMICs).

A secondary data analysis was undertaken using population-based disability survey data from five LMICs, including two national surveys (Guatemala, Maldives) and 3 regional/district surveys (Nepal, India, Cameroon). 19,337 participants were sampled in total (range 1,617–7,604 in individual studies). Anxiety, depression, and physical and sensory functional difficulties were assessed using the Washington Group Extended Question Set on Functioning. Age-sex adjusted logistic regression analyses were undertaken to assess the association of anxiety and depression with hearing, visual or mobility functional difficulties.

The findings demonstrated an increased adjusted odds of severe depression and severe anxiety among adults with mobility, hearing and visual functional difficulties in all settings (with ORs ranging from 2.0 to 14.2) except for in relation to hearing loss in India, the Maldives and Cameroon, where no clear association was found. For all settings and types of functional difficulties, there was a stronger association with severe anxiety and depression than with moderate. Both India and Cameroon had higher reported prevalences of physical and sensory functional difficulties compared with Nepal and Guatemala, and weaker associations with anxiety and depression

Aesthetics and the perceived stigma of assistive technology for visual impairment

DOS SANTOS, Aline Darc Piculo
FERRARI, Ana Lya Moya
MEDOLA, Fausto Orsi
SANDNES, Frode Eika
2020

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Purpose: 

The aim of this study was to identify factors that influence the perceived stigma of two assistive devices for visual impairment, namely the white cane and smart glasses.

 

Method: 

Face-to-face semi-structured interviews with eight European students were conducted to probe their experiences and knowledge related to disability, assistive technology, visual impairment, as well as handheld and wearable devices.

 

Results: 

Close relationships with disabled people seems to have a positive influence on participants perceptions about stigma, disability, and assistive technology. Academic background seems to not have any influence. The aesthetics of assistive devices was observed as an important factor that influences the adoption or abandonment of the device.

 

Conclusion: 

Device without negative symbolism but with modern aesthetics (smart glasses) were positively accepted by the participants than the device with traditional aesthetics and symbolisms of visual impairment (white cane). Designers should, therefore, consider aesthetics in addition to functionality in order to avoid the perceived stigma, thereby reducing the chances of device abandonment.

The Social Network: How people with visual impairment use mobile phones in Kibera, Kenya

HOLLOWAY, Catherine
BARBARESCHI, Giulia
ARNOLD, Katherine
MAGOMERE, Grace
WETENDE, Wycliffe Ambeyi
NGARI, Gabriel
OLENJA, Joyce
May 2020

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Living in an informal settlement with a visual impairment can be very challenging resulting in social exclusion. Mobile phones have been shown to be hugely beneficial to people with sight loss in formal and high-income settings. However, little is known about whether these results hold true for people with visual impairment (VIPs) in informal settlements. Findings of a case study of mobile technology use by VIPs in Kibera, an informal settlement in Nairobi are presented. The study used contextual interviews, ethnographic observations and a co-design workshop to explore how VIPs use mobile phones in their daily lives, and how this use influences the social infrastructure of VIPs. Findings suggest that mobile technology supports and shapes the creation of social infrastructure. However, this is only made possible through the existing support networks of the VIPs, which are mediated through four types of interaction: direct, supported, dependent and restricted

 

Paper presented at CHI 2020, April 25–30, 2020, Honolulu, HI, USA

Overview on accessibility of video conferencing apps and services

STAKEHOLDER GROUP OF PERSONS WITH DISABILITIES FOR SUSTAINABLE DEVELOPMENT
May 2020

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The purpose of this document is for United Nations staff and partners to make their video conferences as inclusive as possible for all persons with disabilities. The Stakeholder Group of Persons with Disabilities gathered the following information from representative organizations of persons with disabilities, in particular from the International Disability Alliance and its members, and from additional research. This list is by no means exhaustive, but rather attempts to provide an accessibility overview. 

Celebrating the value of employees with disabilities

Sightsavers
March 2020

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In this blog, Rasak Adekoya (Programme Officer Inclusion Works, Sightsavers Nigeria) shares his career story, tells us about his role helping employers appreciate candidates and employees with disabilities, and what it’s like leading a film shoot as a blind person.

 

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium

Prevalence of trachoma in Pakistan: Results of 42 population-based prevalence surveys from the Global Trachoma Mapping Project

KHAN, A A
et al
January 2020

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Previous phases of trachoma mapping in Pakistan completed baseline surveys in 38 districts. To help guide national trachoma elimination planning, this work was carried out to estimate trachoma prevalence in 43 suspected-endemic evaluation units (EUs) of 15 further districts. A population-based trachoma prevalence survey was planned for each EU. Two-stage cluster sampling was employed, using the systems and approaches of the Global Trachoma Mapping Project.

 

Ophthalmic Epidemiol. 2020 Apr;27(2):155-164

doi: 10.1080/09286586.2019.1708120

Accuracy of school-based vision screening by teachers in Pakistan: A qualitative study

BECHANGE, STEVENS
January 2020

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Main objectives

1 – To explore the knowledge and competencies of teachers in carrying out visual acuity testing.

2 – To investigate how visual acuity testing practices were applied.

3 – To determine teachers’ motivations and attitudes towards carrying out school-based visual acuity testing.

Summary

Although the school-based vision screening programme was well received and supported by the schools and health providers, limited time allocated for training and practice; limited supervision and the lack of refresher training; trainers insufficiently experienced in training non-health staff and teachers’ involved had many other responsibilities and could not allocate sufficient time to conduct the activity properly which undermined the effectiveness and efficiency of the programme.

Integrating geospatial data and measures of disability and wealth to assess inequalities in an eye health survey: An example from the Indian Sunderbans

MOHANTY, Soumya
et al
December 2019

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The Sunderbans are a group of delta islands that straddle the border between India and Bangladesh. For people living on the Indian side, health services are scarce and the terrain makes access to what is available difficult. In 2018, the international non-governmental organisation Sightsavers and their partners conducted a population-based survey of visual impairment and coverage of cataract and spectacle services, supplemented with tools to measure equity in eye health by wealth, disability, and geographical location. Two-stage cluster sampling was undertaken to randomly select 3868 individuals aged 40+ years, of whom 3410 were examined

 

Int J Environ Res Public Health. 2019 Dec; 16(23): 4869

doi: 10.3390/ijerph16234869

TT Tracker app aims to improve surgical outcomes and patient care

JENSEN, Kimberley
et al
November 2019

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Trichiasis (TT) operations are generally conducted in remote and resource-poor settings, which can make it difficult to follow-up and assess surgical outcomes. Sightsavers developed an Android-based mobile phone application, called the TT Tracker, which helps surgeons, assistants and supervisors to collect and analyse information about surgical outcomes and performance, and to determine when and where follow-up appointments are required. 

 

Community Eye Health. 2019; 31(104): 93.

Unimproved water sources and open defecation are associated with active trachoma in children in internally displaced persons camps in the Darfur States of Sudan

MACLEOD, C K
October 2019

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To estimate the proportion of children with trachomatous inflammation—follicular (TF) and adults with trachomatous trichiasis (TT) in internally displaced persons (IDP) camps in the Darfur States of Sudan and to evaluate associated risk factors. 

A random-effects hierarchical model was used to evaluate factors associated with TF and TT. Thirty-six IDP camps were represented in the survey data in which 1926 children aged 1–9 years were examined, of whom 38 (8%) had TF. Poor sanitation, younger age and living in a household that purchased water from a vendor were associated with TF in children aged 1–9 years.

 

Transactions of The Royal Society of Tropical Medicine and Hygiene. 2019 Oct 11;113(10):599-609

DOI:10.1093/trstmh/trz042

Medication management for people with disabilities

SINGLECARE
September 2019

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This guide provides tips for people with disabilities and their caregivers to properly handle prescriptions and manage medications. Practical advice is given on:

  • How to read medication labels
  • Managing medications at home
  • Medication strategies for people with visual impairments
  • Medication management for people with a physical disability and/or mobility limitations
  • Medication management for people with intellectual disabilities
  • Tips for effective medication management as the caregiver of a person with a disability

Estimating the intracluster correlation coefficient for trachomatous inflammation-follicular in population-based trachoma prevalence surveys: results from a meta-regression of 261 standardised pre-intervention surveys in Ethiopia, Mozambique, and Nigeria.

MACLEOD, Colin
et al
September 2019

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This study used a parametric bootstrap model to estimate intracluster correlation coefficient (ICC) for trachomatous inflammation-follicular (TF) in 1-9 year-olds, from 261 population-based trachoma prevalence surveys completed using standardised GTMP methodologies in Ethiopia, Mozambique, and Nigeria from 2012-2016.

Results from this study were used to draw up the most recent WHO 2018 recommendations on design effect (DE) estimates for sample size calculations for survey

 

American Journal of Epidemiology, 2019 Sep 11. pii: kwz196

doi: 10.1093/aje/kwz196

 

 

Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: successes and challenges

SENYONJO, Laura
et al
September 2019

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In 2009 Ghana began to design a trachoma pre-validation surveillance plan, based on then-current WHO recommendations. The plan aimed to identify active trachoma resurgence and identify and manage trichiasis cases, through both active and passive surveillance approaches. This paper outlines and reviews the adaptations made by Ghana between 2011 and 2016

Infectious Diseases of Poverty volume 8, Article number: 78 (2019)

Environmental Accessibility Assessment for People with Vision, Hearing and Speech Disabilities in Mongolia

BATDULAM, Tumenbayar
CHIMEDSUREN, Оchir
URANCHIMEG, Davaatseren
ENKHTSETSEG, Byambaa
2019

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Purpose: The main objective of this paper was to assess environmental accessibility for people with vision, hearing and speech disabilities in Mongolia, with particular focus on public buildings and public transportation.

 

Methods: A standardised internationally-used questionnaire, consisting of 29 questions, was used for the accessibility of public buildings assessment.  The questionnaire results were grouped into categories and descriptive statistics were obtained. To determine quality and accessibility to public transportation a standardised sheet, consisting of 51 questions from the internationally accepted SERVQUAL, was used. This model is commonly used for measurement of the discrepancies between actual performance and customer expectations.

 

Result: Assessment of public buildings in Mongolia revealed that they were moderately accessible for people with vision, hearing and speech disabilities. The assessment of public transportation found that the discrepancy between actual performance and customer expectation is the highest across all indicators for people with hearing and speech impairments.

 

Conclusion: The research findings indicated a strong need to pay closer attention to the current environmental unfriendliness and inaccessibility faced by people with vision, hearing and speech disabilities.

Intersections of Disability and Gender in Sports: Experiences of Indian Female Athletes

SETH, Nainika
DHILLON, Megha
2019

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Purpose: This qualitative study aimed to compare the experiences of two groups of female athletes - those with and without visual disability- who participate in sports.

 

Method: In-depth interviews were conducted with 16 athletes and thematic analysis of the data was done.

 

Results: Both groups identified various benefits of engaging in sports, including increased fitness and higher self-esteem. Para-athletes felt that sports provided them with opportunities to break stereotypes associated with disability. Both groups also identified certain barriers impeding sports participation, the most pervasive of these being poor infrastructure.  In terms of differences, athletes without disability were initiated into sports at a much earlier age, had enjoyed more freedom in choosing their sport, and were given more family support than the para-athletes.

 

Conclusion: An analysis of the findings in terms of the Self-Determination Theory (Deci & Ryan, 2002) indicated that needs for competence, autonomy and relatedness were being more wholly met through sports-related experiences for athletes without disability than for the para-athletes.

 

Implications: Current conditions within para-sport need to be improved by providing more sporting choices to athletes with disability, easier access to sports opportunities at an earlier age, development of self-efficacy with regard to sports, challenging of stereotypes, and generating awareness among parents that sports can be a viable and safe option for their daughters.

Integrating face washing into a school-based, handwashing behavior change program to prevent trachoma in Turkana, Kenya

TIDWELL, James
et al
August 2019

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Trachoma is the leading infectious cause of blindness, and facial cleanliness has been associated with reduced odds of trachomatous inflammation and Chlamydia trachomatis infection.  This study reports on the results of a program integrating face washing into a school-based handwashing promotion program in Turkana County, Kenya

 

American Journal of Tropical Medicine and Hygiene. 2019 Oct;101(4):767-773

doi: 10.4269/ajtmh.19-0205.

Rapid assessment of avoidable blindness (RAAB) and disability and equity survey. Nampula, Mozambique

SIGHTSAVERS
July 2019

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This report describes the findings of a rapid assessment of avoidable blindness (RAAB) conducted in Muchinga Province, Zambia in 2017.

The prevalence of blindness was just over 4% and the major cause was cataract, followed by glaucoma. Only 37% of people who require cataract surgery have received it, meaning there is an urgent need to scale up access to cataract surgical services in the province.

In addition to the standard RAAB questionnaire, an additional two sets of questions were administered to the participants to understand their disability and socioeconomic status: the Washington Group Short Set of Questions on Disability (WGSS) and the Equity Tool (ET)

A snapshot of the chalkboard writing experiences of Bachelor of Education students with visual disabilities in South Africa

SUBRAYEN, Roshanthni
DHUNPATH, Rubby
July 2019

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Background: South African higher education policy frameworks highlight renewed interest in equity, access and participation imperatives for students with disabilities (SWDs). However, students with visual disabilities continue to face barriers in their teaching practice school placements.

 

Objectives: This article aims, firstly, to provide early insights into the barriers experienced by students with visual disabilities in their teaching practice school placements in under-resourced schools in KwaZulu-Natal, South Africa. Secondly, it introduces learning communities and a teaching practice pre-placement booklet to enhance equity, access and participation in teaching practice school placements.

 

Method: This study adopted a qualitative methodology using semi-structured interviews to elicit data from two Bachelor of Education students with visual disabilities, who were part of a teaching practice learning community managed by the Disability Unit at the University. Thematic analysis was used, using Tinto’s Learning Community Model which generated valuable evidence to argue for institutional commitment to achieve equity, access and participation for students with visual disabilities.

 

Results: Through engagement with a teaching practice learning community and a teaching practice pre-placement booklet, two students with visual disabilities responded to and managed the chalkboard in ways that promoted teaching and learning in the classroom. These retention support trajectories provide evidence to support enhanced equity, access and participation. Given the stigma associated with disability and the need for equity at policy level, higher education institutions should seriously consider systemic mechanisms for access, participation and success outcomes in the teaching practice school placements of students with visual disabilities.

 

Conclusion: Barriers to participation signal the need for accessible teaching and learning strategies for use by students with visual disabilities in their teaching practice school placements. Teaching practice assessors should be alerted to contextual differences in resourced and under-resourced school settings and the diverse ways in which SWDs navigate these differences.

 

 

African Journal of Disability, Vol 8, 2019

Improving social participation of adolescents with a visual impairment with community-based mentoring: results from a randomized controlled trial

HEPPE, Eline C M
WILLEMEN, Agnes M
KEF, Sabina
SCHUENGEL, Carlo
May 2019

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Purpose: The efficacy of a community-based mentoring program for adolescents with a visual impairment vs. care-as-usual was tested on social participation including satisfaction with social support.

 

Materials and methods: Adolescents (15–22 years; 46% boys) were randomized to an intervention group with mentors with visual impairment (N = 25), an intervention group with mentors without visual impairment (N = 26), or care-as-usual (N = 25). One-on-one mentoring activities regarded school/work, leisure activities, and social relationships.

 

Results and conclusions: Multilevel growth modelling revealed no effect of mentoring on changes in social participation compared to the care-as-usual group (participation [95% CI –0.30, 0.21, d = 0.1]; social participation composite [95% CI –0.24, 0.26, d = 0.24]). Mentees matched to mentors with visual impairments increased more on satisfaction with their social support compared to mentees matched to mentors without impairments and the care-as-usual group [95% CI 0.02, 0.49, d = 0.38]. Age, characteristics of the impairment, and number of match meetings were not associated with change in social participation during the mentoring program. This evaluation showed no benefit of mentoring for social participation of adolescents with a visual impairment. The value of mentors and mentees sharing the same disability needs further investigation. This trial is registered in the Netherlands Trial Register NTR4768.

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