Family members' reports of the technology use of family members with intellectual and developmental disabilities.

BACKGROUND: A nationwide survey of family members of people with intellectual and developmental disabilities ranging in age from birth through adulthood was conducted to replicate a similar effort by Wehmeyer and update the knowledge base concerning technology use by people with intellectual and developmental disabilities. METHOD: Survey responses provided information about use of technology for mobility, hearing and vision, communication, independent living, and in the area of computer use. In addition, survey items queried the use of electronic and information technology devices such as use of email, mobile telephones and digital cameras. RESULTS: Survey results showed that although the use of computers for individuals with intellectual and developmental disabilities is more prevalent, other technology use frequency is much the same as in the late 1990s. However, technology needs did vary among school-age individuals over time. CONCLUSION: Implications of results for technology use of people with disabilities are discussed through the lens of frequency of use and needs for individuals with disabilities.

Evaluation of cognitively accessible software to increase independent access to cellphone technology for people with intellectual disability.

BACKGROUND: There are over two billion telephones in use worldwide. Yet, for millions of Americans with intellectual disabilities (ID), access to the benefits of cellphone technology is limited because of deficits in literacy, numerical comprehension, the proliferation of features and shrinking size of cellphone hardware and user interfaces. Developments in smart phone technology and PDA-based cellphones provide an opportunity to make the social and safety benefits of cellphones more independently accessible to this population. METHOD: This project involved employment of universal design and other specialised software development methods to create a multimedia cellphone interface prototype which was compared with a typical mainstream cellphone in a usability evaluation for individuals with ID. Participants completed a structured set of incoming/outgoing phone tasks using both the experimental and control conditions. Usability measurements included the amount of assistance needed and errors made in completing the cellphone use sequence. RESULTS: A total of 22 individuals with ID participated in the research by engaging in a series of incoming and outgoing cellphone calls using both the multimedia cellphone prototype system and a mainstream Nokia 6360 cellphone. Test subjects required significantly less help (P = 0.001) and made significantly fewer errors (P < 0.001) when completing eight calls using the specialised multimedia phone system as compared with the mainstream phone. CONCLUSIONS: The statistical evidence of both usability results provide promising evidence of the feasibility of implementing universal design and other specialised software development methodologies for increasing independent access to the benefits of cellphone technologies for students and adults with ID. Issues related to designing cognitively accessible interfaces, study limitations and future directions are discussed.

Treatment of common bile duct stones using mono-octanoin.

A retrospective analysis of 48 patients undergoing mono-octanoin infusion via nasobiliary catheter following failure of endoscopic extraction of common bile duct stones is reported. Among 35 patients who received a complete course of treatment, nine (26 per cent) had duct clearance by the completion of the infusion and a further eight on subsequent endoscopic retrograde cholangiopancreatography (ERCP) (total 49 per cent). Two patients had a successful stone extraction after enlargement of the sphincterotomy (total non-surgical clearance rate 54 per cent). None of five patients with stones greater than 2 cm in diameter had stone clearance at the completion of the infusion and only one at subsequent ERCP. Among 13 patients receiving an incomplete course of treatment seven had clear ducts on repeat ERCP (54 per cent). Mono-octanoin infusion via a nasobiliary catheter is of limited value in the management of this difficult group of patients, although it may be successful in some.

Post-operative fatigue - a real phenomenon attributable to the metabolic effects of surgery on body nutritional stores.

Ambulatory monitoring of activity was undertaken in 97 patients before and at intervals following surgery employing a lightweight recorder and sensors to monitor posture and movement over 24h periods. A subjective assessment of fatigue, anthropometric measurements and clinical details were noted prior to each recording. Results were assessed using multiple regression analysis. Few patients exhibited any subjective feeling of fatigue. However, objective assessment did show a reduction in activity, several of the changes correlating with factors related to surgical stress and post-operative nutritional depletion. Reduction in time standing was related to both weight change at 2 weeks (p < 0.005) and duration of surgery (p < 0.05). Increase in time spent lying correlated with muscle loss at 2 weeks (p < 0.005). Number of steps walked was only influenced by weight change at 2 weeks (p < 0.05). Reduction in post-operative mobility may be related to the metabolic consequences of the surgery and its effects on depletion of nutritional stores. Manipulation of the response and aggressive nutritional support might well reduce post-operative fatigue.