Search Results (80)

In the European Union (EU), cultural participation is recognised both as a human right and as a key factor in fostering a shared European identity. To promote access to culture, the EU has launched several initiatives, including the European Heritage Label (EHL), which aims to highlight heritage sites of symbolic significance for Europe. This article discusses how accessibility for persons with disabilities features in the EHL. It does so further by outlining the international obligations undertaken by the EU to promote participation in culture and ensure accessibility, particularly under the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Drawing on a document analysis of key legal and operational EHL texts, the article demonstrates that accessibility is only partially integrated into the initiative and is weakly prioritised in both the site selection and monitoring processes. While self-reporting by the EHL sites on accessibility has improved in recent years, the measures adopted tend to be limited in scope and depth. Overall, the article calls for a stronger and more systematic integration of accessibility requirements within the EHL framework, as well as for the meaningful involvement of organisations of persons with disabilities in assessing and monitoring the accessibility of EHL sites. Full article

Background/Objectives: The design of removable partial dentures (RPDs) influences long-term clinical success and patient satisfaction. Maxillary Kennedy Class I partial edentulism can be treated with clasp-retained (C-RPD), attachment-retained (A-RPD), or implant-retained (I-RPD) removable partial dentures. Evidence on their long-term effects on esthetics, oral health-related quality of life (OHRQoL), and masticatory function is limited. This study compared patient-reported outcomes of these three RPD types over five years. Methods: Eighty-eight patients received C-RPD, semi-precision attachment A-RPD, or mini-implant I-RPD. Outcomes: Esthetic satisfaction (OES), OHRQoL (OHIP-14), and chewing function (CFQ) were assessed pre-treatment, post-treatment, and at 1- and 5-year follow-ups. Treatment effect sizes were analyzed using ANCOVA adjusting for baseline scores, age, gender, and education, while long-term trends were assessed by repeated-measures ANCOVA. Results: Treatment group significantly influenced outcomes. C-RPD users reported lower esthetic satisfaction, OHRQoL, and chewing function than A-RPD or I-RPD users (p < 0.001). Baseline scores predicted post-treatment outcomes (lower pre-treatment = lower post-treatment scores). Over five years, OES worsened in all groups (p = 0.004) with C-RPDs, consistently showing the worst scores. OHIP-14 scores increased most in C-RPD wearers (17.6 → 28.4; p < 0.001) indicting worst OHRQoL, while A-RPD and I-RPD scores remained significantly lower (10.8 → 17.4 and 10.9 → 13.1, respectively). CFQ scores followed similar trend: C-RPD: 20.43; A-RPD: 13.59; I-RPD: 12.40 (p < 0.001). Age, gender, and education had minimal or no significant impact. Conclusions: C-RPDs are associated with lower esthetic satisfaction, poorer OHRQoL and reduced chewing function, with a marked decline over five years. In contrast A-RPDs and I-RPDs showed higher treatment effect sizes and more stable patient-reported outcomes over 5 years. Due to study limitations, results should be interpreted cautiously, as they may reflect treatment self-selection rather than prosthesis design alone. Full article

Digital technologies are revolutionizing health systems worldwide. People with higher digital health literacy are better equipped to access reliable health information, utilize telehealth services, and effectively manage their health through applications. However, a notable digital divide exists for people with intellectual disabilities, and the digitization of healthcare can limit their health opportunities. This scoping review examines the current evidence on digital health literacy among people with intellectual disabilities, emphasizing specific challenges and the need for tailored adaptations. Eleven articles from ten databases were included in the review. Although digital health literacy is becoming increasingly important, it is rarely discussed for people with intellectual disabilities. The term “digital health literacy” is not used, with the exception of one article. However, the focus is mostly on applicability and often at the functional level. The findings underscore that people with intellectual disabilities are underrepresented in research studies and interventions related to digital health literacy. Additionally, the results indicate the lack of a theoretical population-specific framework that focuses on competencies and life experiences. Participation in the digital world is a human right (UN CRPD). Addressing the digital gap is crucial, as improving digital health literacy can lead to better health outcomes, equitable access to health services, and reduced health disparities among people with intellectual disabilities. Based on the results, research directions for developing a population-specific framework for this highly vulnerable group are discussed. Full article

The post-pandemic world has seen a large shift to hybrid working, including for staff at European universities. Under the UN Convention on the Rights of Persons with Disabilities, European Union law, and the related non-discrimination law of the EU Member States, employers are obliged to provide reasonable accommodations to staff members with a disability, including allowing them to work on a hybrid basis and providing additional support to facilitate this where this is needed for a disability-related reason. Hybrid working potentially offers a number of advantages for persons with disabilities, including increased flexibility and autonomy, reduced need for commuting, and generally allowing staff to arrange their work around health-related limitations. Universities now usually have policies on hybrid working. This article considers whether and how hybrid working policies at seven European universities address the specific situation of persons with disabilities. It reveals a diversity of approaches, including policies in which staff with disabilities are ‘invisible’ and policies that pay significant attention to ensuring that staff with disabilities are able to benefit from hybrid working and are provided with suitable accommodations. It argues that university hybrid working policies should address the situation of staff with disabilities and make explicit links with the duty to provide reasonable accommodation. Full article

This article examines the accessibility of public space for individuals with disabilities in the Netherlands, as well as the relevant legal frameworks intended to promote accessibility. It discusses the Convention on the Rights of Persons with Disabilities (UN CRPD) and efforts to implement its provisions at the local level. The article first provides an overview of Dutch legislation and regulations concerning accessibility in public spaces. It then presents an analysis of the experiences of individuals with disabilities in navigating streets and pavements in two Dutch cities, Utrecht and Almere. The central question is to what extent equal participation in public space has been realised. The findings indicate that national legislation remains inadequate in addressing the accessibility of streets and pavements. Despite the constitutional amendment in January 2023, which prohibits discrimination on the grounds of disability, substantive equality is largely dependent on the individual policies and bylaws of the 342 municipalities. The involvement of individuals with disabilities in shaping the inclusive use of public space is therefore crucial at the local level. This article highlights local initiatives that have successfully drawn the attention of municipal policymakers and civil servants to the importance of accessible streets. Full article

Background: Reduced-port totally robotic pancreaticoduodenectomy (rpRPD) has been introduced to address limitations of conventional robotic pancreaticoduodenectomy (cRPD), particularly regarding assistant mobility and visualization. This study aimed to evaluate the clinical feasibility and procedural consistency of rpRPD in comparison with cRPD and laparoscopic pancreaticoduodenectomy (LPD). Methods: We conducted a retrospective cohort study of patients who underwent pancreaticoduodenectomy between January 2015 and December 2024. Patients were categorized into rpRPD (n = 40), cRPD (n = 60), and LPD (n = 262) groups. Clinical outcomes and learning curves were compared using regression and cumulative sum (CUSUM) analysis. Results: Baseline characteristics were similar across groups. The rpRPD group demonstrated significantly shorter operative time (p < 0.001) and lower blood loss (p < 0.05) than cRPD, with no significant differences in postoperative complications or hospital stay. The learning curve analysis revealed that rpRPD had lower variance (5839.3 vs. 8919.1) and more stable performance than cRPD despite a slightly longer stabilization point. Lymph node retrieval was comparable across groups, supporting oncological equivalence. Conclusions: rpRPD offers comparable perioperative and oncologic outcomes to cRPD and LPD while improving operative efficiency and procedural predictability. It represents a technically feasible and safe option for minimally invasive pancreatic surgery. Full article

In the current clinical psychiatric practice in most of the world, treatment decisions are based on a person’s capacity to make these decisions. When a person lacks the capacity to understand and appreciate treatment decisions, in many jurisdictions a third-party substitute decision maker (SDM) is appointed on his or her behalf in order to promote safety and optimal clinical outcome. In Ontario, Canada, for example, family members (typically) or public guardians are appointed as SDMs, and they form an integral part of the medical–legal system in psychiatric care. Clinicians working with both patients and their SDMs in these circumstances encounter unique challenges and deliver care in specialized ways, though little research has focused on their experiences and reflections. Based on focus group data, this qualitative study uses a descriptive and interpretative phenomenological approach through thematic analysis to examine these aspects from clinicians working in both inpatient and outpatient settings of an urban teaching hospital’s psychiatric services in Toronto, Canada. Seven key themes emerged: Clinicians (1) appreciate hardships and challenges in lives of SDMs and patients—including the challenging emotions and experiences on both sides, and the risks and relational changes from being an SDM; (2) have an understanding of the patient’s situation and respect for patient autonomy and wishes—they are promoter of autonomy and mindful of patients’ prior wishes amidst patients’ fluctuating capacity, facilitating communication, keeping patients informed and promoting transitioning from SDM to self-determination; (3) have a special working relationship with family SDMs—including supporting SDMs, avoiding harm from delayed or denied treatment, and educating and collaborating with SDMs while maintaining professional boundaries; (4) at times find it difficult working with SDMs—stemming from working with over-involved or uninterested family SDMs, coping with perceived poor SDM decisions, and they sometimes ponder if SDMs are necessary; (5) delineate differences between family and Public Guardian and Trustee (PGT) SDMs—they see PGT as closely aligned with medical decision makers, while family SDMs are more intimately involved and more likely to disagree with a physician’s recommendation; (6) recognize the importance of the SDM role in various contexts—through seeing social values in having SDMs, and acknowledging that having SDMS help them to feel better about their actions as they work to protect the patients; and (7) express ideas on how to improve the current system—at public, societal, and family SDM levels. We conclude that clinicians have unique mediating roles, with privilege and responsibility in understanding the different roles and challenges patients and SDMs face, and have opportunities to improve patient and SDM experiences, clinical outcomes, carry out education, and advocate for ethically just decisions. These clinical roles also come with frustration, discomfort, moral distress and at times vicarious trauma. Clinicians’ unique understanding of this complex and nuanced intersection of patient care provides insight into the core issues of autonomy, duty to care and protect, advocacy, and emotional dynamics involved in this sector as a larger philosophical and social movement to abolish SDMs, as advocated by the Convention on the Rights of Persons with Disability (CRPD), is taking place. We briefly discuss the role of supported decision making as an alternative as. Full article

Objectives: This study evaluated the dental and alveolar bone stress distribution of a mandibular Kennedy Class I restored with a bilateral implant-assisted removable partial denture (IARPD) compared with a conventional removable partial denture (CRPD) through the application of finite element analysis (FEA). Methods: Kennedy Class I plaster models were made, including teeth from the lower left first premolar and lower right canine. The models were scanned, resin-based replicated and digitized. Using Solidworks software, internal hexagonal implants (10 mm × 4 mm) were virtually placed at the level of the first molars. Each model was grouped into a unit, and a load of 200 N was applied, simulating masticatory forces. Von Mises stress distributions were calculated via FEA for the vertical, diagonal and combined forces. Results: In the IARPD, the stress generated in the alveolar bone by the vertical (4.2 Mpa), diagonal (12.2 MPa) and combined forces (12.3 MPa) was lower than that of the CRPD (7 MPa, 26.3 MPa and 32 MPa, respectively). Similarly, at the lower central incisor, the IARPD generated less stress than the CRPD due to the action of the vertical, diagonal and combined forces. Conclusions: Our preliminary data suggest that bilateral implant placement may result in less stress on bone and teeth during rehabilitation with a Kennedy Class I IARPD, with different orientations of the forces applied. Full article

Although Zimbabwe has made significant progress regarding the development of a policy framework that caters to the needs of people with disabilities through various pieces of legislation, such as the Disabled Peoples Act (DPA), ratifying the Convention on the Rights of Persons with Disabilities (CRPD) and adopting a new Constitution which has provisions for disability rights, people with disabilities in Zimbabwe are yet to benefit from these policies, as they are not fully implemented. Focus group discussions and semi-structured interviews were conducted with 20 youth aged between 18 and 35 with disabilities, and 5 key informants in Gweru, to analyze their perceptions regarding the disability policy framework in Zimbabwe. Most of the youth with disabilities lacked knowledge on the various policies regarding disabilities. This was attributed to poor implementation of such policies and a general negative attitude of society towards disability rights. Youth with disabilities are not fully benefiting from the current disability policies due to a lack of knowledge and some implementation gaps. The participants suggested full implementation of such policies and involvement of youth with disabilities in policy formulation and implementation. Full article

This contribution examines the human rights framework and legislative developments in South Africa on persons with mental illness, revealing that the initial focus of the legislation was on control and detention at the cost of the rights of mental health care users. Presently, under its Constitutional democracy, South Africa has progressive Mental Health Legislation focusing on the rights of mental health care users and the least restrictive means of treatment. The contribution considers the impact of the legislative developments on the human rights of mental health care users. There are, however, challenges with the implementation of the legislation most notably illustrated by the Life Esidimeni disaster where a mass deinstitutionalization project led to the loss of life. South Africa’s revised Mental Health Policy Framework holds a renewed commitment to respect a mental health care user’s right to dignity, integrity, privacy, and freedom of movement. This is one step closer to the realisation of the obligations created by the United Nations Convention on the Rights of Persons with Disabilities (CRPD). The contribution considers the 2018 concluding observations by the United Nations Committee on the Rights of Persons with Disabilities, which lays bare areas where yet further improvement is needed in South Africa to eradicate all forms of discrimination against persons with disabilities and, in particular, persons with mental illness Areas where progress have been made are highlighted. South Africa has made steady progress but needs to intensify its efforts to domesticize the CRPD. Full article

The emergence of Artificial Intelligence (AI) and Virtual Reality (VR) technologies offers transformative potential for the advancement of inclusive education, particularly for students with disabilities. This systematic review critically evaluates the current state of research to assess the impact of AI and VR on enhancing educational accessibility, personalisation and social inclusion in education. AI-driven adaptive systems can dynamically tailor learning experiences to individual needs, while VR offers immersive, multi-sensory environments that promote experiential learning. Despite these advances, the review also identifies significant challenges, including the high cost of implementation, technical barriers and limited teacher readiness, which hinder widespread adoption. Ethical concerns such as privacy and algorithmic bias are cited as key areas that need careful consideration. The findings underscore the urgent need for further empirical research to explore the long-term impact of these technologies and advocate for more equitable access to AI and VR tools in underserved educational settings. Ultimately, the review highlights the importance of integrating AI and VR as part of a broader strategy to foster genuinely inclusive learning environments that align with the goals of the Convention on the Rights of Persons with Disabilities (CRPD). Full article

This study focused on searching for more effective nanomaterials for environmental remediation and health protection; thus, coliform bacteria, yeast and the organic food dye sunset yellow were selected as target pollutants to be eliminated under solar light by Ag/Cr-TiO₂ and Pd/Cr-TiO₂. Firstly, Cr³⁺ was in situ incorporated into the anatase crystalline lattice by the sol-gel method; then, Ag or Pd nanoparticles were deposited on Cr-TiO₂ by chemical photoreduction. The scientific challenge addressed by the development of these composites was to analyse the recovery of Cr, to be employed in photocatalyst formulation and the enhancement of the TiO₂ photocatalytic activity by addition of other noble metals. By extensive characterization, it was found that after TiO₂ doping with chromium, the parameters of the crystal lattice slightly increased, due to the incorporation of Cr ions into the lattice. The TiO₂ band gap decreased after Cr addition, but an increase in the optical absorptions towards the visible region after noble metals deposition was also observed, which was dependent of the Ag or Pd loading. Generally, it was observed that the noble metals type is a factor that strongly influenced the effectiveness of the photocatalysts concerning each substrate studied. Thus, by using Ag(0.1%)/Cr-TiO₂, the complete elimination of E. coli from samples of water coming from a highly polluted river was achieved. Pd(0.5%)/Cr-TiO₂ showed the highest efficiency in the elimination of S. cerevisiae from a lab prepared strain. On the other hand, the Pd(0.1%)/Cr-TiO₂ sample shows the highest dye degradation rate, achieving 92% of TOC removal after 180 min. Full article

Health equity is an important aspect of wellbeing and is impacted by many social determinants. The UN Convention on the Rights of Persons with Disabilities (CRPD) is a testament to the lack of health equity and the many health inequity issues based on social determinants experienced by disabled people. The health equity/health inequity situation of disabled people is even worse if their identities intersect with those of other marginalized groups. Many societal developments and discussions including discussions around the different sustainability pillars can influence the health equity/health inequity of disabled people. The general aim of this study was to better understand the academic engagement with the health equity and health inequity of disabled people beyond access to healthcare. To fulfill our aim, we performed a scoping review of academic abstracts using a hit count manifest coding and content analysis approach to abstracts obtained from SCOPUS, the 70 databases of EBSCO-HOST, Web of Science, and PubMed. Health equity and health inequity abstracts rarely cover disabled people as a group, less with many specific groups of disabled people, and even less or not at all with the intersectionality of disabled people belonging to other marginalized groups. Many social determinants that can influence the health equity and health inequity of disabled people were not present. Ability-based concepts beyond the term ableism, intersectionality-based concepts, and non-health based occupational concepts were not present in the abstracts. Our qualitative content analysis of the 162 abstracts containing health equity and disability terms and 177 containing health inequity and disability terms found 65 relevant abstracts that covered problems with health equity disabled people face, 17 abstracts covered factors of health inequity, and 21 abstracts covered actions needed to deal with health inequity. Our findings suggest a need as well as many opportunities for academic fields and academic, policy, and community discussions to close the gaps in the coverage of health equity and health inequity of disabled people. Full article

This article documents and explores the history of the e-scooter ban in Toronto, Ontario, Canada as a pathway to examining broader issues concerning the eradication of accessibility barriers in public spaces for pedestrians with disabilities and respectful uses of consultation to develop disability-inclusive regulations. The use of e-scooters poses a particular dilemma to accessibility for persons with disabilities. On the one hand, the concept of disability contemplates attitudinal and environmental barriers, as noted, for example, in the Preamble of the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD). Attitudinal and environmental barriers have traditionally stemmed from interests that are inherently opposed to the collective interests of disabled persons. Examples include attitudes that project stigma against persons with disabilities or a focus on seeking to preserve historical features of the built environment for their aesthetics, without consideration for their accessibility or functionality for disabled persons. They have also generally originated in periods of historical marginalization or exclusion of persons with disabilities. By contrast, e-scooter debates and connected debates regarding the regulation of micromobility vehicles, contain at least one dimension that could very well be shared with persons with disabilities—that is, the preservation of the environment. E-scooters are also a phenomenon of contemporary disability exclusion: policies concerning environmental sustainability, including those promoting e-scooters, are being developed contemporaneously with growing international and national legal recognition of disability rights. These factors render arguments over appropriate regulation of the use of public spaces more complex as, within those arguments, one sees two competing positive policy directions that need to be addressed: the rights of pedestrians with disabilities and environmental sustainability. This article concludes with theoretical and practical suggestions for strengthening regulatory policymaking to address these and other complex intersectional issues of accessibility policy design. Full article

As educational systems are confronted with attacks under the guise of “Critical Race Theory” bans, teacher educators of Color navigate the contradictions of preparing teacher candidates to be culturally sustaining within a suppression of racial discourses. For many teacher educators of Color, who are often tasked to carry out the social and racial justice work of teacher education programs, they are experiencing an exacerbated racial harm. In this article, we explore how a racial-affinity critical race professional development (CRPD) space for teacher educators of Color committed to racial justice serves as a space of support, healing, and regeneration amidst systemic racism and protections to white comfort in teacher education. Weaving together three counterstories from participants in the CRPD, we examine how this space supports teacher educators in recentering communities of Color knowledge systems and ways of being to sustain themselves and reclaim teacher education. These counterstories also offer implications for teacher education to address the ways in which it supports and maintains white comfort and the need for a restorative framework for addressing past and ongoing racial harm. Full article