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The incorporation of technology, and more recently AI [Artificial Intelligence], into our everyday lives has been progressing at an unprecedented pace. Siri, Alexa, Cortana and various other digital assistants and chatbots populate our everyday interactions for most service-related matters. Acknowledging that technology, work, and social relations are deeply entangled with each other, this paper combines a literature review of anthropomorphisation of AI and emerging technology with a focus on gender and work, and empirical examples drawn from real-world applications and chatbots in the service industry in India, to critically analyse the gendering of technology. We unpack the tendency to ascribe a feminine identity to assistive technology and argue that gendering of emergent assistive technology is performative and relational. It materialises through particularistic manifestations drawing from the sociocultural context. Furthermore, this gendering of technology is co-constituted by the sexual division of labour and gendered norms of work.
Upper limb motor dysfunction significantly impacts daily activities and quality of life for individuals with stroke. Existing assistive robots often struggle to balance portability, ease of use, and motion assistance. This research presents WELiBot, a novel wearable end-effector-type upper limb assistive robot, designed with a 4R-5R parallel mechanism and an arc-shaped guide rail to provide controlled assistance in lifting, reaching, and circumferential motions. The study introduces the conception of the robot design, focusing on its functional requirements and mechanical structure. The kinematic and static characteristics of WELiBot were analyzed to evaluate its feasibility and effectiveness. Based on this design, a prototype with a 1/4 arc-shaped guide rail was fabricated to test motion feasibility and assistance effects. To assess its performance, electromyography experiments were conducted with four healthy participants. The results showed a significant reduction in biceps brachii muscle activity, confirming the robot’s ability to reduce user effort. Future work will focus on attaching the guide rail to the body for improved usability and refining the control strategy to enhance motion assistance and adaptability in daily life support applications.
The UK welfare landscape is increasingly challenging due to ongoing austerity involving public sector cuts, service retrenchment, and withdrawal of statutory responsibilities. This article shows that as the welfare state contracts, precarity increases and responsibility for service provision is progressively devolved to front-line individuals and service users. To illustrate, the article examines the use of assistive and everyday technologies to improve social housing residents’ quality of life based on a longitudinal mixed methods study conducted between 2020 and 2022. The findings highlight how housing providers can support person-led technology interventions for older residents, where minor improvements positively impact day-to-day living. However, interventions are often limited by practicalities, capacity, and cost. This article connects technological engagement in housing to the ongoing ‘responsibilisation’ of many areas of housing provision to social landlords and tenants. This suggests an extension of responsibility where social housing providers are papering over the cracks in the welfare state.
Virtual reality (VR) offers the prospect of a safe and effective adjunct therapeutic modality to promote mental health and reduce distress from symptoms in palliative care patients. Common physiological and psychological symptoms experienced at the end of life may impact the person’s participation in day-to-day activities that bring them meaning. The purpose of this study was to examine the effect of VR interventions on occupational participation and distress from symptoms.
Objectives
To describe the stimulus, results, and learnings from a single-site pilot study of virtual reality therapy in a specialist palliative care setting.
Methods
Participants engaged in a VR session lasting from 9 to 30 minutes related to coping with pain, inner peace and mindfulness, adventure, and bucket list.
Methods measures
The pilot prospective quantitative observational cohort study was conducted from November 2021 through March 2022 using a pre-post VR intervention research design. Quantitative data was collected using patient-rated assessments and a wireless pulse oximeter. Occupational performance, satisfaction, and distress symptoms were measured using the Canadian Occupational Performance Measure and the Palliative Care Outcomes Collaboration Symptom Assessment Scale (PCOC SAS). The intervention and study design adhered to international guidelines.
Results
Ten participants engaged in the VR interventions. Data showed significantly improved occupational performance and satisfaction scores (p < .001), decreases in PCOC SAS distress from pain (p = .01), fatigue (p < .001), and heart rate (p = .018). No adverse side effects were observed.
Significance of results
Outcomes included an analysis of virtual reality’s effectiveness to alleviate symptom burden and increase occupational participation for palliative care patients. Of specific interest to the research team was the application of virtual reality in a community–based and inpatient palliative care context to supplement allied health services and its feasibility of integration into standard palliative care.
Conclusion
VR therapy showed positive improvements in the participants’ occupational performance, satisfaction, and distress from pain and fatigue.
Chapter 7 presents an introduction and overview of inclusive teaching within the context of science in the early years. Inclusive teaching is about proactive, intentional and purposeful decisions being made by the EC professional to allow all students to reach their full potential. Inclusive practices, such as differentiation and the Universal Design for Learning framework, are described. Case studies are presented that provide opportunities to identify inclusive practices in science teaching and learning.
This chapter proposes that the myths of Hephaistos, the ancient Greek god of metalwork and the only physically impaired member of the Olympic pantheon, can provide insights into ancient inspirations for and understandings of assistive technology. It explores the range of different types of assistive technology that impaired and disabled individuals used in classical antiquity to facilitate their physical mobility, covering staffs, sticks, crutches, corrective footwear, extremity prostheses, conveyances, equids, bearers, and caregivers. It notes the frequent association of impairment and technology in classical antiquity. It argues for a reassessment of the suitability of the Medical Model for use in relation to impairment and disability in classical antiquity under certain circumstances.
Communication changes following acquired brain injury (ABI) may necessitate use of augmentative and alternative communication (AAC). Speech pathologists regularly assist people with ABI and their families with AAC assessment and recommendations, as well as education and training on AAC use. To date, there has been no Australian research investigating the perspectives of speech pathologists working in the field of ABI and AAC. This research aimed to 1) Explore speech pathologists’ insights regarding enablers and barriers to considerations and uptake, and ongoing use, of AAC by people with ABI and 2) Understand their perspectives on AAC acceptance, abandonment and rejection.
Method:
A qualitative research design, with semi-structured interviews, was used with seven speech pathologists working across three Australian states. Interviews were transcribed verbatim, and thematically analysed. To triangulate results, the lived experience reflections of one co-author, who has an ABI and uses AAC, were drawn on.
Results:
Seven themes were identified, relating to four of the five domains of the World Health Organization’s assistive technology model. These included that AAC should be person-centred, with consideration of both products and personnel required, and with effective policy aiding AAC trial, uptake and use.
Conclusion:
This research has highlighted considerations for AAC use by people with ABI, from the perspective of speech pathologists and aided by lived experience reflections. Speech pathologists need to understand the breadth of products, and good practice service steps, to ensure successful AAC use and skill development. Listening to the perspectives of people with ABI is central to that understanding.
Assistive technology for older people promises much, but the research evidence suggests that it delivers little. One hypothesis to explain the lack of positive impact is that assistive technology is often implemented with little involvement of older people or other stakeholders, such as family members or care staff. The suggestion is that co-production may ensure that assistive technology solutions are better tailored to people's needs, capacities and living situations. In this article, we review existing studies to examine what works in co-production in relation to processes of design and implementation of assistive technology for older people. Our results show a growing interest in co-production as an approach in this field, with a wide range of approaches being employed. We highlight a number of key lessons from the research, including key issues around who needs to be engaged in the co-production, as well as essential elements of the process itself. Our review suggests that there is considerable potential in using co-production to improve effectiveness of technological solutions to the challenges of age-related impairments. However, we also emphasise the need for more longitudinal research in this area, to examine whether such collaborative approaches can truly deliver the promise of assistive technology for older people.
The rise in assistive technology (AT) solutions to support people with an acquired brain injury (ABI) has warranted clinicians to build capability in assisting clients to select goal-centred AT. The study explored, amongst ABI clinicians, (a) capability, attitudes, and barriers with AT implementation, (b) age-related differences in technology self-efficacy and capability (c) strategies to support AT use in rehabilitation and (d) thematic analysis of AT-related experiences.
Method:
Mixed methods design. Online survey circulated to ABI clinicians across New South Wales, Australia, comprising purpose-designed items as well as the Modified Computer Self-Efficacy Scale (MCSES; range 0–100)
Results:
Clinicians (n = 123) were evenly distributed across decadal age groups. The majority were female (90%, n = 111) and one-third were occupational therapists.
Clinicians scored strongly on the MCSES (Mdn = 76, IQR = 19), with younger age groups significantly associated with higher scores (H[3] = 9.667, p = .022). Most clinicians (92%) were knowledgeable of mainstream technology for personal use, but over half (65%) reported insufficient knowledge of suitable AT for clients. Clinicians reported positive attitudes towards AT, however, time to research and develop proficiency with a range of AT was the primary barrier (81%).
Thematic analysis suggested that whilst the ideal AT experience is client-motivated requiring multidisciplinary guidance, the clinician role and experience with AT is evolving, influenced by rapid technological advancement and extrinsic opportunities to access AT.
Conclusions:
Whilst clinicians have positive attitudes towards AT, there is a gap in clinician implementation. There is need to support further resources to build clinician capability and access to AT.
The environment, and assistive technologies as part of this, can play an important role in supporting the participation and wellbeing of people living with dementia. If not considered, environments can be overwhelming and disempowering. Disability approaches including environmental considerations and assistive technology were often not offered routinely with people living with dementia. Concerned by this, dementia advocates aimed to create change in this area. The Environmental Design-Special Interest Group (ED-SiG) of Dementia Alliance International was developed as an international consumer-driven community of practice bringing together people with different relevant expertise including living experience (people living with dementia, care partners), architecture and design, occupational therapy, rehabilitation and care provision. This practice opinion piece provides an overview of dementia, the need for collaborative practices within practice with people living with dementia, and the considerations of assistive technology, environmental design and the global context. The reflection provides insights into this international community of practice, with personal reflections of members with living experience of dementia, and benefits and opportunities in considering environmental design and assistive technology from the perspectives of members. This work demonstrates and advocates collaborations that centre the perspectives and expertise of people living with dementia.
This chapter concludes the monograph, emphasising how important the study of ancient assistive technology such as prostheses and aids is for achieving a fuller understanding of the lived experiences of the impaired and disabled in antiquity, and considering how much the objects themselves can tell us about their users. It reiterates that the assistive technology that has survived from antiquity has done so because the objects were included in the tombs and graves of their users, which indicates that they were viewed as part of the individual's body rather than separate from it.
This chapter surveys the evidence for extremity prostheses and assistive technology (walking sticks, canes, crutches, corrective footwear) in classical antiquity. It discusses the different ways in which an extremity such as an arm or leg might be lost (surgical intervention, military activity, judicial and extra-judicial punishment, self-mutilation or deliberate mutilation), and how individuals dealt with their resulting impairments and disabilities. Not everyone could utilise a prosthesis due to the nature of their impairment; they might need to, or indeed choose to, use another type of assistive technology, such as a crutch.
Therapeutic Education (TE) is a powerful tool in the multidisciplinary intervention to improve lifestyle and acquire management skills for chronic diseases, including obesity, a clinical condition whose cure is highly threatened by low long-term adherence to therapeutic recommendations. The urgent need to promote persistent lifestyle change and concordance to treatment in PwO is globally recognized. TE programs offer a vast number of long-term management skills, but it yet deals with a consistent drop-out rate, and we believe that Assistive Technologies (AT) can become a powerful tool to boost independence and improve participation.
Objectives
The goal of our study was to devise and validate an innovative multidisciplinary approach to obesity and binge eating disorder, based on the sinergy between the medical-psychological field and assistive techonolgy.
Methods
We developed “TERESA” (Therapeutic Educational Robot Enhancing Social interActions) (fig. 1), a social humanoid robot, and implemented it to collaborate in a TE programs in order to enhance social interactions, improve knowledge acquisition and adherence to treatment. The specific TE intervention, called Education towards Choice and Awareness, was based on 3rd generation cognitive-behavioral approaches and consisted in eight informative and experimental meetings.
Results
Taking part in the TE-TERESA integrated protocol determined and improvement in psychopathological domains (anxiety, negative mood, quality of life) and a stronger concordance to the therapeutic protocol.
Conclusions
Our research paves the way for the clinical use of Assistive technology (AT), highly promoted by the WHO to help people with numerous disabling clinical conditions improve their quality of life and acquire self-management skills.
This paper presents a soft, tendon-driven, robotic glove designed to augment grasp capability and provide rehabilitation assistance for postspinal cord injury patients. The basis of the design is an underactuation approach utilizing postural synergies of the hand to support a large variety of grasps with a single actuator. The glove is lightweight, easy to don, and generates sufficient hand closing force to assist with activities of daily living. Device efficiency was examined through a characterization of the power transmission elements, and output force production was observed to be linear in both cylindrical and pinch grasp configurations. We further show that, as a result of the synergy-inspired actuation strategy, the glove only slightly alters the distribution of forces across the fingers, compared to a natural, unassisted grasping pattern. Finally, a preliminary case study was conducted using a participant suffering from an incomplete spinal cord injury (C7). It was found that through the use of the glove, the participant was able to achieve a 50% performance improvement (from four to six blocks) in a standard Box and Block test.
Community engagement (CE) is critical for research on the adoption and use of assistive technology (AT) in many populations living in resource-limited environments. Few studies have described the process that was used for engaging communities in AT research, particularly within low-income communities of older Hispanic with disabilities where limited access, culture, and mistrust must be navigated. We aimed to identify effective practices to enhance CE of low-income Hispanic communities in AT research.
Methods:
The community stakeholders included community-based organizations, the community healthcare clinic, the local AT project, and residents of the Caño Martín Peña Community in San Juan, Puerto Rico. The CE procedures and activities during the Planning the Study Phase comprised working group meetings with stakeholders to cocreate the funding proposal for the study and address the reviewers’ critiques. During the Conducting the Study Phase, we convened a Community Advisory Board to assist in the implementation of the study. During the Disseminating the Study Results Phase, we developed and implemented plans to disseminate the research results.
Results:
We identified seven distinct practices to enhance CE in AT research with Hispanic communities: (1) early and continuous input; (2) building trusting and warm relationships through personal connections; (3) establishing and maintaining presence in the community; (4) power sharing; (5) shared language; (6) ongoing mentorship and support to community members; and (7) adapting to the changing needs of the community.
Conclusion:
Greater attention to CE practices may improve the effectiveness and sustainability of AT research with low-income communities.
There are currently limited guidelines on how to design complex assistive technologies (ATs), which necessitates expertise beyond that possessed by designers, occupational therapists (OTs), or end-users. To address this issue, we conducted a series of four participatory workshops to study various configurations of OT-designer-user collaboration in co-designing do-it-yourself (DIY) ATs for an older adult with mobility impairment. We then proposed a specific co-design framework for such OT-designer-user collaboration.
Interdisciplinary research using qualitative methods was employed to investigate the barriers to and facilitators of cultural participation for First Nations Elders who use wheeled mobility and live on reserve in Ontario, Canada. Themes were extracted into three broad categories: (1) impact of Elder participation in cultural activities, (2) usefulness of wheeled mobility devices, and (3) barriers to participating in cultural events. Barriers included lack of transportation, inability to access the outdoors safely and independently, challenging reserve terrain, stigma of being “disabled”, and feeling like a burden. Findings suggest that wheeled mobility can increase the active participation of Elders in cultural events, but demonstrate a need to facilitate the use of wheeled mobility on reserves in Ontario, Canada.
The aim of this study was to explore the experiences of family carers supporting a relative living with dementia during and after the move to technology-enriched supported accommodation (TESA). The paper explores the informal carers (ICs) roles, the factors prompting the move to TESA, alongside their perceptions of their relatives’ experience of the move and of life in a technology-enriched environment. Within a qualitative study 25 semi-structured interviews were conducted with ICs and data were analysed following a thematic approach. Four themes were identified, reflecting the shift in roles and identity of both ICs and persons living with dementia. The move to TESA was linked to a perceived reduction in care-giving pressures, with positive outcomes reported for both the ICs and the people living with dementia. Smart home technologies in the facilities did not appear to impact on the decision-making during transition, however, they were valued as part of the lived experience for the people living with dementia within the TESA facilities. These findings are relevant to policy makers, commissioners and providers of services to highlight the engagement of all stakeholders in the provision of care for people living with dementia and their families early from diagnosis in order to facilitate person-centred practices in community settings.
This paper presents the experiences of formal carers working in technology-enriched supported accommodation for people living with dementia, examining their care-giving role from a person-centred care perspective. Within a qualitative study, 21 semi-structured interviews were conducted with formal carers and data were analysed following a thematic approach. Four main themes were identified that mapped to the attributes of the person-centred practice framework (PCPF): promoting choice and autonomy, staffing model, using assistive technology and feeling that ‘you're doing a good job’. Central to person-centred practice in these settings was the promotion of choice, autonomy and independence. The dichotomy between safety and independence was evident, curtailing the opportunities within the environmental enablers and associated embedded assistive technologies. Formal carers reported considerable job satisfaction working in these settings. The small-scale, home-like facilities seemed to have a positive effect on job satisfaction. These findings are relevant to policy makers, commissioners and service providers, highlighting the facilitators of person-centred care in community dwellings for people living with dementia and the role of formal carers in promoting this approach.
Assistive technologies (ATs) are being ‘mainstreamed’ within dementia care, where they are promoted as enabling people with dementia to age in place alongside delivering greater efficiencies in care. AT provision focuses upon standardised solutions, with little known about how ATs are used by people with dementia and their carers within everyday practice. This paper explores how people with dementia and carers use technologies in order to manage care. Findings are reported from qualitative semi-structured interviews with 13 people with dementia and 26 family carers. Readily available household technologies were used in conjunction with and instead of AT to address diverse needs, replicating AT functions when doing so. Successful technology use was characterised by ‘bricolage’ or the non-conventional use of tools or methods to address local needs. Carers drove AT use by engaging creatively with both assistive and everyday technologies, however, carers were not routinely supported in their creative engagements with technology by statutory health or social care services, making bricolage a potentially frustrating and wasteful process. Bricolage provides a useful framework to understand how technologies are used in the everyday practice of dementia care, and how technology use can be supported within care. Rather than implementing standardised AT solutions, AT services and AT design in future should focus on how technologies can support more personalised, adaptive forms of care.