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Background: Advances in health equity rely on representation of diverse groups in population health research samples. Despite progress in the diversification of research samples, continued expansion to include systematically excluded groups is needed to address health inequities. One such group that is infrequently represented in population health research are adults with intellectual disability. Individuals with intellectual disability experience pervasive health disparities. Representation in population health research is crucial to determine the root causes of inequity, understand the health of diverse populations, and address health disparities. The purpose of this paper was to develop recommendations for researchers to increase the accessibility of university health research and to support the inclusion of adults with intellectual disability as participants in health research. Methods: A comprehensive literature review, consultation with the university ethics review board, and review of United States federal regulations was completed to identify barriers to research participation for individuals with intellectual disability. A collaborative stakeholder working group developed recommendations and products to increase the accessibility of university research for participants with intellectual disability. Results: Eleven key barriers to research participation were identified including gaps in researchers' knowledge, lack of trust, accessibility and communication challenges, and systematic exclusion among others. Together the stakeholder working group compiled seven general recommendations for university health researchers to guide inclusion efforts. Recommendations included: 1) address the knowledge gap, 2) build community partnerships, 3) use plain language, 4) simplify consent and assent processes, 5) establish research capacity to consent, 6) offer universal supports and accommodations, and 7) practice accessible dissemination. In addition, four products were created as part of the stakeholder working group to be shared with researchers to support the inclusion of participants with intellectual disability. 1) Supports I Need Checklist, 2) Plain language glossary of health and research terms, 3) Understanding Consent and Assent in Plain Language, 4) Easy-Read Paper Template. Conclusion: Community members and individuals with intellectual disability want to be included in research and are eager to engage as research participants. It is the responsibility of the researcher to open the door to university health research. The recommendations discussed in this paper could increase accessibility for a broader range of research participants and, in particular, promote the inclusion of individuals with intellectual disability to advance health equity in population health research. [ABSTRACT FROM AUTHOR]

Information in museums is predominantly presented visually, behind glass, or roped off, excluding visitors who are blind or low vision (BLV) and learn best through touch. Some museums create touch objects to interpret artifacts for tactile learners and they are critical to accessible interpretation. We interview fifteen museum access specialists from diverse institutions across the United States to understand their current practices and evaluate their responses with six BLV accessibility experts. We define a taxonomy that describes the range of touch objects currently offered by museums. We report that the majority of museums were producing low-fidelity touch objects and that all six BLV accessibility experts preferred high-fidelity touch objects. Based on our findings, we recommend designing high-fidelity touch objects, leveraging digital fabrication, and developing touch object design guidelines for future interpretations. These recommendations support accessible interpretation in museums and can be adopted in other learning environments. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Planning Education & Research is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper examines the relevance of the Technology Acceptance Model for e-Government websites at federal government level in the United States through an exploratory research study. Various unfunded government mandates over the past several years have required agencies to create websites, put services on the sites, and make them accessible to citizens, and the federal e-Government now includes tens of thousands of sites. Section 508 of the Rehabilitation Act, for example, was passed to ensure e-Government sites would be accessible to persons with disabilities. By studying the implementation of the requirements of Section 508 through a number of data collection techniques and in terms of the Technology Acceptance Model, this paper seeks to use this particular law as an example through which to better understand the processes by which government agencies adopt e-Government requirements and the actions that government managers can take to improve the implementation of such adoption. [ABSTRACT FROM AUTHOR]

Despite decades of discussion, debate, and incremental gains, acceptance of popular music education in collegiate institutions is still in its inception. Higher education (and indeed, education in general) in the United States is rife with pervasive inequality and injustice, excluding large numbers of potential students on the basis of race, class, income, and cultural orientation. If music education is to continue and thrive in the 21st century and beyond, widespread curricular changes are needed in preservice music teacher education to move toward a model that is inclusive, equitable, diverse, and culturally responsive. The purpose of this paper is to illuminate several music programs across the United States as samples of the numerous collegiate institutions wrestling with curricular change. Though differing in size, scope, and population, these programs have one thing in common: faculty with a desire to enact change. Through the examples illustrated here, it is our hope that others wishing to initiate change may have some possible paths from which to choose on their journey toward making music education more accessible for all. [ABSTRACT FROM AUTHOR]

Modem urban transportation systems continuously challenge, and are challenged by, the changing nature of 21st-century travel demand. Today, congestion is the norm in cities of the United States, and researchers and practitioners are seeking solutions to these problems. Urban commuting is identified as contributing to the suboptimal performance of transportation systems. This paper offers a review and critique of recent research on urban commuting, emphasizing geographical dimensions of this topic. Three broad areas of research related to urban commuting are discussed. These include (1) urban sustainability, (2) land use, and (3) geographic information systems (GIS). Major themes are examined in an effort to elicit thought on future geographic research. At the conclusion of the paper, summary remarks are provided and avenues for research are outlined. [ABSTRACT FROM AUTHOR]

Universal design (UD) educational frameworks provide useful guidelines for designing accessible learning environments with the intention of supporting students with and without disabilities. This article describes how one university instructor defined and applied the principles of Universal Instructional Design (UID) to pedagogy, while designing three online courses. The paper presents the course design process, detailing how UD principles can be operationalised to increase ‘cognitive access’ through a variety of pedagogical practices. The paper illustrates ways in which instructors can consider UID during the five phases of instructional design (analysis, design, development, implementation and evaluation). The courses highlighted in this study incorporated varied assignment formats, flexible options, a highly structured format and regular interactions with peers and instructors. Results of the study show that students valued the organisation, instructor interaction and flexible options provided. Implications for practice are presented for instructors seeking to design inclusive course environments. [ABSTRACT FROM PUBLISHER]

Based on China’s latest national railway network planning proposal, the connectivity and accessibility indices of China’s high-speed railway network (CHSRN) in different time periods are computed to evaluate the implications of high-speed rail (HSR) for Chinese cities. An overall index for measuring the connectivity-accessibility of cities on the HSR network is proposed based on three indicators: (a) the Beta index, to reflect the connectivity of the HSR, (b) the number of reachable counties by HSR within the 500-km domain of a city, to reflect the location-based accessibility of the HSR, and (c) the population of the reachable places by HSR within the 500-km domain of a city, to reflect the potential-based accessibility of the HSR. Finally, the differences in the normalized connectivity-accessibility levels of different categories of cities are qualified to measure the impact of China’s future national HSR network on the potential development of cities. It is found that “Mid-to-Long-Term Railway Network Plan (Revised in 2016)”, if fully realized, would profoundly change the HSR connectivity/accessibility of different cities. Most notably, cities in the Yangtze River Delta would suffer the most whereas cities of the central and western regions would gain the most. This could potentially contribute to, or bring about new changes in, the socioeconomic landscapes in China. The methodological contribution of this paper is twofold. Firstly, an overall index to evaluate the comprehensive connectivity and accessibility levels of the HSR network is designed. Secondly, this paper investigates how to qualify the impact of the future HSR network on different tiers of cities in different time periods according to the change of the overall connectivity/accessibility index. [ABSTRACT FROM AUTHOR]

Even though mobility is a requirement for participation in “modern life”, the truth is that mobility is unevenly distributed and it constitutes a field of contestation and dispute among social classes. Mobility does not derive from individual decisions or free choices. On the contrary, it is the result of the interaction between individual attributes and social structure. To grasp this interaction, it is necessary to go well beyond observed mobility. This paper explores the unequal access to urban opportunities among different social classes in Montevideo. It does so by computing potential public transport accessibility to two types of crucial opportunities: jobs and education. The paper findings show an unequal distribution of potential mobility, especially for jobs and upper level public education. Primary public schools are an exception, revealing the spatial footprint of the mature Uruguayan social protection network at this level. This paper's approach allows to identify and describe various fields of contestation such as urban form, transit network, the state provision of public goods (in the case of education), through examining the effects of uneven mobility on social goods access and, as a result, on social equity. [ABSTRACT FROM AUTHOR]

Active transportation modes are increasingly being acknowledged for their individual and societal benefits. As a result, funding for pedestrian and bicycle infrastructure in the United States has increased substantially in recent years. However, pedestrian and bicycle equity impacts often go overlooked, which has resulted in an inequitable distribution of active transportation costs and benefits. The paper contributes to this small but growing field by developing an enhanced understanding of active transportation equity, identifying limitations in research and in practice, and providing a set of recommendations for planners and researchers. These recommendations include considering other transportation-disadvantaged groups beyond low-income and minority populations in equity analysis, adopting new performance measures, increasing inter-agency coordination, the need for stronger guidance from the federal government, and more representation from transportation-disadvantaged groups in the public participation and decision-making process. If the costs and benefits of active transportation are to be fairly shared among all users, equity will need to be meaningfully addressed in the planning process. [ABSTRACT FROM PUBLISHER]

The structure of transportation networks and the patterns of accessibility they give rise to are an important determinant of land prices, and hence urban spatial structure. While there is ample evidence on the cross-sectional relationship between location and land value (usually measured from the value of improved property), there is much less evidence available on the changes in this relationship over time, especially where location is represented using a disaggregate measure of urban accessibility. This paper provides evidence of this dynamic relationship using data on home sales in the Minneapolis-St Paul, MN, USA metropolitan area, coupled with disaggregate measures of urban accessibility for multiple modes, for the period from 2000 to 2005. Our investigation tracks the effects of marginal changes in accessibility over time, as opposed to static, cross-sectional relationships, by using an approach in which the unit of observation is a ‘representative house’ for each transportation analysis zone in the region. This approach allows us to control for changes in structural attributes of houses over time, while also isolating the effect of changes in accessibility levels. Results of this approach are compared with a cross-sectional model using the same variables for a single year to illustrate important differences. Empirical estimates indicate that while most of the models estimated using a cross-sectional specification yield positive and significant effects of accessibility on sale prices, these effects disappear when the models are transformed into first-difference form. We explain these findings in light of the state of maturity of urban transportation networks. [ABSTRACT FROM AUTHOR]

Columns are usually the weak links in conventional bridges with regard to seismic design. Damage of reinforced concrete (RC) columns caused by moderate earthquakes is usually repairable, but significant damage is expected in the event of strong ground shaking. Advanced materials and/or innovative detailing have been developed for RC bridge columns to minimize damage while meeting or exceeding the ductility requirements per current codes. Rocking columns with either internal or external energy dissipators, commonly referred to as hybrid rocking columns, are novel columns with an improved seismic performance. Despite decades of research on rocking columns and promising laboratory findings, they have never been used in any bridge in the United States because of concerns regarding the accessibility and durability of internal tendons, and the lack of system redundancy when tendons are lost. The present study proposes a new class of rocking bridge columns that do not need internal pre- or post-tensioning tendons (or bars). Instead, tendons are placed outside of the column to be fully accessible and replaceable. One half-scale precast bridge column cast with ultrahigh performance concrete (UHPC) was tested twice under the same loading protocol. All external tendons were replaced in the second round of testing to validate repair by the fuse replacement technique. The damage of the precast UHPC column was insignificant throughout testing and retesting. Furthermore, the precast column showed the same displacement capacity, a slightly lower lateral strength, and insignificant residual displacements compared with those of a reference cast-in-place column (CIP). One drawback of the precast column was a lower effective stiffness compared with that of CIP column. A parametric pushover study was performed to investigate the seismic performance of the proposed columns with different fuse materials and lengths and to determine the best fuse configurations for a successful design. Finally, design guidelines were recommended to facilitate future investigations. [ABSTRACT FROM AUTHOR]

In 1939, the Futurama exhibit at the New York World's Fair amazed visitors with its diorama showing futuristic freeways crossing the countryside and reshaping cities. After the fair, the exhibit's designer, Norman Bel Geddes, elaborated the model into a proposal for a national freeway network. This paper examines the network structure and geographic dimensions of Bel Geddes's vision and compares it to the Interstate Highway System, created several years later. Despite the futuristic trappings inherited from the Futurama model, the two networks are surprisingly similar except in their relation to cities, which Bel Geddes's network avoids. The majority of elements in Bel Geddes's system have been incorporated into actual routes and networks, and it can be expected that his system would have gone through many of the same adaptations to changing economic, environmental, and political circumstances as the Interstate Highway System. [ABSTRACT FROM AUTHOR]

Mobility management aims at the provision of accessible, multimodal, and affordable transportation services to all individuals in a community, including the elderly, disabled and lower income individuals. It has much potential to deliver public transit services in a cost efficient way and uses a customer driven and market based approach to make it more responsive to the needs of individuals in a community. In mobility management, there is much emphasis on coordination and collaboration, which makes mobility management an attractive option for many communities, especially in an era of limited funding and shortage of resources. To explore the feasibility of its practice in this country, this paper has tried to disseminate valuable information on regulations and statutes that help to establish the legal foundation for mobility management and also support services that are available from advocacy agencies and interest groups to develop, manage, and sustain such programs. [ABSTRACT FROM PUBLISHER]

Bikeshare programs are increasingly popular in the United States and they offer an important alternative mode choice for many types of last-mile trips. Bikeshare systems have not captured high levels of ridership from disadvantaged populations, but there is some evidence that current bikeshare systems have specifically targeted certain populations to ensure sufficiently high demand for profitability. Far less attention has been paid to bikeshare programs' potential to provide greater access to jobs and essential services for disadvantaged communities. This paper uses two case study cities (Chicago and Philadelphia) to first, examine whether bikeshare systems have targeted specific populations, and to second, quantitatively assess the potential for bikeshare systems to provide greater accessibility for disadvantaged communities. Our results demonstrate that a well-designed bikeshare system can generate greater accessibility improvements for disadvantaged communities than the same system would produce for other populations. Using a newly developed spatial index that combines the potential for increased access to jobs and essential services, the level of bike infrastructure, and the disadvantaged population shares, we also find evidence that existing bikeshare systems have been specifically designed to target certain ridership. We find that locating stations in proximity to disadvantaged communities has the potential to increase household access (by bike and by bike-to-transit) to jobs and essential services and can close accessibility gaps between mobility constrained populations and critical services. The spatial index can be applied to identify potential locations to locate bikeshare stations (dock-based bikeshare systems) or rebalance bikes (dockless bikeshare systems) to address bikeshare equity issues. [ABSTRACT FROM AUTHOR]

This paper investigates the spatial accessibility of African Americans to golf as an example of continued social injustice. Because of its developmental diversity, demographic diversity, and rich golf history, North Carolina is chosen to examine the relationship between the spatial distributions of golf courses and African Americans. Most previous analyses of golf and ethnicity have focused on other dimensions of inaccessibility and have ignored the spatial dimension. Despite the impression that is left by Tiger Woods' success and notoriety, African Americans remain disproportionately inaccessible to golf An index of net accessibility, controlling for market size, indicates that census tracts with high percentages of African-American population also are unexpectedly underserved with golf The correlation between net access and percent black is -.56. Inaccessibility is illustrated in rural, metropolitan, elite golf resort, and coastal geographic settings. This case study illustrates the outcomes of profound power relations and tensions that are played out on carefully crafted islands of privilege that signify humanity's power over nature and its willingness to exclude portions of itself from the fruits of that power. [ABSTRACT FROM AUTHOR]

Copyright of Regional Studies is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Multi-base arithmetic blocks (MAB) are the most frequently used physical materials for teaching about decimal numbers, despite published reservations about their appropriateness. This paper presents an alternative, LAB (linear arithmetic blocks) and compares the two materials on the basis of epistemic fidelity and accessibility for students. Two teaching experiments involving 30 matched students indicated that LAB is considerably more accessible for students, and identify three contributing factors (LAB modeling number with length rather than volume, MAB incorporating an apparent dimensional shift and having prior use). Use of LAB was associated with more active engagement by students and deeper discussion. Epistemic fidelity is critical to facilitate teaching with the models, but we attribute the enhanced classroom environment to the greater accessibility of the LAB material. Further research is warranted, so that teaching of mathematics with physical materials can be improved. [ABSTRACT FROM AUTHOR]

This study sought to assess how accessible public library websites are to patrons with disabilities, understand the types of accessibility errors that library websites have, and investigate the relationship between library website accessibility and community demographics libraries serve. A total of 120 public library website URLs were evaluated on four different types of pages using Deque's Axe evaluation tool for testing WCAG 2.1 compliance. Results showed that public library websites overwhelmingly failed to meet the accessibility standards required by law in Sect. 508 of the Rehabilitation Act. Color contrast errors were the most common type of error found for each type of page. It was found that there were no significant relationships between community demographics libraries serve and accessibility errors. This study provides up-to-date information on public library website accessibility and looks further than previous studies into how accessibility errors can differ across page types as well as how accessibility may relate to community demographics. [ABSTRACT FROM AUTHOR]

This paper addresses the links between real estate production, transport infrastructure and class-related spatial tensions in the context of urban neoliberalism in Chile. As case studies we focus on two of the most intensely redeveloping areas in Santiago, the Estación Central municipality in inner Santiago which experiences rapid high-rise property-led redevelopment, and the peri-urban growth zone of Chicureo in the municipality of Colina. From the perspective of urban political economy and using mobility-related questionnaires, in-depth interviews with inhabitants and media analysis we detect important differences between inner-city and peri-urban dynamics. While the redeveloping inner area of Santiago, in spite of being an exclusionary space where lower income-oriented affordable housing is absent, is not a disputed space in terms of access to mobility means, the expanding fringes of the city show strong class-related differences among new and old inhabitants. It seems that with view to mobility opportunities urban neoliberalism has variegated geographies that at the same time might show temporarily positive (Estación Central) and very negative results (Chicureo). In terms of public policy these results indicate that the inner area of Santiago is an opportunity for locating social housing production, given the relatively equal access to mobility opportunity for the different income groups. In the meanwhile, the deepening of mobility-related inequalities on the urban peripheries is highly problematic and needs more scholarly and political attention. [ABSTRACT FROM AUTHOR]

In many large Latin American urban areas such as the São Paulo Metropolitan Region (SPMR), growing social and economic inequalities are embedded through high spatial inequality in the provision of state schools and affordable public transport to these schools. This paper sheds light on the transport-education inequality nexus with reference to school accessibility by public transport in the SPMR. To assess school accessibility, we develop an accessibility index which combines information on the spatial distribution of adolescents, the location of existing schools, and the public transport provision serving the school catchment area into a single measure. The index is used to measure school accessibility locally across 633 areas within the SPMR. We use the index to simulate the impact of a policy aiming at increasing the centralisation of public secondary education provision, and find that it negatively affects public transport accessibility for students with the lowest levels of accessibility. These results illustrate how existing inequalities can be amplified by variable accessibility to schools across income groups and geographical space. The research suggests that educational inequality impacts of school agglomeration policies should be considered before centralisation takes place. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a profound impact on religious practices and participation across the United States. In the midst of new risks and uncertainty, churches across the country adjusted whether and how they gathered in a myriad of ways. This mixed-method study examined the pandemic's particular impact on congregational ministry to and with people with disabilities and their families. Drawing upon interviews with and surveys of 200 church ministry leaders in 48 states, we capture the diverse ways in which nine aspects of these distinctive ministries were affected. Among the most pronounced impacts were sharp (and often sustained) declines in the number and consistency of ministry volunteers, as well as in the number of people with disabilities served through the ministry and attending congregational activities. Although commitment to this ministry largely remained undiminished within churches, depictions of ministry effectiveness were more mixed. Some variations in depictions of the pandemic's impact were associated with church and ministry demographics. We offer recommendations for research and practice aimed at strengthening the capacity and commitment of churches to support the full participation of people with disabilities and their families. [ABSTRACT FROM AUTHOR]

In recent years, the United States has been experiencing historically high suicide rates. In the face of mental health care provider shortages that leave millions needing to travel longer to find providers with schedule openings, if any are available at all, the inaccessibility of mental health care has become increasingly central in explaining suicidality. To examine the relationship between access to care and suicide, we leverage a dataset mapping all licensed US psychiatrists and psychotherapists (N = 711,214), as of early 2020, and employ real-world transportation data to model patients' mobility barriers. We find a strong association between reduced mental health care provider spatial-social accessibility and heightened suicide risk. Using a machine learning approach to condition on a host of 22 contextual factors known to be implicated in suicide (e.g., race, education, divorce, gun shop prevalence), we find that in locales where individuals seeking care can access fewer mental health care providers, already more likely to be saturated by demand, suicide risk is increased (3.2% for each reduced SD of psychiatrist accessibility; 2.3% for psychotherapists). Additionally, we observe that local spatial-social accessibility inequalities are associated with further heightened risk of suicide, underscoring the need for research to account for the highly localized barriers preventing many Americans from accessing needed mental health services. [ABSTRACT FROM AUTHOR]

In 2015, the American with Disabilities Act (ADA) celebrated its 25th anniversary. While libraries have instituted ADA compliance initiatives since the law came into effect in 1990 and new libraries are generally designed with compliance in mind, to be truly accessible for all people, libraries must incorporate principles of universal design not just into the physical building but into all aspects of the library, including our web presence and the services we provide to patrons. This paper argues that libraries are falling far short of true accessibility and that there needs to be a serious mental shift in how we think about access to our services and spaces. A potential tool for this shift lies in incorporating universal design into all aspects of libraries. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Disability Studies is the property of Canadian Disability Studies Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: This study examined self-reported physical activity (PA) participation, well-being, and perceived needs of Canadians with disabilities during the COVID-19 pandemic. In addition, we assessed physical and mental health and the extent to which pre-identified needs were being met or unmet. Methods: Two iterations of the COVID-19 Disability Survey were conducted during two pandemic timeframes: June–December 2020 (iteration 1, n = 599) and December 2020–September 2021 (iteration 2, n = 528). PA participation was assessed with the International Physical Activity Questionnaire. Physical and mental health were assessed with the PROMIS Global-10 questionnaire. A needs assessment was conducted on 11 needs pre-identified in partnership with community organizations. Results: Approximately 50% of respondents to both iterations reported that they did not do any moderate-vigorous intensity PA. While physical health was not different between timeframes, mental health was worse during iteration 2 than iteration 1 (p = 0.028). During both timeframes, access to recreation and leisure facilities was the greatest unmet need. Conclusion: These data highlight the low levels of PA and the perceived changes in PA, mental health, and recreational needs of Canadians with disabilities during the pandemic. The findings of the Survey were used to support policy change to remove barriers to PA participation for people with disabilities in Ontario. [ABSTRACT FROM AUTHOR]

The movement towards inclusive public education for deaf and hard of hearing children (DHH) has steadily gathered momentum during the last fifty years. Both within the United States and abroad, inclusive public education has been facilitated through legislative action with varied results. Varied interpretation of inclusion policy, notably the "Least Restrictive Environment" (LRE) clause of the Individuals with Disabilities Education Act in the United States, an emphasis on assimilation, and a default preference for auditory-oral communication have often resulted in isolating and inaccessible experiences for DHH students in the mainstream. The purpose of this article is to review theory and research on effective practices in inclusion for DHH students. The research is summarized with respect to accessibility, social-emotional considerations, and language policy. It is often asserted that communication access and cultural identity are major factors that impact the successful inclusion of these students with bicultural identity related to greater wellbeing. Deaf schools may be the LRE placement option for some students and source of resource and support for DHH students and educators in all settings. The authors suggest that a shift towards a more inclusive experience in mainstream settings is emerging through the use of Universal Design for Learning (UDL), classroom technology, and culturally responsive education that integrates sign language and Deaf culture to foster bicultural identities. Strategies for effective inclusion include co-enrollment, deaf awareness programming, and consistent policy that equalizes the status of sign languages. Future research is recommended in effective practices in auditory and visual accommodations, integration of technology in K-12 classrooms, and the relation of policy to practice in inclusive education for DHH students. [ABSTRACT FROM AUTHOR]

Background: Pediatric hospitals in the United States are increasingly leveraging patient-facing mobile apps as their digital front doors for patients, families, and caretakers. These mobile health apps are sanctioned by pediatric hospitals to inform the public or populations about pediatric care to provide individualized information, to enhance communication, and to improve patient experience. Yet the functionalities and user feedback of these hospital mobile apps have not been systematically investigated. Objective: Our aim was to understand the current state of hospital-owned mobile apps provided by large pediatric hospitals, comparatively analyze and report the services provided, and identify potential gaps to inform developers and providers. The American Hospital Association defines large hospitals as those having a bed count of more than 400. Methods: We conducted a systematic search on Google Play and Apple App Store to identify all hospital-owned mobile apps from the large pediatric hospitals included in our review. Our inclusion criteria were (1) apps provided by large pediatric hospitals; (2) hospital-owned apps available in Apple App Store and Google Play; and (3) apps that are provided for general populations. Specialty apps that serve specific user groups or populations focusing on education, telehealth, specific conditions or procedures, or apps intended for research or clinician use were excluded. The features and functionality of the included apps were examined. Results: Of the 16 pediatric hospitals included in our review, 4 (25%) had no general patient-facing apps, 4 (25%) had one app, and 8 (50%) had more than one app available on Google Play or Apple App Store. The 12 hospitals with at least one mobile app had a combined total of 72 apps. Of these 72 apps, 61 (85%) were considered specialty and were excluded from our review, leaving a total of 11 (15%) apps to analyze. Among the 11 apps analyzed, the most common feature was appointment scheduling or reminder (n=9, 82%). Doctor search (n=8, 73%) and patient resources (n=8, 73%) were the second most common, followed by payment, billing, or claims (n=7, 64%), patient portal integration (n=6, 55%), personal health management (n=6, 55%), hospital way finding (n=5, 45%), message a provider (n=4, 36%), urgent care wait times (n=4, 36%), video chat (n=4, 36%), and health information access (n=4, 36%). Parking information (n=3, 27%) was the least common. Conclusions: Out of the 16 pediatric hospitals identified for our review, 75% (n=12) offer mobile apps. Based on the most common features, these apps were intended to help improve accessibility for patients and families in terms of finding providers, scheduling appointments, and accessing patient resources. We believe the findings will inform pediatric hospital administrators, developers, and other stakeholders to improve app feature offerings and increase their impact on service accessibility and patient experience. [ABSTRACT FROM AUTHOR]

This article discusses how COVID-19 has impacted the American workforce, symptoms of Long COVID syndrome, Multiple Chemical Sensitivity, and ways to avoid triggering its symptoms when sanitizing the workplace and using Universal Design practices to increase accessibility and decrease transmission of COVID-19 among workers. Interface with healthcare providers, rehabilitation professionals, and employers is emphasized. [ABSTRACT FROM AUTHOR]

Abstract: Essential Air Service (EAS) is a federally subsidized program in the United States that provides air transport connections to rural and remote locations. Critics suggest that EAS is too expensive and that many of its airports are underutilized. Proponents of the program argue that connections between rural locales and larger urban hubs help maintain local economic activity. The purpose of this paper is to examine the variations in local geographic markets and their impacts on service levels. Specifically, we use exploratory and confirmatory statistical approaches combined with spatial analysis to examine the geographic, demographic, socio-economic and local business determinants that contribute to commercial flight activity from EAS airports. Results suggest that geographic proximity to larger hubs, subsidy levels and the local population of the EAS catchment area are critical factors in flight activity at EAS airports. [Copyright &y& Elsevier]

Abstract: Essential Air Service (EAS) is a federally funded program in the United States that provides connecting, commercial air service between rural communities and their nearest large or medium commercial hub airport. During fiscal year 2010, $170million dollars were spent to provide this service to 107 communities in the US. However, with significant variations in subsidies to each airport (ranging from $427,757 to $3,082,403) and marked differences in passengers served, there are serious concerns regarding the overall efficiency of the EAS program. The purpose of this paper is to use data envelopment analysis integrated in a geographic information system for evaluating service efficiencies at the community level. Policy implications and strategies to improve the EAS program are discussed. [Copyright &y& Elsevier]

Abstract: Habitable volume is an important spacecraft design figure of merit necessary to determine the required size of crewed space vehicles, or habitats. In order to design habitats for future missions and properly compare the habitable volumes of future habitat designs with historical spacecraft, consistent methods of both defining the required amount of habitable volume and estimating the habitable volume for a given layout are required. This paper provides a brief summary of historical habitable volume requirements and describes the appropriate application of requirements to various types of missions, particularly highlighting the appropriate application for various gravity environments. Then the proposed “Marching Grid Method”, a structured automatic, numerical method to calculate habitable volume for a given habitat design, is described in detail. This method uses a set of geometric Boolean tests applied to a discrete set of points within the pressurized volume to numerically estimate the functionally usable and accessible space that comprises the habitable volume. The application of this method to zero gravity and nonzero gravity environments is also discussed. This proposed method is then demonstrated by calculating habitable volumes using two conceptual-level layouts of habitat designs, one for each type of gravity environment. These include the US Laboratory Module on ISS and the Scenario 12.0 Pressurized Core Module from the recent NASA Lunar Surface Systems studies. Results of this study include a description of the effectiveness of this method for various resolutions of the investigated grid, and commentary highlighting the use of this method to determine the overall utility of interior configurations for automatically evaluating interior layouts. [Copyright &y& Elsevier]

Abstract: This paper examines the efficiency and equality in geographic accessibility provided by hospitals. We use the criteria efficiency, availability of the service, and equality. Quantitative measures are defined for all criteria, and are measured using a geographical information system. We then compare existing locations with optimal locations satisfying two objectives, one that minimizes hospital–patient distance, and another that captures as many patients as possible within a pre-specified time or distance. The results of our study indicate that the existing locations provide near-optimal geographic access to health care. Some potential for improvement is indicated. [Copyright &y& Elsevier]

Abstract: This paper and the proposed formulation contribute to an apparent gap in transit research design by integrating equity considerations into the transit frequency-setting problem. The proposed approach provides a means to design transit service such that equitable access to basic amenities (e.g., employment, supermarkets, medical services) is provided for low-income populations or disadvantaged populations. The overarching purpose is to improve access via transit to basic amenities to: (1) reduce the disproportionate burden faced by transit dependent populations; and (2) create a more feasible transportation option for low-income households as an opportunity to increase financial security by reducing dependence on personal autos. The formulation is applied to data from a mid-sized US metropolitan area. The example application illustrates the formulation successfully increases access to employment opportunities for residents in areas with high percentages of low-income persons, as well as demonstrates the importance of considering uncertainty in the locations of populations and employment. [Copyright &y& Elsevier]

Abstract: In the United States, the goal of essential air service (EAS) is to provide a minimum level of air transport service from smaller, often remote communities to the national network. While supporters of EAS tout the economic benefits of connecting rural and isolated communities, critics cite high costs, low use and antiquated eligibility requirements as factors which compromise the value of the program. In this paper, a comprehensive database of US airports is combined with network analysis techniques and a geographic information system to evaluate population access (at the census tract level) to EAS airports for 2006. Results suggest that redundant coverage of EAS market areas by alternative Federal Aviation Administration designated hub airports can contribute to EAS airport market leakage and that alternative definitions of EAS community eligibility have the potential to dramatically increase programmatic efficiency and reduce federal monies spent on EAS subsidies. [ABSTRACT FROM AUTHOR]

Abstract: The Web has become an integral part of postsecondary education within the United States. There are specific laws that legally mandate postsecondary institutions to have Web sites that are accessible for students with disabilities (e.g., the Americans with Disabilities Act (ADA)). Web accessibility policies are a way for universities to provide a general guide to action for faculty and staff that serve as Website developers for the organization. The purpose of this study is to examine the extent and effectiveness of Web accessibility policies at land-grant universities in the United States. To that end, this paper presents a conceptual foundation for the study, ranging from an overview of Web accessibility studies, to legal mandates, to literature on organizational policies. Data collection consists of a content analysis of the Web accessibility policies of land-grant universities. Results show that while most universities have a Web accessibility policy, most policies have serious deficiencies. The deficiencies are of sufficient magnitude that many schools are likely in violation of the ADA and at risk for a law suit from a disabled person unless these policies are strengthened. [Copyright &y& Elsevier]

Abstract: This review documents the history of one large health system’s approach to the enactment of the Americans with Disabilities Act, following the settlement of a lawsuit. This paper represents the various activities within the Kaiser Permanente health system from 2001 to the present that were conducted to improve access and remove architectural, attitudinal, and other barriers for people with disabilities, to educate and train providers concerning culturally competent care for people with disabilities, and to develop patient-centered best practices and models of care for people with disabilities. Health systems can improve care for people with disabilities through organized, multifaceted, and ongoing approaches to removal of barriers, provider education and training in culturally competent care, and establishment of patient-centered best practices and models of care. [ABSTRACT FROM AUTHOR]

Abstract: During the past decade, air passenger service in the United States has been exposed to numerous carrier bankruptcies, antitrust investigations, mergers, labor problems and a massive increase in competition. These internal elements, combined with the rising costs of fuel and the threat of terrorism combine to make a relatively uncertain air travel landscape for both passengers and operators. Moreover, these dynamics have generated significant geographical shifts in airline route structures and airports serviced by commercial carriers. These factors, combined with increasing levels of consumer access to fare and routing information, have altered the landscape of air travel accessibility in the United States. The purpose of this paper is to examine issues of consumer air travel accessibility through an analysis of three critical measures: flight segments, flight time and ticket costs. In addition, a typology of air passenger accessibility is generated for the 156 busiest commercial airports in the United States using these three measures. Results suggest significant local and regional biases in time and cost, relative to distance, for many US markets. [Copyright &y& Elsevier]

Abstract: Cardiovascular diseases (CVDs) are a leading cause of mortality in the US. Rates of mortality vary spatially and demographically, influenced not only by individual patient characteristics but also by levels of accessibility to hospital services and facilities. In 2000, Kentucky ranked third in the nation for heart-related deaths. The purpose of this paper is to assess geographical accessibility and service utilization related to ambulatory care sensitive CVDs in Kentucky. This study utilizes the Kentucky Hospital Discharge Database to evaluate service utilization and the Compressed Mortality File to examine mortality related to CVDs. A spatial statistical comparison of the geographical distribution of service usage and travel time to hospitals assists in assessing the relationship between accessibility and health. Our findings suggest that the distribution of utilization and mortality is geographically variable. People living in rural areas travel further to services; populations residing more than 45min from health facilities are more likely to be socially and economically marginalized. Spatial clustering of high rates of hospital utilization occurs in areas with lower accessibility. [Copyright &y& Elsevier]

Abstract: With the number of disabled travelers continuously increasing, the airline industry is faced with the challenges associated with making online reservations accessible to the disabled. In this paper, we investigate the disability-accessibility of the online reservations systems of commercial US airline carriers, as well as, those of foreign carriers that fly to/from the US. [Copyright &y& Elsevier]

The landscape for STEM instruction is rapidly shifting in the United States. Attention toward STEM instruction and assessment opportunities is increasing. All students must have opportunities to gain access to the STEM content and show what they know and are able to do. We caution that attention to fairness and accessibility is critical for students from special populations, particularly English learners and students with disabilities. Opportunities for equitable access to STEM instruction and assessment are diminished without accessibility. In this report, we use an assets‐based perspective to discuss and reframe common misconceptions and challenges as opportunities. We argue that attention to accessibility at the onset of STEM instruction and assessment is the pivotal foundation for fair opportunities in STEM. We highlight key opportunities and conclude with recommendations for improved fairness and access in STEM. Report Number: RR‐21‐11 [ABSTRACT FROM AUTHOR]

Audio description (AD), narrative description of key visual elements for visually impaired or blind audiences, is provided in English in the United States; however, Spanish-language AD is almost nonexistent. Because Spanish is the most spoken and fastest growing non-English language in this country, training translation students to provide AD in Spanish fills a gap for the visually impaired Latino population. This article shows how a project on AD for the theater was used in a community-based course at Montclair State University (New Jersey), what challenges we encountered, and how those challenges were overcome. I also provide a step-by-step program plan to help implement such initiatives. In addition to learning about AD, I guided my students to reflect critically upon language, arts, and accessibility in the multicultural reality of the United States. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic required an abrupt shift from face-to-face to online instruction for many students in higher education in the United States. Prior research has raised some concerns about both equitable access to online courses, and the quality of instruction in online courses compared to face-to-face courses. This survey study included a retrospective pretest approach to comparing students experiences before and after the transition to online instruction. The sample of 1731 students ranged across all available topics of study and all class standings from first-year students to doctoral students at a R1: Doctoral Universities—Very High Research Activity university according to the Carnegie classifications. Quality of instruction was addressed through the three principles of Universal Design for Learning. Students reported that most areas of quality of instruction were poorer after the transition, with having Engagement dropping by the largest effect size. However, Representation showed a small effect of improvement following the transition. Students who preferred online instruction reported less loss of instructional quality. Similarly, students eligible for disability services also reported less loss of instructional quality. Doctoral students reported significantly poorer access on multiple measures compared to all four years of undergraduate students' standings. Results are discussed in terms of patterns, exceptions, effect sizes, and recommendations for future research. [ABSTRACT FROM AUTHOR]

The article presents the discussion on technology tools for expanding accessibility in instructional media and digital content. Topics include remote work posing certain ergonomic challenges offering needed opportunities for accommodating workers with disabilities; and number of workers living with permanent physical or intellectual disabilities requiring reasonable accommodation for successfully maintaining employment.

In the 1970s and 1980s, feminists in the United States began businesses in order to financially support themselves while enacting women's movement politics. Owning and operating a feminist business in a permanent location required large capital investment in order to rent space, buy supplies, and pay workers. Women's, and especially lesbians', social positioning due to discriminatory gender, racial, and sexual orientation laws affected whether or not being able to own a restaurant or store was even possible. Coffeehouses provided an alternative means through which to build feminist communities, with lower initial capital required than restaurants. Feminist coffeehouses in this article will primarily refer to recurring temporary public spaces that served refreshments and provided entertainment. This model of feminist organization expanded participation in some ways; without high fixed costs, coffeehouses enabled women with less money, women from marginalized racial groups, and women with marginalized sexual orientations the ability to create spaces centered on food, drink, and socializing. However, these spaces were not utopic; racism, ageism, trans‐exclusionism, and classism created tension in their respective communities. As coffeehouse organizers tried to address various inequalities, their approach in treating each identity category as discrete often erased women who experienced multiple forms of oppressions simultaneously. [ABSTRACT FROM AUTHOR]

Background: The medical home (MH) model has been promoted by both the federal and state governments in the United States in recent years. To ascertain American children's MH status, many studies have relied on a large set of survey items, posing a considerable burden on their parents. We aimed to identify individual survey items or domains that best predict MH status for children and use them to develop brief markers of MH status. We also examined whether the identified items differed by status of special health care needs and by racial/ethnic group.Method: Using the 9-year data from Medical Expenditure Panel Survey, we examined associations between children's MH status and individual survey items or domains. We randomly split the data into two halves with the first half (training sample, n = 8611) used to identify promising items, and the second half (validation sample, n = 8779) used to calculate all statistical measures. After discovering significant predictors of children's MH status, we incorporated them into several brief markers of MH status. We also conducted stratified analyses by status of special health care needs and by racial/ethnic group.Results: Less than half (48.7%) of the 8779 study children had a MH. The accessibility domain has stronger association with children's MH status (specificity = 0.84, sensitivity = 1, Kappa = 0.83) than other domains. The top two items with the strongest association with MH status asked about after-hours primary care access, including doctors' office hours at night or on the weekend and children's difficulty accessing care after hours. Both belong to the accessibility domain and are one of several reliable markers for children's MH status. While each of the two items did not differ significantly by status of special health care needs, there were considerable disparities across racial/ethnic groups with Latino children lagging behind other children.Conclusion: Accessibility, especially the ability to access health care after regular office hours, appears to be the major predictor of having a MH among children. The ongoing efforts to promote the MH model need to target improving accessibility of health care after regular hours for children overall and especially for Latino children. [ABSTRACT FROM AUTHOR]

Digital access to banking and financial systems is no longer merely a way to augment physical transactions or experiences. It is now the primary way that consumers interact with banking and financial services. As a result, it is essential and equitable that full digital access to these services be provided for people with disabilities. Building on a recently published survey that investigated the accessibility issues within banking and financial systems for blind users, this evaluation of 100 banking and financial websites in the USA provides a current analysis of the broader state of banking and finance website accessibility for people with disabilities. The results of our research not only document these current findings as an accessibility baseline for banking and finance websites but also reveal common problems and strategies that may benefit the banking and finance industries. [ABSTRACT FROM AUTHOR]

Most analyses of accessibility by public transit have focused on travel time and not considered the cost of transit fares. It is difficult to include fares in shortest-path algorithms because fares are often path-dependent. When fare policies allow discounted transfers, for example, the fare for a given journey segment depends on characteristics of previous journey segments. Existing methods to characterize tradeoffs between travel time and monetary cost objectives do not scale well to complex networks, or they rely on approximations. Additionally, they often require assumed values of time, which may be problematic for evaluating the equity of service provision. We propose a new method that allows us to find Pareto sets of paths, jointly minimizing fare and travel time. Using a case study in greater Boston, Massachusetts, USA, we test the algorithm's performance as part of an interactive web application for computing accessibility metrics. Potential extensions for journey planning and route choice models are also discussed. [ABSTRACT FROM AUTHOR]

Objectives: Due to the low prevalence of rare diseases (RDs) and the small number of individuals affected with a RD, challenges complicate the development of and accessibility to medications and medical devices to prevent, identify, treat or cure these RDs. The aims of this study were to analyse and compare regulations and policies related to accessibility of orphan drugs (ODs) in different countries which have policies or systems in place which are specific for RDs and ODs in Europe and the United States (US). Methods: A comprehensive literature review was carried out. A total of 20 120 articles which contained information about accessibility and legislations, regulations and governmental policies related to RDs and ODs were retrieved. Key findings: Sixty‐eight articles were included in this study. Classification of information related to 24 countries was based on six themes: OD policies, marketing authorisations, incentives offered, pricing of ODs, reimbursement and pharmacovigilance. The EU and United States have adopted policies and regulations aimed to improve OD accessibility in the last 20 years. Although all included countries had an OD legislation, only 16 countries had an OD or RD plan in place. Conclusions: Comparison of different legislations and policies in each country can be used to identify and address deficiencies in the field of RDs and improve accessibility of ODs. [ABSTRACT FROM AUTHOR]

Transportation-planning researchers have long argued that the end goal of a transportation system is increasing accessibility, or opportunities for individuals to meet their daily needs, but that US practice tends to focus on increasing mobility, or opportunities to travel farther and faster. This study finds evidence that the gap between theory and practice may be closing when it comes to accessibility, but that significant barriers still exist to the wider adoption of the accessibility paradigm among metropolitan planning organisations, the main entities responsible for regional transportation planning in the USA. We measure this gap by creating an accessibility index based on content analysis of a nationally representative sample of 42 US regional transportation plans (RTPs). We then use regression-tree analysis to determine the characteristics of metropolitan areas that are most likely to employ accessibility concepts. Finally, we identify barriers to a wider adoption of the accessibility paradigm. Most RTPs include accessibility-related goals, but few define the term or use accessibility-oriented performance measures. The lack of clarity on accessibility leaves vehicle speed as the fundamental criterion for success in most plans. Our analysis finds that MPOs serving large regions with high per capita income are the most likely to produce plans that focus on accessibility. We argue that such places produce more accessibility-oriented RTPs because they have greater planning capacity and recommend changes to federal planning guidelines that could speed the adoption of the accessibility paradigm in RTPs. [ABSTRACT FROM AUTHOR]