Prevalence and sociodemographic factors associated with vision difficulties in Ghana, Gambia, and Togo: a multi-country analysis of recent multiple Indicator cluster surveys

Background The sense of sight is one of the important human sensory abilities that is required for independent functioning and survival. The highest burden of sight-related problems is recorded in low-and middle-income countries, especially in sub-Saharan Africa. Despite the burden, nationally representative analyses to understand the prevalence and determinants of vision difficulties are hard to find. Therefore, this study addressed this knowledge gap by estimating the prevalence of vision difficulties and its correlates in gender-stratified models in three West African countries: Ghana, Gambia, and Togo. Methods The study used the most recent Multiple Indicator Cluster Surveys of Ghana (2017–2018), Gambia (2018), and Togo (2017). Summary statistics were used to describe the participants and logistic regression was used to perform the bivariate and multivariate analyses. The analyses were performed using Stata version 14 and the complex survey design of the datasets was accounted for using the ‘svyset’ command. Results Gendered differences were observed for vision difficulties. More women than men reported vision difficulties in Ghana (men: 14.67% vs women: 23.45%) and Togo (men: 14.86% vs women: 23.61%), but more men than women reported vision difficulties in Gambia (men: 11.64% vs women: 9.76%). We also observed gender differences in how age, education, marital status, and region of residence were significantly associated with reported vision difficulties. The direction and magnitude of these relationships were different among men and women across the survey data in Ghana, Gambia, and Togo. Conclusion The findings imply the need to tackle the existing gender inequities that are associated with vision difficulties to promote the quality of life of individuals, especially among older adults.

Effectiveness of IADL interventions to improve functioning in persons with Schizophrenia: A systematic review

Background of the study: Instrumental activities of daily living (IADL) are activities that are needed to live an independent life. Psychotic disorders are associated with deficits in everyday functioning, causing impairment/disability in activities of daily living. Activities play a crucial role to measure functional health or disability. People with Schizophrenia often present difficulties in social and occupational reintegration that may be associated with problems in performing daily activities, including independent living, education, working, and socializing. Activities of daily living and instrumental activities of daily living (life skills training) including leisure and social skills training intended to reintegrate the patient into the community to lead an everyday life. Aim: The aim of this review was to identify the effect of skill-based interventions on independent functioning in persons with Schizophrenia. Methods: The authors conducted database searches of Google Scholar, PubMed, Science Direct, ProQuest, EBSCO from 1st January 1992 to 31st December 2020. The researcher extracted data, and the quality of included studies was rated by two authors independently. We used the Cochrane Risk of Bias (ROB) tool for assessing the quality of selected studies. The search identified nine studies that met the inclusion criteria with 655 participants. The outcome measure was independent functioning skills. Results: The interventions in the review were multifaceted with different combinations of psychoeducation, cognitive-behavioral methods, training in social skills, and IADL. The interventions resulted in significant improvement in functioning skills and reduction in relapse rates. Conclusion: Results of this review have revealed moderate to strong evidence for skills training, either behavioral or social skills to improve social and independent functioning, reduce caregiver burden, and improve negative symptoms. The review also supported that interventions could be generalized across settings.

Subjective Time in Dementia: A Critical Review

The capacity for subjective time in humans encompasses the perception of time’s unfolding from moment to moment, as well as the ability to traverse larger temporal expanses of past- and future-oriented thought via mental time travel. Disruption in time perception can result in maladaptive outcomes—from the innocuous lapse in timing that leads to a burnt piece of toast, to the grievous miscalculation that produces a traffic accident—while disruption to mental time travel can impact core functions from planning appointments to making long-term decisions. Mounting evidence suggests that disturbances to both time perception and mental time travel are prominent in dementia syndromes. Given that such disruptions can have severe consequences for independent functioning in everyday life, here we aim to provide a comprehensive exposition of subjective timing dysfunction in dementia, with a view to informing the management of such disturbances. We consider the neurocognitive mechanisms underpinning changes to both time perception and mental time travel across different dementia disorders. Moreover, we explicate the functional implications of altered subjective timing by reference to two key and representative adaptive capacities: prospective memory and intertemporal decision-making. Overall, our review sheds light on the transdiagnostic implications of subjective timing disturbances in dementia and highlights the high variability in performance across clinical syndromes and functional domains.

Executive Functioning in Adults with Down Syndrome: Machine-Learning-Based Prediction of Inhibitory Capacity

The study of executive function decline in adults with Down syndrome (DS) is important, because it supports independent functioning in real-world settings. Inhibitory control is posited to be essential for self-regulation and adaptation to daily life activities. However, cognitive domains that most predict the capacity for inhibition in adults with DS have not been identified. The aim of this study was to identify cognitive domains that predict the capacity for inhibition, using novel data-driven techniques in a sample of adults with DS (n = 188; 49.47% men; 33.6 ± 8.8 years old), with low and moderate levels of intellectual disability. Neuropsychological tests, including assessment of memory, attention, language, executive functions, and praxis, were submitted to Random Forest, support vector machine, and logistic regression algorithms for the purpose of predicting inhibition capacity, assessed with the Cats-and-Dogs test. Convergent results from the three algorithms show that the best predictors for inhibition capacity were constructive praxis, verbal memory, immediate memory, planning, and written verbal comprehension. These results suggest the minimum set of neuropsychological assessments and potential intervention targets for individuals with DS and ID, which may optimize potential for independent living.

Concurrent Associations between Expressive Language Ability and Independence in Adolescents and Adults with Fragile X Syndrome

Background. Few individuals with fragile X syndrome (FXS) successfully meet adult normative expectations in education, employment, peer relations, and habitation, although there is within-syndrome variability in this regard. The primary goal of this study was to determine whether expressive language skills contribute to the capacity for independent functioning in adulthood even after controlling for nonverbal cognitive ability. Methods. Participants were 18- to 23-year-olds with FXS. Expressive language was assessed using the psychometrically validated Expressive Language Sampling (ELS) conversation and narration procedures. The language produced was transcribed and analyzed to yield measures of expressive vocabulary, syntax, and intelligibility. Parents concurrently completed questionnaires on the independent functioning of the participants with FXS. Results. All three ELS measures were significantly corelated with multiple measures of independence. The magnitudes of the correlations were reduced when nonverbal IQ was controlled through partial correlation. Nonetheless, many of the partial correlations were medium to large and several were statistically significant. Conclusions. Expressive language skills appear to contribute uniquely to the capacity for independence, although longitudinal data are needed to evaluate the possibility of a bidirectional relationship between these domains. Thus, language intervention may be a prerequisite for preparing youth with FXS for an independent adult life.

Design and Implementation of Online Crime Investigation System for Anonymous Person

Crime investigation system keeps track and maintains history about each and every case in the database which ultimately avoids manual and paper work. It is based on decentralized client-server architecture in order to facilitate independent functioning of all units. Here information flows from lower units to higher units and vice-versa. The project is built on multi-tier architecture. It provides quick access to data which is essential for effective prevention, control and detection of crime. It also helps decision-making and decision support processes. Crime investigation system is an intelligent decision support system that can assist human investigators by automatically constructing plausible scenarios. Some of the benefits of crime investigation system to existing system are quick retrieval of data, huge saving of time, proper deployment & utilization of manpower, cost reduction leading to saving in expenditure. It enables the police service to supervise and administer any incident and process related information by providing standardized processes and procedures to monitor and improve performance. Using this application people can give their complaint through online. To register any type of complaint they need to register his personal details along with login details. Once he/she registers in the application he/she can post their complaints.

Experience of midwives in providing care to labouring women in varied healthcare settings: A qualitative study

Background: Midwives are essential to timely, effective, family-centred care. In South Africa, patients have often expressed dissatisfaction with the quality of midwifery care. Negative interpersonal relationships with caregivers, lack of information, neglect and abandonment were consistent complaints. Less is known about how midwives experience providing care.Aim: This research explored and described the experiences of midwives in providing care to labouring women in varied healthcare settings.Setting: Midwives practicing in the Gauteng province, South Africa, in one of three settings: private hospitals, public hospitals or independent maternity hospital.Methods: A convenience sample of midwives (N = 10) were interviewed. An exploratory and descriptive design, with individual semi-structured interviews conducted, asked a primary question: ‘How is it for you to be a midwife in South Africa?’ Transcribed interviews were analysed using thematic coding.Results: Five themes were found: proud to be a midwife, regulations and independent function, resource availability, work burden and image of the midwife.Conclusion: Midwives struggle within systems that fail to allow independent functioning, disallowing a voice in making decisions and creating change. Regardless of practice setting, midwives expressed frustration with policies that prevented utilisation consistent with scope of practice, as well as an inability to practice the midwifery model of care. Those in public settings expressed concern with restricted resource appropriation. Similarly, there is clear need to upscale midwifery education and to establish care competencies to be met in providing clinical services.Contribution: This research provides evidence of the midwifery experience with implications for needed health policy change.

Smartphones for Vision Rehabilitation: Accessible Features and Apps, Opportunity, Challenges, and Usability Evaluation

In today’s world, digital technology and smartphones have become a part of our everyday lives. Smartphones are one of the most advance forms of digital technology that can be viewed as assistive technology for disabled, including for individual with a visual loss. However, they are often not considered as assistive technology for visual impairment and blind, especially in low middle-income countries. There have been a lot of development in the mobile technology that incorporates computer technology, including electronic information, communication technology as well as touch-screen accessibility. Such an advancement in smart technology of mobile devices leads to the transformation of the interface technique from visual smartphones interaction into a truly eyes-free means interaction by using other body senses, such as haptic, gesture, and sound, etc. These innovative accessible features and applications enhance the accessibility of smartphones significantly to individuals with visual impairment. There are many built-in accessible features and third-party accessible applications that enable to access many useful information and contents in the smartphones. Such aesthetic technology facilitates in performing daily activities, independent functioning, movement, social inclusion and participation, educational activities, accessing information of today’s digital society, sighted help, and finally helps to improve the quality of life. Therefore, these smart technologies make smartphones to serve as assistive technology for people with visual impairment and blindness. The smartphones are visually and physically demanding, and are ubiquitous any time and any place, and user can carry it at everywhere. They are universally design, so less social stigma to the users and less discomfort when using it. To view smartphones as assistive technology universally, healthcare providers, caregivers or rehabilitation professionals need to be informed, and make aware of the beneficial aspect of smartphones and its accessibility. Finally, engineers and developers are continuously fostering to develop more innovative and readily accessible apps for visual impairment. Since single app does not fit all purposes for visual impairment and blind, there is a potential need of developing clinical guidelines on the use of such accessible apps or features that will help to recommend appropriately for various types of functions.