EVOLVING TRENDS IN PALLIATIVE CARE

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ANCIENT WRITING
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New Government New Technology Defines Economy
and Society

• Information Age
• Wireless
• Internet Technologies

• Industrial Age
• Steam Engine
• Electricity

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• STIGMA
• STEREOTYPING
• DISCRIMINATION
• LACK OF EDUCATION
• UNDEREMPLOYMENT
• LACK OF TRANSPORTATION

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????????? ???? ??????? ???? 9- ??????

• Convention 9 states
• Parties shall take appropriate measures to
  ensure to persons with disabilities access, on an
  equal basis with others, to the physical
  environment, to transportation, to information
  and communications, including information and
  communications technologies both in urban and
  in rural areas.

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Rehabilitation Act of 1973, Section 504Americans
with Disabilities Act

• No otherwise qualified individual may be denied
  admission or participation solely on the basis of
  a handicap.
• Education is optional
• Civil rights law
• Equal access, not equal outcome

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UN Declaration on the Rights of Disabled Persons
(1975)

• Disabled people, whatever the origin, nature and
  seriousness of their handicaps and disabilities,
  have the same fundamental rights as their fellow
  citizens of the same age, which implies first and
  foremost the right to enjoy a decent life, as
  normal and full as possible.

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?????? (????????) ????
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???????

• People with disabilities want to do the same
  things as everyone else. They want to work and
  play and move around independently.
• Its often the little things that get in the way,
  and technology can help.

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?????? ????Assistive Technology

• What is assistive technology?
• Assistive Technology refers to any "product,
  device, or equipment, whether acquired
  commercially, modified or customized, that is
  used to maintain, increase, or improve the
  functional capabilities of individuals with
  disabilities."
• The United States Assistive Technology Act of 1998

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• A magnifying glass
• Anti-glare screen for the monitor
• Door handles instead of door knobs
• Calculators/clocks with extra large digits

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?????? ???? ?? ????? ?????? ????

• Dragon Naturally Speaking (software)
• JAWs (screen reader software)
• ZoomText (screen magnifier software)
• Talking clock
• AlphaSmart portable note taker

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Dragon Naturally Speaking software
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Zoom Text computer software
35
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Scan and speak systems
Computers can turn written documents into spoken
words.
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Electronic aids to daily living
If you have limited mobility, it can be hard to
control household devices. Voice recognition
software converts spoken commands into signals
that can control things.
Infrared and radio signals can control the
television, computer, telephone, lights and door
systems.
38
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??????? ? ICT

• Over 10 of the world's population suffer from a
  variety of disabilities. However, information and
  communication technologies (ICTs) have the
  potential for making significant improvements in
  the lives of these persons.

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????? ??????? ?? ?????? ????

• 4 of infants/toddlers nationally have AT listed
  on their IFSPs (DOE Report to Congress, 2003)
  this number shown little change over the years.
• 18.1 of providers sampled believed that all
  children on their caseloads who needed AT were
  receiving it 44 reported that few or none of
  the children who needed AT were receiving it.

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???????? ( ?????????) ??????Adaptive Computing

• What is adaptive computing?
• Looking within the broader category of assistive
  technology, adaptive computing refers
  specifically to the use of computer software and
  hardware to maintain, increase, or improve the
  functional capabilities of individuals with
  disabilities.

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• Hardware
• Ergonomic keyboards
• Trackball mouse
• Large screen monitors
• Head operated mouse
• Video Magnifier (CCTV)

• Software
• Speech-to-text software (Dragon Naturally
  Speaking)
• Screen reader software (JAWs)
• Screen enlarging software (ZoomText)

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???? ???? ?? ?????? ????

• Aids for Daily Living
• Augmentative Communication
• Computer Applications
• Home/Worksite Modifications
• Prosthetics and Orthotics
• Aids for Vision/Hearing
• Wheelchair/Mobility Aids
• Vehicle Modifications

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Technology has enabled the invention of a
wheelchair which can

• rise to various heights, so the user can talk to
  people who are standing or reach things on high
  shelves

Images of the iBOT by kind permission of
Independence Technology

• drive over rough ground and go up and down
  pavements

• climb up and down stairs.

The joystick that controls the chair is
detachable, so that the user can drive the
chair into a car rather than lifting it.
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???????? ??????
Very few visually impaired people are totally
blind. Most have some vision that they need to
make the most of.
This may involve magnifying things to make them
bigger and easier to see. Special software can
magnify the area around the cursor up to 32 times.
It might mean choosing colours for text and
backgrounds that are best for the individual user.
Is this text easy to read?
Or is this text easier?
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GPS
Global Positioning Systems (GPS) for visually
impaired people are being developed.
The system runs on a PDA. The user can download
maps to help them find their way around.
Road junctions and places of interest are spoken
by the system into headphones as the user
approaches them, a bit like a talking map.
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Input and output devices
Standard keyboards are often used by those with
visual impairment, but Braille keyboards and
printers are available.
Braille displays allow the user to read the
output of the screen by touch.
Image courtesy of Hooleon
Using a video magnifier, printed material and
objects can be placed under a camera and the
magnified image displayed on a television screen
or computer monitor.
Magnifiers are mostly used for reading, but can
also be used for writing or sewing, or to view
objects at a distance such as a board in a
classroom.
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????? ??? ???????

• The Dubby is a speech synthesizer with a QWERTY
  keyboard
• The Pocket Communicator is a handheld device that
  stores phrases that can be combined to form
  messages.
• Both the Dubby and the Pocket Communicator could
  be considered Aids for Daily Living. When a
  student doesnt have a personal device, a
  university owned laptop may be borrowed for use
  on campus, The laptop can be loaded with software
  that reads text out loud

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???? ??????? TTY teletypewriter
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??? ???? ????? ????? ???????? ???????
People with little or no hearing can find it
difficult to make telephone calls.
Text messages and Instant Messaging are quick and
visual, and so can be used by deaf people.
Telephones are being developed that have screens
showing faces. The telephone converts the sounds
into clear lip movements. This gives hearing
impaired users the extra visual support of being
able to lip read while they listen.
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???? ????? ?????- Virtual signing
Virtual signing projects are in development.
These could be used in post offices, asking
simple questions such as First or second class?
They use computer characters to produce sign
language where a human signer isnt available.
They can also be used to interpret web pages.
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????? ??? ???????Assistive Listening Devices

• The Pocketalker is a portable device that works
  by amplifying sound picked up through a
  microphone and sending it straight to ear buds.
• An FM Listening system is a portable wireless
  listening system. In an educational setting a
  professor may wear a microphone and transmitter
  that sends the professors voice to a receiver
  equipped with earphones or a neck loop that works
  with students hearing aids.

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???????? Transcribing -

• Transcribers use laptop computers and
  sophisticated abbreviation software to provide
  real-time communication access for students who
  experience hearing loss.
• Two laptop computers are linked with either a
  wireless connection or with a serial cable. The
  hearing transcriber can then use one of the
  laptops that is equipped with abbreviation
  software to transcribe what is being said in the
  classroom so the student with hearing loss can
  read it in realtime from the second laptop.

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Trackball Mice

• This trackball has buttons that are flush to the
  sides of the unit. This means that the click can
  be activated with the forearm or elbow if needed.
  Users without fine motor control can use gross
  movements to control mouse movement and action.

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Joystick Mouse

• The joystick has click, double click, and drag
  switch options. The cursor will move in the
  direction the joystick indicates but with
  controlled movement. It will not go flying across
  the screen like a regular mouse.

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Sip and Puff Joystick Mouse

• The Jouse is a joystick-operated USB mouse that
  is controlled with the mouth or chin. Mouse
  clicks can be performed with sip and puff
  technology.

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Mouse-free computing
People who find it difficult to use a traditional
mouse have many alternatives

• a camera attached to the screen can track head or
  eye movements, and use them to move the cursor

• mice can be controlled by the feet

• trackballs are like upside-down mice. They can be
  easier for many disabled people to use.

Image courtesy of Logitech
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Head Mouse

• A head mouse works by having a wireless optical
  sensor track a tiny target that is placed on the
  forehead or glasses of the user. This is
  especially useful with an on-screen keyboard.

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On-Screen Keyboard

• Onscreen Keyboards often work in conjunction with
  word prediction software to cut down the number
  of keystrokes needed. They can be used with a
  variety of input devices such as head pointers,
  sip and puff switches, joysticks and mice.

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DataHand

• DataHand is a unique option that provides for
  standard QWERTY keyboard action with minimal
  repetitive motion and magnetic switches for an
  extremely light touch.

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Half Keyboards

• For users who can use only one hand due to
  paralysis or injury this device can be very
  helpful. Additionally, it can be used by those
  who need to use their other hand with a stylus or
  other device.

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Speech Mike

• The Philips Speech Mike contains a small
  trackball, trigger style mouse buttons, a
  speaker, and a microphone all in one
  ergonomically designed product. It can be used
  with Voice Recognition software such as Dragon or
  Via Voice.

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Refreshable Braille Display

• This refreshable Braille display can mount under
  a laptop and convert the text that is visually
  depicted on screen into Braille
• ?????? ????

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Tactile Image Enhancer

• The tactile image enhancer exposes
  flexi-paper,  which is a plastic type paper that
  can be run through a standard office copier or
  marked with a soft lead pencil, to heat, and the
  dark parts swell. The pages are passed through
  the enhancer in a matter of seconds.

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Freestanding Readers

• The Reading Edge is a stand-alone unit that can
  scan and read documents out loud. Users
  can listen with headphones or can plug the unit
  in to a recorder. 

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Freestanding Magnifiers

• Alladin Magnifiers can be found on the Anchorage
  Campus in the Consortium Library, in the Learning
  Resource Center, and in the DSS Adaptive
  Computing Lab
• ?????

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Hand Held Magnifiers

• Lightweight and portable these devices can be
  used anywhere.

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????? ???? ???? ??????? ??????
People with cognitive disabilities can find it
hard to remember things and process information.
Tasks that seem simple to most people, such as
making the bed or brushing teeth, can easily be
forgotten.
PDAs, watches and telephones can be programmed to
vibrate and show a message when a reminder is
due. The user has to respond to show they have
read the message.
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????? ??????? ?? ???????? ?? ????

• Computers allow students to gain individual
  attention in large group
• Free teachers from other responsibilities so they
  can assist students
• Students have the support necessary to progress
  at own rates
• Allow for easier integration of different subjects

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?????? ?? ???? ??????? ????? ????? ?? ?????

• FM Listening Systems
• Wireless microphone sends the sound of the
  instructor or professors voice directly to the
  hearing aids of a student
• Transcribing
• A hearing transcriber types what is being said so
  the student can read it in real time
• Decoder for Captioned Videos/DVDs
• Data projectors need a decoder to display
  captions
• Optic overhead
• A camera projects information that is being read
  out loud onto a screen (student papers,
  newspapers, etc.)

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?????? ?? ???? ??????? ????? ????? ?? ?????

• Laptop Computer
• Students may have peripherals such as a portable
  scanner, refreshable Braille display, or
  headphones to reference course materials and take
  notes in class
• Portable Magnifiers
• Student can toggle to access board, handouts, etc
  
• Data Projector/Microscope Camera
• Videos typically shown on a TV can instead be
  projected on a screen/Images typically viewed
  through microscope can be viewed on a computer
• Tactile Representations
• Models, raised line drawings, etc.

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?????? ?? ???? ??????? ????? ????? ?? ?????

• Blackboard or other Course Web Site
• By posting course outlines and assignments on
  blackboard students who need directions can
  access them as many times as needed and because
  the documents are electronic students have choice
  in the mode of access (on screen, out loud,
  printed, etc)
• Laptop Computer
• Students can use a filereader to reference
  alternate format course materials and take notes
  in class
• Recording Device
• Students can tape record lectures to listen to
  later if processing information takes repetition

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?????? ?? ???? ??????? ????? ?????? ? ????

• Ergonomic Furniture/Assistive Devices
• Chairs with lumbar support and/or height
  adjustable tables, podiums, specialized keyboards
  and mice, etc
• Note taking Devices
• In addition to volunteer note takers, a recorder
  can be used as well as tools like graphic tablets
  
• Laptop Computer
• Student can view alternate format materials in
  class on screen, navigating with input device
• Basic Adjustments
• Sticky Keys (key combinations one key at a time),
• BounceKeys (ignores repeated key strokes)
• ToggleKeys (which uses sound to alert a user when
  Caps Lock, Scroll Lock, or Num Lock are pressed)

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