ORCID Profile
0000-0003-4124-3351
Current Organisation
Metro South Health
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Publisher: Informa UK Limited
Date: 18-07-2014
DOI: 10.3109/17483107.2014.941953
Abstract: People with disability have a right to assistive technology devices and services, to support their inclusion and participation in society. User-centred approaches aim to address consumer dissatisfaction and sub-optimal outcomes from assistive technology (AT) provision, but make assumptions of consumer literacy and empowerment. Policy discourses about consumer choice prompt careful reflection, and this paper aims to provide a critical perspective on user involvement in assistive technology provision. User-centred approaches are considered, using literature to critically reflect on what user involvement means in AT provision. Challenges at the level of interactions between practitioners and consumers, and also the level of markets and policies are discussed, using ex les from Australia. There is no unanimous conceptual framework for user-centred practice. Power imbalances and differing perspectives between practitioners and consumers make it difficult for consumers to feel empowered. Online access to information and international suppliers has not surmounted information asymmetries for consumers or lifted the regulation of publicly funded AT devices. Ensuring access and equity in the public provision of AT is challenging in an expanding market with erse stakeholders. Consumers require personalised information and support to facilitate their involvement and choice in AT provision. Implications for Rehabilitation Variations in approaches informing AT provision practices have a profound impact on equity of access and outcomes for consumers. An internationalised and online market for AT devices is increasing the need for effective information provision strategies and services. Power imbalances between practitioners and consumers present barriers to the realisation of user-centred practice.
Publisher: MDPI AG
Date: 24-04-2019
DOI: 10.3390/SOC9020030
Abstract: The United Nations Convention on the Rights of Persons with Disabilities (CRPD) recognizes the role of Assistive Technologies (AT) in enabling independent living and inclusion of people with disabilities. Research into the provision of AT and disability services in general has highlighted the importance of social context and its influence on in idual outcomes. However, there is little recognition of sibling roles, relationships and rights in the guidance available for practitioners. This paper explores the socio-technical context of home modification practice and the importance of involving siblings. The international context and concepts behind AT provision, including home modifications, and issues emerging from practice in Australia’s new National Disability Insurance Scheme (NDIS) are discussed. Based on extensive practical experience and peer review, the “5 S’s for Siblings” is presented as a practice approach for involving siblings in the home modification process. Policy and practice implications are presented, including communication strategies for working in partnership with in iduals and their families, and alignment with national standards and human rights principles. Involving siblings in the home modification process recognizes the important role they play in the lives of people with disabilities, both now and in the future.
Publisher: Informa UK Limited
Date: 06-08-2020
DOI: 10.1080/10400435.2018.1485780
Abstract: Reforms to Australia's disability and rehabilitation sectors have espoused the potential of assistive technology as an enabler. As new insurance systems are being developed it is timely to examine the structure of existing systems. This exploratory study examined the policies guiding assistive technology provision in the motor accident insurance sector of one Australian state. Policy documents were analyzed iteratively with a set of qualitative questions to understand the intent and interpretation of policies guiding assistive technology provision. Content analysis identified relevant sections and meaningful terminology, and context analysis explored the dominant perspectives informing policy. The concepts and language of assistive technology are not part of the policy frameworks guiding rehabilitation practice in Queensland's motor accident insurance sector. The definition of rehabilitation in the legislation is consistent with contemporary international interpretations that focus on optimizing functioning in interaction with the environment. However, the supporting documents are focused on recovery from injuries where decisions are guided by clinical need and affordability. The policies frame rehabilitation in a medical model that separates assistive technology provision from the rehabilitation plan. The legislative framework provides opportunities to develop and improve assistive technology provision as part of an integrated approach to rehabilitation.
Publisher: Informa UK Limited
Date: 09-05-2018
DOI: 10.1080/17483107.2018.1470264
Abstract: This is a position paper describing the elements of an international framework for assistive technology provision that could guide the development of policies, systems and service delivery procedures across the world. It describes general requirements, quality criteria and possible approaches that may help to enhance the accessibility of affordable and high quality assistive technology solutions. The paper is based on the experience of the authors, an analysis of the existing literature and the inputs from many colleagues in the field of assistive technology provision. It includes the results of discussions of an earlier version of the paper during an international conference on the topic in August 2017. The paper ends with the recommendation to develop an international standard for assistive technology provision. Such a standard can have a major impact on the accessibility of AT for people with disabilities. The paper outlines some the key elements to be included in a standard. Implications for Rehabilitation Assistive technology is a key element in rehabilitation, but many people have no access to affordable AT solutions. The recommendations in the paper aim to inform policies, systems and service delivery procedures on how to improve access to AT across the world.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2012
Publisher: Informa UK Limited
Date: 27-06-2020
Publisher: MDPI AG
Date: 08-09-2015
Publisher: Informa UK Limited
Date: 02-03-2016
Publisher: Emerald
Date: 15-06-2015
DOI: 10.1108/JPMH-06-2013-0040
Abstract: – This paper studies the experiences of asylum seekers in Australia. The purpose of this paper is to explore the relationship between mental wellbeing, living conditions, and Australia’s detention policies in light of human rights. – Using grounded theory, data were collected via observations, semi-structured interviews, key-informant interviews, and document analysis. Participants included seven asylum seekers and three professionals working with them. – In light of a human rights framework, this paper reports on the mental distress suffered by asylum seekers in detention, the environments of constraint in which they live, and aspects of detention centre policy that contribute to these environments. The findings highlight a discrepancy between asylum seekers’ experiences under immigration detention policy and Australia’s human rights obligations. – This research indicates human rights violations for asylum seekers in detention in Australia. This research project involved a small number of participants and recommends systemic review of the policy and practices that affect asylum seekers’ mental health including larger numbers of participants. Consideration is made of alternatives to detention as well as improving detention centre conditions. The World Health Organization’s Quality Rights Tool Kit might provide the basis for a framework to review Australia’s immigration detention system with particular focus on the poor mental wellbeing of asylum seekers in detention. – This study links international human rights law and Australian immigration detention policies and practices with daily life experiences of suffering mental distress within environments of constraint and isolation. It identifies asylum seekers as a vulnerable population with respect to human rights and mental wellbeing. Of particular value is the inclusion of asylum seekers themselves in interviews.
Publisher: Hindawi Limited
Date: 2017
DOI: 10.1155/2017/5612843
Abstract: Assistive technology was once a specialised field of practice, involving products designed for populations with specific impairments or functional goals. In Australia, occupational therapists have, at times, functioned as gatekeepers to public funding, prescribing products from a predefined list. An expanding range of accessible mainstream products available via international and online markets has changed the meaning and application of assistive technology for many people with disability. In the policy context of consumer choice and cost-effectiveness, have occupational therapists been left behind? This paper describes the change in context for access to assistive technology resulting in expanded possibilities for participation and inclusion. A case study of environmental control systems is used to explore the overlap of mainstream and assistive products and the funding and services to support their uptake. The analysis describes a future policy and practice context in which assistive technology includes a spectrum of products decoupled from access to independent advice and support services. A broader scope of occupational therapy practice has potential to enhance the occupational rights of people with disability and the efficiency and effectiveness of assistive technology provision.
Publisher: Springer Berlin Heidelberg
Date: 2010
Publisher: MDPI AG
Date: 14-10-2019
DOI: 10.3390/SOC9040069
Abstract: If human rights begin in small places close to home, technologies that enable people with disability to access and control their home environments are an important human rights instrument. Smart homes exemplify recent advances in design, building construction, and integration of technologies within the built environment. They draw on multiple social and technical disciplines that share a broad vision but lack a common language, creating ambiguity and limiting the usefulness of the evidence base in determining optimal ways to integrate technologies and housing design to meet erse needs. The convergence of mainstream and assistive technologies offers the potential of accessible and affordable strategies for inclusion, but also risks further exclusion of marginalized sections of the population. Coordination of efforts might accelerate translation of knowledge and diffusion of innovations into the practices of planning, designing, building, and sustaining housing that promotes independent living. This conceptual paper reviews the theoretical frameworks and terminology from fields of research involved in the design and use of technologies in the home environment to enable people with disability and older people. It considers approaches to design and interventions that could inform policies and practices as well as further research and development activities.
Publisher: Informa UK Limited
Date: 02-09-2019
Publisher: Wiley
Date: 18-04-2016
Abstract: Occupational therapists use a range of strategies to influence the relationship between person, environment and occupation and facilitate people's participation and inclusion in society. Technology is a fundamental environmental factor capable of enabling inclusion, and occupational therapy models articulate a role for assistive technology (AT) devices and services, but there is a gap between theory, research and practice. The context of AT provision in Australia presents systemic barriers that prevent optimal application of AT devices and services for societal health promotion and in in idualised solutions. The Integrating Theory, Evidence and Action method (ITEA) was used to answer the question 'How can occupational therapy support AT provision to enable older people and people with disability?' A wide range of sources were systematically analysed to explore the complexities of AT provision in Australia. The International Classification of Functioning, Disability and Health (ICF) and IMPACT AT provision can be improved by focusing on evidence for and congruence between theory, process and outcomes, rather than isolated interventions. Occupational therapists should consider the influence of contextual factors on practice, and work with consumers to improve access and equity in AT provision systems.
Publisher: MDPI AG
Date: 22-05-2019
DOI: 10.3390/SOC9020039
Abstract: The combination of choice as a contested concept and its increasing adoption as a policy principle necessitates a critical analysis of its interpretation within Australia’s reforms to disability services. While choice may appear to be an abstract and flexible principle in policy, its operationalization in practice tends to come with conditions. This paper investigates the interpretation of choice in the National Disability Insurance Scheme (NDIS), via an interpretive policy analysis of assistive technology (AT) provision. Analysis of policy artefacts reveals a diminishing influence of disability rights in favor of an economic discourse, and contradictory assumptions about choice in the implementation of legislation. The language of choice and empowerment masks the relegation of the presumption of capacity to instead perpetuate professional power in determining access to resources by people with disability.
Publisher: MDPI AG
Date: 25-12-2022
DOI: 10.3390/SOC13010007
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1053/J.GASTRO.2016.04.002
Abstract: Little is known about in utero exposure to and postnatal clearance of anti-tumor necrosis factor (anti-TNF) agents in neonates. We investigated the concentrations of adalimumab and infliximab in umbilical cord blood of newborns and rates of clearance after birth, and how these correlated with drug concentrations in mothers at birth and risk of infection during the first year of life. We performed a prospective study of 80 pregnant women with inflammatory bowel diseases at tertiary hospitals in Denmark, Australia, and New Zealand from March 2012 through November 2014: 36 received adalimumab and 44 received infliximab 39 received concomitant thiopurines during pregnancy. Data were collected from medical records on disease activity and treatment before, during, and after pregnancy. Concentrations of anti-TNF agents were measured in blood s les from women at delivery and in umbilical cords, and in infants for every 3 months until the drug was no longer detected. The time from last exposure to anti-TNF agent during pregnancy correlated inversely with the concentration of the drugs in the umbilical cord (adalimumab: r = -0.64, P = .0003 infliximab: r = -0.77, P < .0001) and in mothers at time of birth (adalimumab, r = -0.80 infliximab, r = -0.80 P < .0001 for both). The median ratio of infant:mother drug concentration at birth was 1.21 for adalimumab (95% confidence interval [CI], 0.94-1.49) and 1.97 for infliximab (95% CI, 1.50-2.43). The mean time to drug clearance in infants was 4.0 months for adalimumab (95% CI, 2.9-5.0) and 7.3 months for infliximab (95% CI, 6.2-8.3 P < .0001). Drugs were not detected in infants after 12 months of age. Bacterial infections developed in 4 infants (5%) and viral infections developed in 16 (20%), all with benign courses. The relative risk for infection was 2.7 in infants whose mothers received the combination of an anti-TNF agent and thiopurine, compared with anti-TNF monotherapy (95% CI, 1.09-6.78 P = .02). In a prospective study of infants born to mothers who received anti-TNF agents during pregnancy, we detected the drugs until 12 months of age. There was an inverse correlation between the time from last exposure during pregnancy and drug concentration in the umbilical cord. Infliximab was cleared more slowly than adalimumab from the infants. The combination of an anti-TNF agent and thiopurine therapy during pregnancy increased the relative risk for infant infections almost 3-fold compared with anti-TNF monotherapy. Live vaccines therefore should be avoided for up to 1 year unless drug clearance is documented, and pregnant women should be educated on the risks of anti-TNF use.
Publisher: Informa UK Limited
Date: 13-06-2016
DOI: 10.1080/17483107.2016.1176260
Abstract: The International Organization for Standardization (ISO) is working on accessibility of products to support people with cognitive impairment. Working Group 10, within the technical committee 173 (assistive products for persons with disability) was formed in 2014 to draft standards for assistive products that support people with cognitive impairment. This article explains the scope and purpose of the working group and the context for its formation, and describes the plans and process for drafting and publishing new international standards. The proposed suite of standards is presented, with ex les from a draft standard on daily time management. It draws on international research evidence for the effectiveness of assistive products designed to support time management in people with cognitive impairment. Ex les of assistive products and their key features are provided based on domains of time as defined in the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). The proposed standards will provide design recommendations for features and functions that increase the accessibility of products used by people with cognitive impairment. They are intended to be used by designers, manufactures, educators and services providers, to facilitate their commitment to inclusion and demonstrate their willingness to work with accessibility regulation. Implications for Rehabilitation New standards based on universal design (UD) principles can guide the design of more user-friendly assistive products for people with cognitive impairment. Greater usability of assistive products, whether mainstream or specially-designed, will make it easier for practitioners to find and introduce assistive solutions to in iduals with cognitive impairment. Greater usability of assistive products for daily time management can decrease the need for user training and support and enable participation.
No related grants have been discovered for Emily Steel.